Twenty-seven patients who were treated surgically because of extrahepatic abdominal hydatid disease between 1981 and 1999 were retrospectively reviewed. Nineteen patients had coexistent hepatic cysts while 8 patients had only peritoneal cysts. The cysts were located in the spleen, pancreas, adrenal gland, mesentery of the intestines, ovaries, retroperitoneum, omentum, abdominal wall, rectovesical region, and the psoas muscle. Due to organ destruction because of large cysts in 8 patients, the involved organ had to be sacrificed. The other 19 patients were treated by a pericystectomy. No postoperative mortality or severe morbidity was seen. In conclusion, symptomatic or large cysts should be surgically treated. In cases suspected of having peritoneal spillage, antihelminthic drugs should be administered. In addition, small asymptomatic cysts may also be effectively treated with antihelminthics.

Intestinal ischaemia/reperfusion causes formation of reactive oxygen intermediates which lead to mucosal cell injury. Glutathione, a scavenger of reactive oxygen intermediates, protects tissues from reactive oxygen intermediate-mediated cell injury. Nitric oxide is a lipophilic gas and its synthesis is stimulated by ischaemic conditions. In this experimental study, we aimed to investigate the role of i. v. L-glutamine infusion on mucosal tissue glutathione and serum nitric oxide concentrations in intestinal ischaemia/reperfusion. External jugular vein of albino rabbits was cannulated with catheter and infused with normal saline at 4 ml/h. After 3 days, they were randomly divided into two main groups. Group 1 (n = 30) received i. v. normal saline alone, group 2 (n = 30) received normal saline + 205 mmol/1 glutamine at 4 ml/h for 24 hours. Next, mucosal glutathione and serum nitric oxide concentrations were measured after 0, 30, 60 min of ischaemia/60 min of reperfusion. Basal glutathione concentrations were similar in normal saline alone and normal saline + 205 mmol/1 glutamine infusion groups (p > 0.05). At 30 and 60 min of ischaemia/60 min of reperfusion, glutathione concentrations were significantly lower in normal saline-infused rabbits compared to the normal saline + 205 mmol/1 glutamine-infused rabbits (p < 0.05). In addition, serum nitric oxide concentrations were found to be significantly increased in rabbits 30 and 60 min after ischaemia/reperfusion when compared to mean basal nitric oxide concentrations obtained from control animals. However, the normal saline + 205 mmol/1 glutamine group had lower serum nitric oxide concentrations than did the normal saline alone group. In conclusion, this study revealed that intestinal mucosal glutathione concentrations were significantly higher in glutamine-receiving rabbits than in non-receiving ones. Additionally, it was shown that nitric oxide concentrations increased in ischaemia both in normal saline alone and normal saline + 205 mmol/1 glutamine receiving groups, while this increase in nitric oxide was more prominent in the normal saline alone group (p < 0.01). These findings show that glutamine supplementation may protect the small intestine from ischaemia/reperfusion injury and may play a regulatory role in the biosynthesis of nitric oxide.

No abstract

Hydatid disease presents as hydatid cysts primarily in the liver and lungs. Although hepatic hydatid cysts (HHCs) may be asymptomatic for many years, they may be symptomatic due to expansion, rupture, and pyogenic infection. Rupture of the HHC into the biliary tract is one of the most serious complications and is frequently related to overenlargement of the cyst or major trauma. Patients with this disease usually have jaundice or fever. We report an asymptomatic HHC ruptured after minor trauma. While the ruptured cyst was presented as the subdiaphragmatic gas on the chest radiography, it was detected as a large cyst with multiple daughter cysts on ultrasound, computed tomography scan, and magnetic resonance imaging.

Background/Aim: Anal sphincter injury (ASI) is a clinical condition that causes anal incontinence and can severely impair an individual's quality of life. Overlapping sphincteroplasty (OSP) is the most preferred surgical method for repairing ASI. The present study aimed to discuss the demographic and clinical characteristics of patients who underwent ASI surgical repair in light of the current literature. Methods: Patients in two groups; males and females, who underwent an operation for grade 3-4 ASI in the General Surgery Clinic at Ataturk University between 2010 and 2021 were retrospectively analyzed. The severity of anal incontinence and quality of life post-operatively using the Wexner score were evaluated. For evaluating post-operative complications, the Clavien-Dindo Classification was used. Results: Over 12 years, 34 adult patients with a mean age of 35.8 (22-66) years underwent ASI surgery, namely 23 (67.6%) women and 11 (32.4) men. Considering the patients' etiopathogenesis, obstetric injuries (55.9%) were the most common cause of ASI. All patients underwent overlapping sphincteroplasty (OSP), while 20.6% also underwent protective stoma. According to the Centers for Disease Control and Prevention (CDC), four patients were classified as Grade 1, four as Grade 2, seven as Grade 3 and one as Grade 5. At a mean follow-up of 35.8 months, the mean Wexner score was 3.59 and the success rate was 88.2% (P=0.445). Males had a longer average hospital stay (P=0.021) and a higher Wexner score (P=0.445), whereas females had a greater complication rate (P=0.388). The quality of life was high, but the Wexner scores were low in all patients. Conclusion: ASI most commonly occurs in women during childbirth. OSP has a high success rate, and opening a diverting ostomy when needed further increases this rate. The Wexner score is a simple and useful system for assessing anal incontinence.