Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item A Rare Cause of Small Intestinal Obstruction: Obturator Hernia(2014) Karagulle, Erdal; Turk, Emin; Yabanoglu, Hakan; 0000-0002-1161-3369; 0000-0003-4766-3373; AAJ-7865-2021; AAJ-5609-2021Obturator hernia is an uncommon disease and its diagnosis is challenging. It is more prevalent in thin, multiparous, elderly women. In this case report a 93-year-old woman patient with a right-sided strangulated obturator hernia was discussed with review of the relevant literature.Item Sacroiliac Pain and CT-Guided Steroid Injection Treatment: High-Grade Arthritis Has an Adverse Effect on Outcomes in Long-Term Follow-Up(2015) Sahin, B. Savran; Aktas, E.; Haberal, B.; Harman, A.; Yazici, A. Canan; Kaygusuz, H.; Aribas, B. K.; 0000-0002-1668-6997; 0000-0002-7386-7110; 0000-0002-3132-242X; 26241533; W-9080-2019; K-9824-2013; AAS-6810-2021OBJECTIVE: The sacroiliac joint (SIJ) is one of the major sources of low back pain that can lead to severe morbidity. Possible SIJ pain requires a thorough evaluation and treatment option. The purpose of this study was to analyze the possible relationships between computed tomography (CT) grading of SIJ arthritis and the effectiveness of intraarticular steroid injection treatment under CT guidance. PATIENTS AND METHODS: A total of 61 patients with SIJ pain who were treated with CT guided intraarticular steroid injection were retrospectively reviewed. Visual analog scale (VAS) scores for pain control were recorded for short-term (day after injection, first week, third week) and long-term (sixth months and final control) follow-up times. SIJ arthritis was graded using CT images according to the New York criteria. Patients were assigned into low-grade (0, 1 and 2) and high-grade (3 and 4) groups. The relationship between arthritis grades and VAS scores in short and long-term follow-ups were statistically analyzed. RESULTS: Mean age and follow-up was 54.8 years (range: 41-68 years) and 27.8 months (range: 24-36 months), respectively. In 40 patients there was low-grade arthritis, while 21 patients were characterized on having high-grade sacroiliac arthritis detected during the radiological evaluation. There was no statistically significant difference between low and high-grade arthritis in regard to short-term VAS scores. On contrary, for long-term VAS scores, there was significant difference between low-and high-grade arthritis. CONCLUSIONS: Steroid injection treatment for SIJ pain is not effective on a long-term basis for patients with high-grade arthritis, and although they have had decreased VAS scores in the short-term, after 2 years of follow-up, their VAS scores significantly increased leading to symptomatic sacroiliac joint pain.Item Endovascular Management of Hematomas in Pediatric Transplant Patients(2022) Ozen, Ozgur; Boyvat, Fatih; Harman, Ali; Karakaya, Emre; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0001-7122-4130; 0000-0002-3462-7632; 35570602; AAD-5466-2021; AAN-1681-2021; AAJ-8097-2021Objectives: Transcatheter arterial embolization is used to control active hemorrhage at different anatomic locations. Because hematomas can suddenly deteriorate and become life threatening for transplant patients, they require prompt diagnosis and intervention rather than conservative management. Here, we evaluated computed tomography in treatment planning and transcatheter embolization effectiveness for hematoma management in pediatric liver transplant patients. Materials and Methods: Between June 2012 and December 2021, 10 pediatric liver transplant patients were referred to our interventional radiology unit. Computed tomography and angiograms were reviewed for hematoma location and presence of extravasation. We analyzed correlations between computed tomography and angiography findings and technical and clinical success of the endovascular interventions. Results: Active leak of contrast material during arterial phase was detected on 9/10 CT scans. Although there was no active bleeding on CT in 1 patient, active arterial bleeding was detected on angiography. On the contrary, in 2 patients, although active bleeding was observed on computed tomography, it was not detected on angiography. Source of bleeding was superior mesenteric artery branches in 4, hepatic artery branch in 2, superior epigastric artery in 1, and phrenic artery in 1 patient. Six of 8 patients with active bleeding were treated with endovascular procedures. The remaining 2 patients received surgery: 1 had bleeding from liver cut surface originating from a hepatic artery branch and received open surgery because the bleeding branch was too thin for catheterization, and 1 was hemodynamically unstable and selective catheterization of the internal thoracic artery would take time. Two patients received embolization procedures with N-butyl 2-cyanoacrylate (glue) diluted with iodized oil, and 1 patient had coil and glue with iodized oil. Embolization with coils was performed in 3 patients. Rate of success with transcatheter arterial embolization was 75%. No complications related to patient comorbidities or embolization procedures were shown. No deaths occurred