Coexistence of situs inversus totalis and ovarian serous cystadenoma in pubertal girls is extremely rare. It is important to preserve ovarian hormonal physiology and fertility if it is detected in the pubertal period. A 16-year-old girl presented with abdominal distension and pain. Radiological evaluation revealed a huge abdominal cystic mass and situs inversus totalis. In laparotomy, unilateral salpingoophorectomy and total cystectomy were performed on the ovarian cystic mass. It was confirmed as serous cystadenoma in pathological evaluation. This is the first reported case in the literature of situs inversus totalis with a huge ovarian serous cystadenoma.

Objective: This survey aims to elucidate patient and health system related factors leading to delayed diagnosis and treatment of breast cancer in Southeastern Anatolia. Methods: Hundred patients admitted to Department of General Surgery at Dicle University between December 2012 and July 2014, and diagnosed with breast cancer in preceding 6 months were included in the survey after their consent. The survey has 4 chapters (patient and health system related factors, demographic data, and assessment of cancer stage) and 25 questions. Results: Fifty-eight percent of patients visited a physician with a 3 months delay after realization of breast cancer symptoms. Only 8% of patients had regular checkups. Nine percent of patients were suspicious of breast cancer due to the lesion in the breast. 86% of patients did not consider it to be a serious matter. Lack of female physicians cited by 2% as the reason for avoiding doctor's visit. Seven percent cited lack of knowledge and 23% being scared. Seventy-seven percent were able to get a doctor's appointment, 82% to get mammography, 78% underwent biopsy in a week. Women between the ages of 30-50 had higher concern about cancer (p<0.05). Women who were illiterate or housewives regarded doctor's visitation as not a good experience (p<0.05). Conclusion: Patients' age and literacy, and efficiency of health system may be contributing factors on the delay of diagnosis and treatment of breast cancer. Cancer awareness should be increased and fear being diagnosed with cancer should be overcome in women between the ages of 30-50 to decrease the delay of diagnoses.

An inguinal hernia containing appendix is termed an Amyand's hernia. It is a rare condition estimated to be found in approximately 1 % of all inguinal hernia repairs. Depending on the presence of inflammation in the hernia sac and obstruction of hernia, clinical presentation can vary. We report a case of left sided inguinal hernia in which appendix vermiformis was detected in a 74 year-old male. Appendix was not inflammated, so it was reduced and then mesh hernioplasty was performed. The postoperative course was uneventful. Performing appendectomy is controversial in Amyand hernias in which appendix is not inflammated. Appendectomy is recommended in left sided Amyand hernias, due to the risc of misdiagnosis if appendicitis develops in future. We didn't perform appendectomy because our patient was elderly and had a low risk for developing acute appendicitis. Amyand hernias are usually diagnosed peroperatively. Decision for appendectomy relies on the inflammation of appendix, the side of the hernia, the age and the comorbidities of the patient.