Xanthogranulomatous cholecystitis is a rare variant of chronic cholecystitis characterized by severe proliferative fibrosis and accumulation of lipid-laden macrophages in regions of destructive inflammation. Xanthogranulomatous cholecystitis clinically and radiologically mimics early-stage gallbladder cancer, with wall thickening on computed tomography. The study included 14 xanthogranulomatous cholecystitis patients that were identified following retrospective analysis of the records of 1248 patients that underwent cholecystectomy between 2005 and 2011. Mean age of the 5 male and 9 female patients was 56.7 years. All 14 patients had gallbladder stones; 10 had a history of acute cholecystitis, 1 had cholangitis, and 2 presented with obstructive jaundice. A right-upper quadrant mass was palpable in 2 patients. All patients underwent cholecystectomy. Open surgery was planned and performed in 6 of the 14 patients, and laparoscopic cholecystectomy was planned in 8 patients, but was converted to open surgery in 1 case. In total, 1 patient developed wound infection, 1 patient had postoperative pneumonia, and 1 patient developed intraabdominal hematoma. None of the patients in the series died. Xanthogranulomatous cholecystitis is difficult to diagnose, both preoperatively and intraoperatively, and definitive diagnosis depends exclusively on pathological examination. Xanthogranulomatous cholecystitis should be a consideration in all difficult cholecystectomy cases.
Hydatid disease is very common in endemic areas and is one of the most frequent parasitoses in Turkey. We present a rare case of hydatidosis related to the right hepatic colon lumen. Hydatid cysts were present on the liver, in the right adrenal region, and also on the hepatic flexura, surrounded by the right colon and omentum. In our case, a cyst adjacent to the ascending colon had ruptured into the colon lumen and developed a cystocolonic communication. Cysts may not always be detectable by ultrasound (US); adrenal and right colonic cysts may not be detected, depending on the patient's colonic gas superposition factors or other reasons related to the operator. In our case, multiple hydatid cysts and cystocolonic communication of complications of the cyst were found with multidetector computerized tomography (MDCT), and then, a colonoscopy identified the cystocolonic communication. These results reveal the important role of CT in the differential diagnosis process. J Clin Exp Invest 2016; 7 (2): 207-210
Background: Recently, the use of a surgical approach in injured patients has begun to be increasingly limited to unstable patients. Advances in imaging techniques and developments in intensive care have increased the applicability of non-operative treatment. Here, we aimed to present our clinical experience with different approaches in some patients.
Bu araştırma ikinci basamak kamu hastanelerinde görev yapan hemşirelerin "Güvenli Cerrahi Kontrol Listesi TR Klinikten Ayrılmadan Önceki Evre " nin kullanımını değerlendirmek amacıyla yapıldı.Yöntem: Araştırma tanımlayıcı bir araştırma olarak iki il ve ilçeleri olmak üzere toplamda altı devlet hastanesinde gerçekleştirildi. Araştırmanın örneklemini cerrahi kliniklerde çalışan ve gönüllü olma esasına dikkat edilerek araştırmayı kabul eden 221 hemşire oluşturdu. Veri toplama aracı olarak kişisel bilgi formu ve Güvenli Cerrahi Kontrol Listesi TR 'ndeki Klinikten Ayrılmadan Önceki Evre kullanıldı.Bulgular: Hemşirelerin %62'sinin 20-29 yaş aralığında olduğu, %59'unun lisans mezunu olduğu, %77'sinin ise güveli cerrahi kontrol listesi ile ilgili hizmet içi eğitim aldığı belirlenmiştir. Hastaların %98'inde kimlik bilgilerinin kontrol edildiği, hastaların rızalarının alındığı ve ameliyat öncesi açlık durumlarının kontrol edildiği belirlenmiştir. Hastaların %49.3'ünde ameliyat bölgesinin hazırlığının yapılmadığı, %45.7'sinde ameliyat bölgesinin işaretlenmediği belirlenmiştir.Sonuç: Ameliyat öncesi doğrulama sürecine klinik hemşirelerin hastanın kimlik doğrulanması, onam alınması ve açlık durumlarının belirlenmesine uyum sağladığı, ancak ameliyat için gerekli olacak özel malzeme, implant, kan veya kan ürünleri hazırlığının kontrollerinin yapılmadığı, neredeyse hastaların yarısında hekimler tarafından yapılması gereken taraf işaretlenmesinin de yapılmadığı belirlenmiştir.
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