due to progression of the hematoma. Conclusions: Transcatheter arterial embolization is effective and safe for treatment of pediatric liver transplant patients with hematomas. Computed tomography has value in identifying the bleeding source and its anatomic relationships and may enhance our intervention abilities to become quicker, more effective, and more secured.Item Comparison of Transforaminal and Interlaminar Epidural Steroid Injection in Managing Lumbar Radiculopathy(2017) Rahatli, Feride Kural; Harman, Ali; Boyvat, Fatih; Zararsiz, Gokmen; https://orcid.org/0000-0002-4226-4034; https://orcid.org/0000-0002-7386-7110; AAL-9808-2021; K-9824-2013; F-4230-2011Purpose: Epidural steroid injection is a commonly used low risky symptomatic treatment option of lumbar radiculopathy in patients with poor response to conservative management. The purpose of this prospective study was to compare the efficacy of transforaminal and interlaminar epidural steroid injection. Materials and methods: In this study computed tomography guided lumbar epidural steroid injections were performed in 87 patients, steroid injections were made by transforaminal and interlaminar technique. The effectiveness of this treatment was evaluated by visual analogue scale at 2 weeks ( acute), 3 months (sub-acute) and 6 months ( chronic) after the injection. Results: In interlaminar group 78.1% patients had effective pain relief at acute term and 73.4% patients had effective pain relief at sub-acute and chronic term. In transforaminal group 82.6% patients had effective pain relief at acute term and 73.9% patients had effective pain relief at sub-acute and chronic term. Transforaminal group showed slightly better pain relief in all terms but the difference was not statistically significant. Patients with symptom duration more than 6 months had statistically significant higher pain relief than the patients with symptom duration less than 6 months in acute term but there was no statistically significant difference between sub-acute and chronic terms. Conclusion: In the current study transforaminal epidural steroid injections for the treatment of lumbar radiculopathy resulted in better pain relief than interlaminar epidural steroid injections in all terms but the difference was not statistically significant.Item Abdominal CT Findings in Patients with Primary Lymphoma Causing Small Bowel Obstruction(2017) Karadeli, Elif; Erbay, Gurcan; Parlakgumus, Alper; Yabanoglu, Hakan; 0000-0002-0352-8818; 0000-0002-1706-8680; 0000-0002-1161-3369; 29132484; AAK-5399-2021; AAK-5370-2021; AAJ-7865-2021The purpose of this study was to investigate retrospectively CT findings in patients with primary lymphoma causing small bowel obstruction. CT scans of 11 patients with small bowel lymphoma were separately analysed in terms of affected section of the small bowel, focality, wall thickness, pattern and degree of contrast enhancement, lymphadenopathy, organ involvement, perforation, and the presence of intraabdominal fluid. Eight patients had diffuse large B-cell lymphoma, and one patient each had marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT), T-cell lymphoma, and anaplastic T-cell lymphoma. Affected sections of the bowels involved were jejunum (n=5, 45.4%), ileum (n=2, 18.1%), and one case (9%) each of distal ileum, distal jejunum, distal jejunum and ileum, and distal jejunum and colon. Primary gastrointestinal (GI) lymphoma is an uncommon disease, that may lead to small bowel obstruction sometimes.Item The Relationship Between Degree of Nasal Septum Deviation With Sinonasal Structures and Variations(2022) Atsal, Gorkem; Demir, Emine; Yildirim, Oben; Edizer, Deniz Tuna; Olgun, Levent; 34690315We aimed to evaluate whether the nasal septum deviation affects the development of sinonasal structures. Patients who had undergone paranasal sinus computed tomography (PNS-CT) imaging due to nasal obstruction were divided into 3 groups according to the septal deviation angle; group I: 0 degrees to 9 degrees, group II: 10 degrees to 15 degrees, and group III: >15 degrees. The features of sinonasal structures were recorded when evaluating PNS-CT. There were totally 234 patients, 119 patients in group I, 68 in group II, and 47 in group III. On the opposite side of the deviation, keros 3 was significantly more in group III (P < 0.001). Although the incidence of concha bullosa and agger nasi cell were not affected by the degree of deviation (P > 0.05), the incidence of Haller and Onodi cells were significantly higher in group III (P < 0.001). In addition, all cells were observed more in the opposite side of the deviation in each group (P < 0.001). Maxillary sinus retention cysts and hypoplasia of maxillary and frontal sinuses, as an indicator of the low pneumatization of the sinuses, are seen more on the same side of nasal septum deviation, increasing with the degree of deviation increases (P < 0.001). Nasal septum deviation affects the development of sinonasal structures by affecting the pneumatization. Preoperative PNS-CT evaluation is important in order to be aware of the situations that we may encounter during surgery and to provide adequate treatment.