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Öğe Effect of surgeon’s judgement on the diagnosis of acute appendicitis(Turkish Surgical Association, 2014) Hasbahçeci, Mustafa; Erol, Cengiz; Törü, Mustafa; Şeker, MehmetObjective: The accuracy of a surgeon’s judgement still remains to be controversial in the diagnosis of acute appendicitis, which is a diagnosis usually based on laboratory data and imaging tests.Material and Methods: Patients with a possible diagnosis of acute appendicitis were reviewed retrospectively with regard to demographic variables, laboratory and imaging results, and treatment modalities. Results: There were 128 patients with a mean age of 31.2±14 years. The mean white blood cell count and the proportion of polymorphonuclear leukocytes were 11403±4669/mm3 and 75±11%, respectively. Appendectomy was performed on 66 (51.6%) patients. Conservative management was applied to 62 (48.4%) patients. Statistical analysis showed that patients with appendicitis have a higher white blood cell count (p=0.015) and a higher proportion of polymorphonuclear leukocytes (p=0.023). Sensitivity, specificity and accuracy rates were 84.6%, 63.7% and 74.3% for ultrasound and 100%, 86.7% and 92.2% for computed tomography, respectively.Conclusion: Diagnosis based on patients’ laboratory and imaging data, in combination with, the surgeon’s judgement appears to yield the best outcomes in patients with suspicion of acute appendicitis.The purpose of this retrospective study was to evaluate the optimal use of laboratory investigation, imaging techniques and surgeon’s judgement to diagnose patients presenting with acute abdominal pain and possible AA.Öğe Incidental pancreatic lipomas diagnosed by computed tomography(AVES, 2014) Hasbahçeci, Mustafa; Erol, Cengiz; Başak, Fatih; Barman, Ahmet; Şeker, Mehmet MetinObjective: Fatty tumours of the pancreas are rarely reported. With the advent of the imaging techniques, diagnosis of such tumours based on radiologic imaging is increasing. Materials and Methods: Between June 2006 and June 2012, four patients with pancreatic lipomas that were diagnosed by computed tomography were reviewed retrospectively with regard to their imaging findings. There were 3 male and one female patient with a mean age of 60.8 years (from 53 to 67 years). Results: A single well-bordered nodular fatty lesion with well-delin- eated thin homogeneous capsule was seen in all patients. The mean densitometric measurement of the lesions was -76 Hounsfield units (HU) (from -83 HU to -63 HU). The size of the lesions was from 7 mm to 12 mm with a mean of 8.75mm. They were located in the tail, body and neck of the pancreas in two, one and one patient, respectively. There was no associated pancreatobiliary pathology. Histopathologic evaluation was not planned because of their incidental diagnosis in these asymptomatic patients. Conclusion: Pancreatic lipomas are silent lesions, incidentally found during imaging procedures. They have specific computed tomography findings and do not require any additional diagnostic imaging.Öğe Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition)(BMC, 2022) Yuan, Qian-Qian; Xiao, Shu-Xuan; Farouk, Omar; Du, Yu-Tang; Sheybani, Fereshte; Tan, Qing Ting; Akbulut, Sami; Çetin, Kenan; Alikhassi, Afsaneh; Yaghan, Rami Jalal; Durur Subaşı, Irmak; Altıntoprak, Fatih; Eom, Tae Ik; Alper, Fatih; Hasbahçeci, Mustafa; Martinez-Ramos, David; Öztekin, Pelin Seher; Kwong, Ava; Pluguez-Turull, Cedric W.; Brownson, Kirstyn E.; Chandanwale, Shirish; Habibi, Mehran; Lan, Liu-Yi; Zhou, Rui; Zeng, Xian-Tao; Bai, Jiao; Bai, Jun-Wen; Chen, Qiong-Rong; Chen, Xing; Zha, Xiao-Ming; Dai, Wen-Jie; Dai, Zhi-Jun; Feng, Qin-Yu; Gao, Qing-Jun; Gao, Run-Fang; Han, Bao-San; Hou, Jin-Xuan; Hou, Wei; Liao, Hai-Ying; Luo, Hong; Liu, Zheng-Ren; Lu, Jing-Hua; Luo, Bin; Ma, Xiao-Peng; Qian, Jun; Qin, Jian-Yong; Wei, Wei; Wei, Gang; Xu, Li-Ying; Xue, Hui-Chao; Yang, Hua-Wei; Yang, Wei-Ge; Zhang, Chao-Jie; Zhang, Fan; Zhang, Guan-Xin; Zhang, Shao-Kun; Zhang, Shu-Qun; Zhang, Ye-Qiang; Zhang, Yue-Peng; Zhang, Sheng-Chu; Zhao, Dai-Wei; Zheng, Xiang-Min; Zheng, Le-Wei; Xu, Gao-Ran; Zhou, Wen-Bo; Wu, Gao-SongGranulomatous lobular mastitis (GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions, etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology. The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidence-based consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.