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Item Zor Histerektomi Nasıl Kolaylaştıralım?(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2019-10-01) Aydeniz, Elif GanimeÖZET Kadın hastalıkları ve doğum dalının en sık ve çeşitli yöntemlerle uygulanan en yaygın majör cerrahisi histerekto midir. Hastanın ve teknik ekipmanın ve cerrahın deneyimine göre ilaveten hastanın fiziksel durumuna göre keza yine anatomisine göre operasyon zor ve kolay diye sınıflandırılabilir. Operasyonu kolaylaştıran en önemli adım hasta için doğru olan cerrahi tekniği seçmektedir. Bu sayede hem komplikasyon riski azalmakta hem de operas yon süresi kısalmaktadır. Tıbbın her alanında olduğu gibi esas hedef asla hastaya zarar vermemektir.Item Amyand’s Hernia: A Case of an Unusual İncarcerated Recurrent İnguinal Hernia(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2019-10-01) Özer, Ali; Can, Meltem GünerABSTRACT An Amyand’s hernia refers to the presence of a vermiform appendix within an inguinal hernia sac. The incidence of this rare condition varies in the literature, ranging from 0.19% to 1.7% of the reported inguinal hernia cases. The clinical presentation is similar to that of an incarcerated or strangulated hernia. In the case presented here, a noninflamed appendix and adherent caecum were detected during a surgery performed for an incarcerated recurrent inguinal hernia. After a prophylactic appendectomy was performed, a mesh was applied for the hernia repairItem Spontaneous Pneumomediastinum Presenting with Neck Swelling(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2019-10-01) Aydın, Attila; Kaya, Murtaza; Bilge, Sedat; Çevik, Erdem; Balcı, Veysel; Aydın, CemileABSTRACT Spontaneous Pneumomediastinum (SPM) is a very rare condition with an incidence of 1/30.000 and 1/44.500, and mostly seen in young men. The present article reports a case of SPM with neck swelling in the Emergency Department (ED). A 24-year-old male patient with fever and swelling on both sides of his neck presented at the ED. Physical examination revealed swelling on both parotid glands, neck and facial area. The pulmonary examination revealed a swelling starting from the upper side of the chest and extending toward the neck region and palpation revealed crepitation from the upper wall of the chest to both temporal fossae. Linear air radiolucency was seen in the posteroanterior chest x-ray. A Cervico-Thoracic CT scan revealed “showed” diffuse bilateral and symmetrical emphysema. SPM was diagnosed. He was admitted to the Thoracic Surgery Department for treatment and follow up. Emergency physicians should consider SPM in the differential diagnosis of patients presenting with neck swelling. It should not be forgotten that close patient follow-up is required due to the possibility of severe complications.Item Joubert Sendromlu Hastanın Skolyoz Cerrahisinde Anestezi Yönetimi: Olgu Sunumu(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2019-10-01) Hayırlıoğlu, Mehmet Bilhan; Vural, Banu Gökay; İyigün, Müzeyyen; Güler, TayfunÖZET Joubert Sendromu, hipotoni, anormal solunum paterni ve göz hareketleri, ataksi, psikomotor gelişme geriliği gibi nörolojik bulgularla karakterize, otozomal resesif geçişli nadir görülen nörolojik bir hastalıktır. Kranial magnetik rezonans görüntülemede serebellar vermis hipoplazisinin neden olduğu molar diş görüntüsü nöroradyolojik tanı kriteridir. Hastalarda erken gelişme dönemindeki hipotoni nedeni ile skolyoz sıklıkla görülür. Bu yazıda Joubert sendromlu bir hastada skolyoz düzeltme operasyonu sırasında anestezi yönetimimiz sunulmaktadır.Item A Case of Splenic Artery Aneurysm Presenting With İntra-Abdominal Bleeding(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2019-10-01) Akan, Gülhan Ertan; Erol, Cengiz; Ersavaş, Cenk; Ulus, SılaABSTRACT Visceral artery aneurysms are rare pathologies. Splenic Artery Aneurysms (SAA) are the most common visceral artery aneurysms accounting for 60% to71% of them, with an incidence of 0.7% in the normal population, even though rates as high as 10% have been found on necropsy studies. This aneurysm has a risk of rupture resulting in death. It can be overlooked (missed) on the imaging modalities when it is thrombosed. Here, we present a case of splenic artery aneurysm, which could be diagnosed with repetitive computed tomography (CT) examinations because it was partially thrombosed and overlooked in the 1st CT. The aneurysm was treated with blind embolization in correlation with CT.Item Periviable Preterm Premature Rupture of Membranes: A Retrospective Study on Determinants of Neonatal Mortality(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2019-10-01) Danışman, Ahmet Nuri; Kaymak, Oktay; İskender, CantekinABSTRACT Purpose: The present study aimed to determine the risk factors for fetal and neonatal mortality in the context of Periviable Preterm Premature Rupture of Membranes (PPROM). Patients and Methods: This was a retrospective cohort study conducted at perinatology department of Zekai Tahir Burak Research and Training Hospital. The study population consisted of patients with PPROM before completing the 23rd gestational week were opted for expectant management. Maternal and Neonatal characteristics were recorded. Multivariate Logistic Regression with backward elimination is performed to investigate the effect of certain parameters on neonatal mortality. Results: In multivariate logistic regression model, gestational age <21 weeks at onset of PPROM (Odds Ratio (95% confidence interval): 8.58 (2.41–30.5), p<0.01) and nulliparity (Odds Ratio (95% confidence interval): 4.47 (1.25–15.9), p: 0.02) were independently associated with stillbirth or delivery before 23rd weeks. According to Cox regression model, the significant determinants of survival were: completed gestational weeks at delivery, sepsis in the first neonatal week and presence of pulmonary hypoplasia. Conclusion: The present data suggest that favorable outcomes can be anticipated in periviable PPROM that has occurred after 22th gestational weeks. Completed gestational weeks at delivery and nulliparity are other important determinants of mortality.Collection Collection Collection