In this case report, our aim was to emphasize that cutaneous involvement can be seen at the time of diagnosis or during the clinical course of visceral organ cancers in general and in colorectal cancers particularly. We also aimed to demonstrate that cutaneous lesions occurring in patients under follow up for visceral organ cancers could be metastases. A rapid progressing scalp lesion was detected in a newly diagnosed rectal cancer patient and the tru-cut biopsy revealed adenocarcinoma metastasis. This patient died due to a myocardial infarction during neoadjuvant chemotherapy. Cutaneous metastatic lesions in colorectal cancers must be evaluated as a sign of advanced disease and treatment protocols should be determined accordingly.

Transversus abdominis plane (TAP) block technique seems to off er one of the most effi cient methods for a local pain control. Our aim is to demonstrate the eff ectiveness and safety of TAP block for post-operative pain control under laparoscopic vision in elderly patients during laparoscopic cholecystectomy. Th e patients aged more than 65 years old, who had cholecystectomy due to symptomatic cholelithiasis, were retrospectively evaluated. Th e patients that were operated under general anesthesia + laparoscopic TAP block and those who were operated only under only general anesthesia were compared according to their' age and gender, comorbidities, American Society of Anesthesiologists scores, visual analog scale (VAS) for pain and length of stay in the hospital. Median (±interquartile range) values of post-operative 24 th -hour-VAS for pain was found consecutively 2 (±1-3) in TAP block + group and 3 (±2-5) in TAP block -group. Th e median post-operative 24 th -hour-VAS value in overall patients was three. Patients' VAS values were higher in the TAP block -group with a statistically signifi cant diff erence (p = 0.001). Furthermore, no statistically signifi cant diff erence was found for other parameters in two groups. Th e laparoscopic-guided TAP block can easily be performed and has potential for lower visceral injury risk and shorter operational time. Effi cacy, safety and other advantages (analgesic requirements, etc.) make it an ideal abdominal fi eld block in elderly patients.

Various kinds of foreign bodies causing appendicitis have been reported. However, a needle contained in the appendix is very rare, especially in adults. We report an unusual case of a twenty year old man who had ingested a needle ten days prior and presented with signs and symptoms of acute abdominal pain. An abdominal computed tomography scan revealed acute appendicitis. The patient was successfully treated with laparoscopic surgical intervention. In cases of a foreign body in the gastrointestinal tract that cannot be removed endoscopically, the emergence of non-specific symptoms may be early symptoms of acute problems in the abdomen.

OBJECTIVES: The purpose of the study was that monitoring, which is used in diagnosis of acute appendicitis, and laboratory values, were evaluated for verifying diagnosis of complicated appendicitis and these parameters revealed cut-off values in complicated acute/non-complicated appendicitis. METHODS: 195 patients, who had had an operation for acute appendicitis between January 2012 and March 2015 and who were proved to have acute complicated/non-complicated appendicitis from the results of histopathology consideration, were included in this study. Patients' age, preoperative serum, WBC, CRP, NLR and BT with USG results were evaluated. RESULTS: Among the groups, there were no meaningful differences in the sense of age. CONCLUSION: It is important that treatment options are evaluated to be able to discriminate complicated appendicitis fast and with a high accuracy. In the case that serum WBC is higher than 13800. CRP is higher than 5.98, NLR is higher than 4.87 and appendicitis diameter is longer than 11mm, infl ammation of appendicitis is complex with gangrene, perforation and abscess and it emphasizes the suggestion of surgical treatment option to patients (Tab. 4, Fig. 1, Ref. 28). Text in PDF www.elis.sk.

The results of the present study suggest that use of the eyedrop-shaped modified Limberg flap is associated with a lower maceration and recurrence rate when compared with the available data on the use of the Limberg flap. Flap necrosis and wound healing was better, and the routine use of drains did not affect the wound-related complications and recurrence rates.