Browsing by Author "Arslan, Esra Elif"

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Abdominal Problems in Children with Congenital Cardiovascular Abnormalities
(2015) Guney, Lutfi Hakan; Araz, Coskun; Beyazpinar, Deniz Sarp; Arda, Irfan Serdar; Arslan, Esra Elif; Hicsonmez, Akgun; 26185717
Background: Congenital cardiovascular abnormality is an important cause of morbidity and mortality in childhood. Both the type of congenital cardiovascular abnormality and cardiopulmonary bypass are responsible for gastrointestinal system problems. Aims: Intra-abdominal problems, such as paralytic ileus, necrotizing enterocolitis, and intestinal perforation, are common in patients who have been operated or who are being followed for congenital cardiovascular abnormalities. Besides the primary congenital cardiovascular abnormalities, ischemia secondary to cardiac catheterization or surgery contributes to the incidence of these problems. Study Design: Cross-sectional study. Methods: In this study, we aimed to screen the intra-abdominal problems seen in patients with congenital cardiovascular abnormalities who had undergone surgical or angiographical intervention(s). Patients with congenital cardiovascular abnormalities who had been treated medically or surgically between 2000 and 2014 were analyzed retrospectively in terms of intra-abdominal problems. The patients' demographic data, type of congenital cardiovascular abnormalities, the intervention applied (surgical, angiographic), the incidence of intra-abdominal problem(s), the interventions applied for the intra-abdominal problems, and the results were evaluated. Results: Fourteen (Group I) of the 76 patients with congenital cardiovascular abnormalities diagnosis were operated due to intra-abdominal problems, and 62 (Group II) were followed-up clinically for intra-abdominal problems. In Group I (10 boys and 4 girls), 11 patients were aged between 0 and 12 months, and three patients were older than 12 months. Group II included 52 patients aged between 0 and 12 months and 10 patients older than 12 months. Cardiovascular surgical interventions had been applied to six patients in Group I and 40 patients in Group II. The most frequent intra-abdominal problems were necrotizing enterocolitis and intestinal perforation in Group I, and paralytic ileus in Group II. Seven of the Group I patients and 22 of the Group II patients died. The patients who died in both groups had more than three congenital cardiovascular abnormalities in the same patient, and 80% of these patients had been operated for congenital cardiovascular abnormalities. Conclusion: The gastrointestinal system is involved in important complications experienced by patients with congenital cardiovascular abnormalities. The mortality rate was higher in operated patients due to gastrointestinal complications. Gastrointestinal complications are more frequent in patients with cyanotic anomalies. The presence of more than one congenital cardiovascular abnormality in a patient increased the mortality rate.
Coexistence of Tubo-Ovarian Abscess and Carcinoid Tumor of the Appendix in A Sexually Inactive Girl: A Case Report
(2022) Acer-Demir, Tugba; Sagnak-Akilli, Muge; Guney, Lutfi Hakan; Arslan, Esra Elif; Fakioglu, Ender; https://orcid.org/0000-0001-5391-9094; https://orcid.org/0000-0002-7437-2734; E-4455-2019; AFT-2490-2022
Background: Tubo-ovarian abscess (TOA) is mostly a sequela of pelvic inflammatory disease (PID) which is seen in sexually active women. Although very rare, TOA could be seen in virgin adolescent girls. Fifteen cases of TOA were reported in virgin girls in English literature. Only one of these cases was suspected to be due to appendicitis. Herein, we present the first case of coexistence of tubo-ovarian abscess and carcinoid tumor of the appendix in a sexually inactive girl. Case presentation: A 13-year-old girl presented with abdominal pain and fever. Ultrasonography reported that there was a 63x48 mm sized, heterogeneous, thick-walled, dense-content complicated cyst in the right ovary which was thought to be a hemorrhagic cyst and a tubular structure, measuring 12 mm in its thickest part which was thought to be the appendix. During the operation, a TOA was observed in the right adnexal region. The thick, edematous appendix which was lying separately was excised. The TOA was evacuated; a drain was placed. The appendix pathology was reported as "carcinoid tumor. " Conclusion: We present the first case of TAO with carcinoid tumor of appendix and the second case of TAO that was suspected to be due to appendicitis. When the sexually inactive TOA cases including our case were reviewed, we found that the median age was 15 years (12-47 years) and 11 of 16 cases (69%) were under 18 years of age. The presenting symptoms were abdominal or pelvic pain in all cases, fever in 11 cases (69%), vomiting in 6 cases (38%), dysuria in 5 cases (31%), and diarrhea in 3 cases (19%). Both perforated appendicitis and TOA patients have the same clinic presentation such as fever, abdominal tenderness, increased leukocyte count, increased inflammatory markers. The differential diagnosis can be achieved by radiological examinations such as ultrasonography, computerized tomography or magnetic resonance imaging.
