In conclusion, we found some important differences in the hemostatic parameters between the patients with CS and healthy controls. Increased platelet count, fibrinogen, PAI-1, and decreased TFPI levels in these patients represent a potential hypercoagulable and hypofibrinolytic state, which might augment the risk for atherosclerotic and atherothrombotic complications. This condition may contribute to the excess of mortality due to cardiovascular disease seen in patients with CS.

Although adrenal ganglioneuroma (GN) is a rare tumor originating from the neural crest tissue of the sympathetic nervous system, detection of this tumor has increased, as imaging procedures such as ultrasonography (US) and computed tomography (CT) have become prevalent. The clinical presentation for most patients is asymptomatic, and most of those tumors are hormone silent. We describe a case of adrenal GN incidentally diagnosed in a 68-year-old female patient. Physical examination, routine laboratory studies, and hormonal tests were within normal ranges. Abdominal CT and magnetic resonance imaging showed a solid oval tumor approximately 6 x 4 cm in the left adrenal gland without remarkable signs of malignancy. Left adrenalectomy was performed for treatment purposes. Histological diagnosis of the tumor was a ganglioneuroma originating from the adrenal medulla. Adrenal GN occurs rarely in adults and preoperative diagnosis is difficult, especially in asymptomatic cases. It needs careful evaluation and surgical treatment. According to our knowledge, this is the fifth case of adrenal GN in an adult patient from Turkey in English literature.

A AB BS ST TR RA AC CT T Polysplenia syndrome is a rare congenital anomaly frequently associated with various visceral anomalies. The most frequent manifestations of this syndrome, in addition to polysplenia are malrotation, congenital heart diseases and gastrointestinal, genitourinary and vascular abnormalities. In this report, we present an adult case of ascites due to prehepatic portal hypertension associated with portal cavernous transformation. The patient had a left-sided liver, right-sided multiple splenules and stomach, interrupted inferior vena cava with azygos continuation and extensive ascites. The portal vein was not observed and collateral vascular structures of cavernous transformation were identified in the hepatic hilus. Portal cavernous transformation with various congenital abnormalities has been reported in the literature; however, there are no cases of polysplenia syndrome presenting with ascites associated with portal cavernous transformation.K Ke ey y W Wo or rd ds s: : Ascites; situs inversus; spleen Ö ÖZ ZE ET T Polispleni sendromu sıklıkla çeşitli organ anomalileri ile ilişkili nadir bir konjenital anomalidir. Polispleniye ek olarak bu sendromun en sık görülen belirtileri malrotasyon, konjenital kalp hastalıkları, genitoüriner, gastrointestinal ve vasküler anomalilerdir. Bu yazıda, portal kavernöz transformasyon ile ilişkili prehepatik portal hipertansiyona bağlı asit gelişmiş olan erişkin bir olgu sunulmuştur. Hastada sol taraflı karaciğer, sağ taraflı çok sayıda aksesuar dalak ve mide, azygos devamlılığı ile kesintiye uğramış inferior vena kava ve yaygın asit vardı. Portal ven gözlenmedi ve karaciğer hilusunda kavernöz transformasyonlu kollateral vasküler yapılar tespit edildi. Literatürde portal kavernöz transformasyon ile beraber çeşitli konjenital anomaliler mevcuttur, ancak asit ile gelen portal kavernöz transformasyon ile ilişkili polispleni sendromu olgusu henüz bildirilmemiştir.A An na ah ht ta ar r K Ke el li im me el le er r: : Asit; situs inversus; dalak T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J M Me ed d S Sc ci i 2 20 01 12 2; ;3 32 2(