Öğe Management of granulomatous lobular mastitis: An international multidisciplinary consensus (2021 edition) (vol 9, 20, 2022)(BMC, 2022) Yuan, Qian-Qian; Xiao, Shu-Yuan; Farouk, Omar; Du, Yu-Tang; Sheybani, Fereshte; Tan, Qing Ting; Akbulut, Sami; Çetin, Kenan; Alikhassi, Afsaneh; Yaghan, Rami Jalal; Durur Subaşı, Irmak; Altıntoprak, Fatih; Eom, Tae Ik; Alper, Fatih; Hasbahçeci, Mustafa; Martinez-Ramos, David; Öztekin, Pelin Seher; Kwong, Ava; Pluguez-Turull, Cedric W.; Brownson, Kirstyn E.; Chandanwale, Shirish; Habibi, Mehran; Lan, Liu-Yi; Zhou, Rui; Zeng, Xian-Tao; Bai, Jiao; Bai, Jun-Wen; Chen, Qiong-Rong; Chen, Xing; Zha, Xiao-Ming; Dai, Wen-Jie; Dai, Zhi-Jun; Feng, Qin-Yu; Gao, Qing-Jun; Gao, Run-Fang; Han, Bao-San; Hou, Jin-Xuan; Hou, Wei; Liao, Hai-Ying; Luo, Hong; Liu, Zheng-Ren; Lu, Jing-Hua; Luo, Bin; Ma, Xiao-Peng; Qian, Jun; Qin, Jian-Yong; Wei, Wei; Wei, Gang; Xu, Li-Ying; Xue, Hui-Chao; Yang, Hua-Wei; Yang, Wei-Ge; Zhang, Chao-Jie; Zhang, Fan; Zhang, Guan-Xin; Zhang, Shao-Kun; Zhang, Shu-Qun; Zhang, Ye-Qiang; Zhang, Yue-Peng; Zhang, Sheng-Chu; Zhao, Dai-Wei; Zheng, Xiang-Min; Zheng, Le-Wei; Xu, Gao-Ran; Zhou, Wen-Bo; Wu, Gao-Song[Abstract Not Available]Öğe Standard laparoscopic cholecystectomy for malposition of the gallbladder caused by right-sided ligamentum teres(Medknow Publications & Media Pvt Ltd, 2013) Hasbahçeci, Mustafa; Erol, Cengiz; Şeker, Mehmet; Başak, Fatih; Alimoğlu, OrhanAtypical localization of the gallbladder associated with right-sided ligamentum teres is a rare anomaly of the biliary system. Although the conventional nomenclature as being a left-sided gallbladder is usually used, this definition may be incomprehensive because of lacking the anatomical detail. This report describes atypical localization of the gallbladder associated with right-sided ligamentum teres and abnormal intrahepatic portal venous branching, surgically removed laparoscopically.Öğe Use of computed tomography to detect postoperative changes after lichtenstein inguinal hernia repair(AVES, 2015) Hasbahçeci, Mustafa; Erol, CengizObjective: This study aimed to evaluate the effect of computed tomography to visualize the post-operative changes after Lichtenstein inguinal hernia repair. Methods: Patients with Lichtenstein inguinal hernia repair and post-operative computed tomography scans were included. There were 11 male patients with 14 hernias; the mean age was 63.9±9.2 years. Time interval between inguinal hernia repair and imaging was 186±70 days (median, 211 days). After multiplanar reformatting, images were reviewed with respect to the postoperative changes and visualization of anatomic structures that were found in the inguinal region. Results: The inferior epigastric artery and vein, inguinal ligament, spermatic cord, and pubic tubercle were clearly detected in all the males. Small fluid collections were observed only during early post-operative period in two patients (14.3%). Minimal thickening of the inguinal ligament with fatty streaks and completely normal appearance were present in eight (57%) and six (43%) inguinal regions, respectively. Conclusion: Multiplanar reformatting helps physicians in visualizing the inguinal anatomy in the patients with hernia post surgery. Lichtenstein inguinal hernia repair may be regarded as the gold standard technique for inguinal hernia repair because of the lack of any destructive anatomical changes.Öğe Usefulness of computed tomography for differentiation of primary inguinal hernia(Gazi University, 2015) Hasbahçeci, Mustafa; Erol, CengizObjective: The perception of inguinal anatomy during hernia formation may be an important issue for the evaluation of hernias. This study was conducted to describe detailed anatomy of inguinal region in patients with primary inguinal hernia by using computed tomography. Methods: Study group included 18 inguinal hernia patients with computed tomography images. Images with multi-planar reformatting were evaluated with regard to anatomical landmarks found in inguinal region. Results: Visualization of inguinal ligament and inferior epigastric artery was possible in all patients. Type of inguinal hernia was defined correctly in all patients by using inferior epigastric artery as an anatomic landmark. Pubic tubercle and lateral crescent sign in differentiation between direct and indirect inguinal hernias had variable sensitivity and specificity (0.69 and 0.60 for pubic tubercle, and 0.69 and 0.80 for lateral crescent sign, respectively). Conclusion: Multi-planar reformatting helps physicians to differentiate types of inguinal hernia by using the inferior epigastric artery as an anatomic landmark.