Deneysel spermatik kord hasarının rat modelinde kord ve testis üzerine etkileri
(Başkent Üniversitesi Tıp Fakültesi, 2017) Arslan, Esra Elif; Güney, L. Hakan
Spermatik kord inguino-skrotal bölge ameliyatlarında dikkat edilmesi gereken en önemli inguinal yapıdır. Cerrahi olarak spermatik kord ve elemanlarına uygulanan hasarların testiküler hasara ve sonuç olarak infertiliteye neden olduğu bilinmektedir. Bu çalıĢmada, ratlarda vas deferenste oluĢturulan hasar tiplerinin; vas deferens, testis ve epididim üzerinde oluĢturduğu etkilerin irdelenmesi amaçlanmıĢtır. ÇalıĢmada kullanılan 34 adet prepubertal erkek Sprague Dawley rat; digital kompresyon, traksiyon, kesi ve kontrol grupları olmak üzere 4 gruba ayrıldı. Digital kompresyon grubunda sağ vas deferens serbestleĢtirilerek ılık ıslak spanç ile iki parmak arasında 4 dakika basınç uygulandı. Traksiyon grubunda sağ vas deferens serbestleĢtirildikten sonra askıya alınarak 10 gr ağırlık ile 4 dakika traksiyon uygulandı. Kontrol grubunda cerrahi model uygulanmadı, sadece vas deferens ve testis varlığı görüldü. Kesi grubunda ise sağ vas deferens serbestleĢtirildikten sonra testiküler arter ve vene zarar verilmeden ortasından tam kesi yapıldı. Vas deferens iki yönden tam kat iki dikiĢ ile onarıldı. Yirmi sekiz gün sonra tüm hayvanlar sakrifiye edildi. Sağ testis, epididim ve vas deferens hücre değiĢiklikleri makroskopik ve mikroskopik olarak değerlendirildi. Vas deferenste sperm varlığı değerlendirmesinde en az sayıda rat traksiyon grubunda mevcuttu (3/9) (p=0,027) ve vas deferens iç çap dağılımları değerlendirilmesinde belirgin azalma gözlendi (p=0,009). Kesi grubunda vas deferens kas kalınlığı/dıĢ çap oranında belirginazalma tespit edildi (p=0,034). Model gruplarında seminifer tübül çap ve sağ testis hacim ortalamaları açısından istatistiksel açıdan anlamlı bir farklılık tespit edilemezken kesi grubunda sağ ve sol testis hacimleri kendi arasında kıyaslandığında fark anlamlı olarak azalmıĢtı (p=0,008). Bu bulgulara göre operasyon esnasında korda uygulanan gerilme ile lümen içerisinde sperm varlığı belirgin olarak etkilenmektedir. Kesi sonrası onarım yapılan vakalarda sperm varlığının devam ediyor olması hasarlanma sonrası onarımın önemini göstermektedir. Yapılacak ameliyatlarda vas deferensi korumak için olabildiğince dikkat etmek gerekmektedir. Spermatic cord is the most important inguinal structure to be protected from injury in inguino-scrotal region operations. It is known that surgical damage to the spermatic cord and its components also causes testicular damage and lead to infertility. In this study, it was aimed to investigate the effects of different types of vas deferens injury on vas deferens, testis and epididymis in rats. Thirty four prepubertal male Sprague Dawley rats used in the study and were divided into 4 groups; digital compression, traction, incision and control groups. In digital compression group, the right vas deferens were released and the pressure was applied between the two fingers for 4 minutes with a warm wet sponge. In the traction group after the right vas deferens were released, traction was applied with a weight of 10 g for 4 minutes. In the control group no surgical model was applied, only vas deferens and testicular presence was observed. In the incision group, the right vas deferens were released and then a complete incision was made from the middle of the vas deferens without damaging the testicular artery and vein. The vas deferens was repaired in two directions with two sutures. Twenty eight days later, all animals were sacrificed. Cell changes that occurred in the right testis, epididymis and vas deferens were evaluated by macroscopic and microscopic. In traction group has least number of rats who have had sperm present in vas deferens (3/9) (p=0,027) and there was significiant decrease of inner diameter of vas deferens (p=0,009). In incision group, vas deferens muscle thickness per external diameter ratio showed significant decrease (p=0,034). There was no statistically significant difference in mean seminiferous tubule diameter and right testis volume within groups. When the right and left testis volumes were compared in the incision group, the difference was significantly decreased in the right testis (that the procedure applied) (p = 0.008). According to these findings, the presence of sperm in the vas deferens lumen is significantly affected by the traction applied to the cord during operation. The presence of sperm in case of the incision group shows the importance of post-injury repair. During inguinal surgeries care must be taken to protect vas deferens especially from traction.
A rare case of a gastric adenomyoma mimicking a gastric duplication cyst
(2018) Arslan, Esra Elif; Demir, Tugba Acer; Guney, Lutfi Hakan; Tepeoglu, Merih; Akilli, Muge Sagnak; Hicsonmez, Akgun; 30260786