Background:Acute appendicitis (AA) is one of the most common causes of emergent surgeries. Many methods are used for its diagnosis.Objectives:This study was conducted to investigate the diagnostic value of MPV and RDW in acute appendicitis.Patients and Methods:This study was a retrospective multi-center cross sectional planned study. The study included 260 patients operated for AA and 158 patients as the control group. Groups were compared in terms of MPV, RDW, white blood cell count (WBC), neutrophil predominance (NP) and platelet count (PC).Results:MPV was significantly lower in AA group, compared to the control group (P < 0.001). The best cut-off level for MVP in AA was ≤ 7.3 fL and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy ratio were 45%, 89.2%, 87.3%, 49.6% and 61.7%, respectively. There was no significant difference between the two groups in terms of RDW and platelet values.Conclusions:MPV is a routinely measured parameter in complete blood count (CBC) and requires no additional cost. It significantly decreased in AA, having a greater sensitivity and NPV when combined with WBC and NP.

PurposeTo investigate the feasibility of the use of gadobenate dimeglumine (also known as Gd‐BOPTA) ‐enhanced T1‐weighted MR cholangiography in diagnosis of acute cholecystitis.Materials and MethodsThis prospectively designed institutional review board‐approved HIPAA‐compliant study was done between January and November 2007. We included 11 consecutive patients (7 male, mean age 59 years) who presented to the emergency room with acute right upper quadrant pain and with equivocal physical examination and/or ultrasound findings. The control group included 15 patients who underwent liver MRI with Gd‐BOPTA. All patients underwent contrast‐enhanced (CE) MR cholangiography examinations. CE‐MR cholangiography was performed on a 1.5 Tesla magnet using 3D T1‐weighted high resolution isotrophic volume examination (THRIVE) obtained at the 90th min after intravenous injection of Gd‐BOPTA. Imaging features detected on CE‐MR cholangiography were correlated with operative and histopathologic findings.ResultsIn the control group, GD‐BOPTA was visualized within the gallbladder in all subjects. For the study group, gallstones were present in nine patients (n = 7 both in gallbladder and cystic duct, n = 1 only in gallbladder, n = 1 only in cystic duct) on MRCP. Hydropic gallbladder was detected in seven patients, significant wall thickening in seven patients, and pericholecystic free fluid in 6 patients. On delayed phase CE cholangiography, significant enhancement of gallbladder wall was seen in 10 patients, and contrast agent excretion into gallbladder was absent in all patients. Surgery was performed in 10 patients, and cholecystostomy was done in 1 patient. Surgery and histopathology findings were consistent with cholecystitis in all patients.ConclusionIn addition to anatomical assessment, Gd‐BOPTA‐enhanced MR cholangiography can provide functional evaluation similar to HIDA scintigraphy in diagnosing acute cholecystitis in patients with acute right upper quadrant pain and equivocal findings. J. Magn. Reson. Imaging 2009;30:578–585. © 2009 Wiley‐Liss, Inc.

The presence of an appendix vermiformis in a femoral hernia sac is called De Garengeot's hernia. It is a very rare clinical condition and requires emergency surgery. However, preoperative diagnosis of De Garengeot's hernia is difficult. Herein, we report a 58-year-old female who presented with sudden-onset painful swelling in the right groin region. Diagnosis was established based on computed tomography findings, and appendectomy with meshfree hernia repair was performed. The postoperative period was uneventful, and the histopathologic examination of the specimen revealed gangrenous appendicitis.

Pilonidal sinus disease is a recurrent and chronic disorder that can be observed in the periumbilical area although commonly seen in sacrococygeal region. Sinus excision with reconstruction of the umbilicus is a surgical option for treatment of umbilical pilonidal sinus disease. We report a case of 21-year-old male patient with umbilical pilonidal sinus that was treated by sinus excision with reconstruction of the umbilicus, which is an agreeable and alternative treatment option of umbilectomy.

Objective: Anorectal abscess is a clinical condition frequently encountered in daily surgical practice and recurrences may occur despite treatment with adequate incision and drainage. The primary aim of this study was to analyze the variables that may have resulted in recurrent anorectal abscess, retrospectively. Material and Methods:Ninety-three patients out of 149 patients who underwent surgery for anorectal abscess at our center between 2011-2012 were included in this study. Data regarding age, gender, presence of recurrence, time to recurrence, abscess type, presence of fistula, fistula type, drain usage, length of hospital stay and follow-up duration were retrospectively recorded. Results:Patients were divided into two groups: the recurrence group and the treatment group. Eleven patients (11.8%) had a recurrence and the median time to recurrence was 3 months. None of the variables evaluated were found to be significantly associated with the presence of recurrence. Conclusion:Variables such as age, gender, type of abscess, presence of fistula or drain usage were not associated with the development of recurrence in patients who underwent incision and drainage of an anorectal abscess.