Due to the rarity and large diversity of the primary retrorectal tumors (RTs), the diagnoses are often difficult and they can be misdiagnosed. We present our experience in light of scarce information available on the clinical manifestations of RTs. The retrospective study included 17 patients diagnosed as RTs between January 2004 and January 2014. Demographic characteristics, length of symptoms, clinical findings, diagnostic methods, evaluations on the treatment procedures and postoperative periods, pathology, complications, and length of hospital stay were recorded. A mean of 1.7 of patients were diagnosed with RTs annually in our hospital. Patients comprised 12 females and 5 males. Pain and discomfort were the most common symptoms at presentation. All the lesions were evaluated by using magnetic resonance imaging (MRI) and computed tomography (CT), and all the patients were treated operatively. Based on the preoperative MRI or CT findings, an anterior approach was performed in 7 patients, a posterior approach in 6 patients, and combined approach in 4 patients. Mean size of tumors was 9.2 6 4.3 cm. Epidermoid cyst (n ¼ 8) was the most common tumor. Except for 1 case of liposarcoma, 16 tumors were confirmed to be of benign nature in histologic examination. Mean length of hospital stay 12.4 6 6.8 days. Retrorectal tumors are heterogeneous and lead to diagnostic difficulties. A high index of clinical suspicion is needed for diagnosis. Preoperative imaging may be helpful in determining the course of treatment. Total excision of a retrorectal tumor may alleviate pressure symptoms and confirm the diagnosis.

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

ÖZETAmaç: Saptırıcı stoma sıklıkla fekal inkontinans, Fournier gangreni, anorektal fistüller ve tıkayıcı inoperable anorektal tümörler gibi durumlarda yapılır. Trefin stoma (TS) laparatomi yapılmaksızın yapılabilir. Biz bu çalışmada TS vakalarımızın sonuçlarıyla ilgili deneyimimizi paylaşmayı amaçladık.Yöntemler: Bu çalışma 2010 ile 2015 yılları arasında kliniğimizde Fournier gangreni, inoperabl anorektal kanser, rektovajinal fistül ve radyoterapi nedeniyle oluşan benign striktür gibi çeşitli nedenlerle TS yapılan 14 hastanın verileri geriye doğru incelendi. Bulgular:Hastalarımızın 10'u erkek, 4'ü kadın idi. Ortalama yaşları 52.07 yıl idi. Hastalarımızdan 7 tanesine Fournier gangreni, 5 tanesine inoperabl anorektal tümör, bir tanesine kompleks rekto-vajinal fistül ve bir tanesine de almış olduğu radyoterapiye bağlı gelişen tıkayıcı striktür nedeniyle TS yapıldı. Hastalarımızın 8 tanesine rejyonel anestezi uygulandı. Tüm hastalarımıza trefin loop sigmoid kolostomi uygulandı. Bir hastamız ostomi prolapsusu nedeniyle ikinci kez opere edildi. Geçici stomalar 3 ay sonra kapatıldı. Ortalama hastanede kalış süresi 14 gün idi.Sonuç: TS görece basit, güvenli ve hızlı yapılan bir uygulama olup laparatomi endikasyonu olmayan hastalarda etkili alternatif bir yöntemdir. Düşük morbidite oranıyla acil ve elektif şartlarda uygulanabilir.Anahtar kelimeler: Fekal diversiyon, Trefin stoma, sonuçlarımız ABSTRACT Objective: Fecal diversion is often indicated in cases with fecal incontinence, Fournier's gangrene, anal fistula, and inoperable obstructive anorectal cancer. Trephine colostomy can be performed without necessitating laparotomy. We present our experience related to the outcome of trephine sigmoid colostomy. Methods:The retrospective study included 14 patients who underwent trephine colostomy due to various conditions including Fournier's gangrene, inoperable anorectal cancer, recto-vaginal fistula, and benign stricture due to radiotherapy at our clinic between January 2010 and January 2015.Results: Patients comprised 4 females and 10 males with a mean age of 52.07 years. The indications for stoma formation were Fournier's gangrene in 7 cases, inoperable anorectal cancer in 5, rectovaginal fistula in 1, and benign stricture due to radiotherapy in 1 case. Eight patients underwent surgery under regional anesthesia. All the patients underwent trephine loop sigmoid colostomy. One patient had second operation on the postoperative period due to colostomy prolapse. The temporary stomas were closed in 3 months. Mean length of hospital stay was 14 days. Conclusion:Trephine stoma is a relatively simple, safe and rapid procedure and an effective alternative to colostomy formation without laparotomy indications. It can be performed under emergency or elective conditions with low morbidity. J Clin Exp Invest 2015; 6 (2): 87-90

Objective: The aim of this study is to evaluate the obstetric and neonatal outcomes of pregnant women delivering large for gestational age (LGA) infants. Material and Methods: A total of 399 pregnant women giving birth to LGA infants in the Gynecology and Obstetrics Department of Dicle University Medical Faculty Hospital between January 2014 and December 2018 were included in this retrospective study. Demographic features, pregnancy and infant data, delivery type (vaginal delivery/cesarean delivery), and patients’ indications for cesarean section were assessed. Results: The mean age of the patients was 32.34±6.63, their gravida was 5.16±2.65 and parity was 3.55±2.36. The mean gestational week was 37.12±2.840 weeks and the mean birth weight was 3922.46±643.546 g. Of all patients, diabetes was detected in 28.5%, polyhydramnios in 11.3%, placental invasion anomaly in 4%, and preeclampsia in 9%. While 83.7% (334) of the patients underwent cesarean section, the remaining 16.3% (65) underwent normal delivery. 3.25% (13) of the patients developed complications during delivery. The rate of fetal anomaly was 11.7% (47) in existing pregnancies while the rate of fetal death was 5.01% (20). Conclusion: A cesarean delivery was performed in the majority of pregnant women with a suspected LGA infant. This group of patients exhibited a very high rate of gestational diabetes mellitus and diabetes mellitus. Existing pregnancies constitute a specifical pregnancy population that should be taken into consideration regarding probable complications and problems with the infant.

Introduction: This study aims to evaluate the pre- and postoperative outcomes of myomas operated in a tertiary clinic. Method: We retrospectively evaluated data from a total of 378 cases operated for myomas between January 2014 and December 2018 in the Dicle University Medical Faculty Obstetrics and Gynecology Clinic.   Results: There were 169 cases of abdominal myomectomy (44.7%), 156 cases of total abdominal hysterectomy (41.3%), 15 cases of laparoscopic myomectomy (4%), 13 cases of total laparoscopic hysterectomy (3.4%), 12 cases of myomectomy during cesarean delivery (3.2%), 9 cases of hysteroscopic myomectomy (2.4%), and 4 cases of vaginal myomectomy (1.1%). Pathology results revealed 341 cases of leiomyoma (88.2%), 32 cases of concomitant leiomyoma and adenomyosis (8.4%), and 13 cases of STUMP (3.3%). There were 5 cases of intraoperative bowel injury, 1 case of bladder injury, and 1 case of postoperative wound infection. Conclusion: Myomas can be surgically treated with satisfactory outcomes and low complication rates. The preferred surgical treatment will majorly depend on the patient's fertility expectations.