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    Primary idiopathic chylopericardium presenting with cardiac tamponade
    (Urban & Vogel, 2014) Karakurt, C.; Celik, S. F.; Celik, R. M.; Elkiran, O.; Ulutas, H.; Kuzucu, A.
    Primary idiopathic chylopericardium is an extremely rare condition especially in children and young adults. Although the exact pathophysiology of primary chylopericardium has not been established, the reflux of chylous fluid into the pericardial space was suggested as the etiology. Damage to the thoracic duct valves and the communication of the thoracic duct to the pericardial lymphatics or abnormally elevated pressure in the thoracic duct could cause chylous fluid reflux. In this report, we described the case of a 4-year-old boy with primary idiopathic chylopericardium presenting as cardiac tamponade who was treated with video-assisted thoracoscopic window and then surgical duct ligation.
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    Pulmonary pseudocyst secondary to blunt or penetrating chest trauma: clinical course and diagnostic issues
    (Springer Heidelberg, 2015) Ulutas, H.; Celik, M. R.; Ozgel, M.; Soysal, O.; Kuzucu, A.
    Traumatic pulmonary pseudocysts (TPPs) are rare complications of chest trauma. The aim of this retrospective study was to report the clinical presentations, diagnosis, complications and treatment for a series of TPPs at a hospital in Turkey. The charts of 996 patients who were admitted for thoracic trauma between 1999 and 2012 were retrospectively reviewed. Fifty-two patients had TPPs, and the data collected for these individuals were sex, age, and type of trauma (blunt and/or penetrating). Univariate analysis of categorical data was performed using Pearson's Chi square test. Results for continuous variables were statistically compared using the Mann-Whitney U test. The patients were 42 males and 10 females aged 12-72 years (mean age 33.1 years). Forty-one had blunt trauma and 11 had penetrating trauma. There was no significant difference between the proportion of blunt trauma patients who developed TPP (41/761, 5.3 %) and the proportion of penetrating trauma patients who developed TPP (11/235, 4.6 %) (p > 0.05). All 42 patients had pulmonary contusion. Only 10 patients (19.2 %) had TPP identified on their chest X-ray, and thoracic computed tomography revealed TPP clearly in all these cases. Forty-two patients (80.7 %) were diagnosed with TPP on day 1 post-trauma. The hospital stays ranged from 2 to 35 days for the patients with blunt-trauma, and from 4 to 15 days for those with penetrating trauma (means 8.8 and 8.0 days, respectively; p > 0.05). Only one patient required thoracotomy for a pseudocyst that did not resolve and became progressively enlarged. This TPP was resected at 6 months post-trauma. One patient died on day 9 post-trauma due to multiple organ failure. The other 40 pseudocysts resolved spontaneously within 1-5 months. Traumatic pulmonary pseudocysts are pulmonary lesions that occur after either blunt or penetrating trauma and tend to be overlooked. Most of these lesions are self-limiting, benign lesion.
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    A report of four cases of acute mediastinitis occurring following tracheoesophageal puncture in laryngectomees
    (Kulak Burun Boğaz İhtisas Dergisi, 2004) Kalcıoğlu, Mahmut Tayyar; Kızılay, Ahmet; Saydam, Levent; Soysal, O.; Özturan, Orhan; Kuzucu, A.
    Tracheoesophageal puncture is a simple procedure for speech rehabilitation of total laryngectomy patients. Despite its relative simplicity this is not an innocent technique without complications. The goal of this study was to determine the incidence of acute mediastinitis as an early postoperative complication related to this procedure and to present outcomes of non-surgical conservative management in this complication. Blom-Singer voice prosthesis was used for 51 secondary tracheoesophageal puncture procedures in 45 patients between 1994 and 2002 according to the technique described by Blom and Singer. In the postoperative period, four patients (7.8%) developed mediastinitis related to this procedure. Of these, one patient had iatrogenic perforation of the posterior esophageal wall. A false dissection plane occurred in the tracheo-esophageal party wall in three patients which subsequently resulted in mediastinitis. Mediastinitis was diagnosed by clinical and radiological findings. All of these patients required prolonged hospitalization, intravenous antibiotics, and chest tube insertion. Only one patient underwent major surgical procedure to treat this complication. In conclusion, tracheoesophageal puncture for voice restoration is now regarded as a routine procedure usually performed in outpatient conditions. However, our experience demonstrates that this technique may be associated with significant complications such as mediastinitis. If mediastinitis is recognised earlier, it may be treated with conservative measures in most of the cases.