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The Importance of Imaging and Fine Needle Aspiration Biopsy in Primary Benign Parapharyngeal Space Tumors
(2021) Aslan Felek, Sevim; Kaptan, Zeynep; Uğurlu, Burak Numan; Yiğit, Hasan; Ünverdi, Hatice; Demirci, Münir
Objective: The purpose of this study is the comparison of the radiological pre-diagnosis with the cytopathological results acquired from fine needle aspiration biopsy (FNAB) and the post-operative final histopathological results in operated patients diagnosed to have primary benign parapharyngeal space (PPS) tumors. Material and Methods: In our study, 20 patients who were considered to be benign with preoperative imaging and FNAB between 2011 and 2017 were observed retrospectively. Patients suspected of malignancy with preoperative imaging or FNAB were excluded from the study. Results: From a total of 20 patients, 11 were female while 9 were male, and the mean age was 54 (21-78). In post-styloid region (n=10), the pre-operative radiological diagnosis was reported as paraganglioma (n=6), and peripheral nerve sheath tumors (n=4). In pre-styloid region (n=10), the preoperative radiological diagnosis was reported as deep lobe parotid tumor (warthin and pleomorphic adenoma) (n=6), lymphadenitis (n=1), minor salivary gland cyst (n=1), lipoma (n=1) and branchial cleft cyst (n=1). Compared to specimen results, preoperative imaging results of 20 patients were consistent with specimen in 18 patients, while specimen results were reported as malignant in 2 patients, although imaging was benign. FNAB was performed in 13 patients without vascular tumor suspicion, and results consistent with specimen results were obtained in 11 patients. Although FNAB results were reported as benign in 2 patients, the specimen result was reported as malignant. Conclusion: In our study, we found that, even if imaging and FNAB in PPS benign masses reported largely accurate results, it is rarely not able to rule out malignancy. These possibilities should be kept in mind when approaching the benign tumors of the parapharyngeal region.
Ultrasonographic guidance should be the first option during central vein catheterization
(2019) Diken, Adem İlkay; Yalçınkaya, Adnan; Özyalçın, Sertan; Kayır, Selçuk; Türkmen, Ufuk
We read the article with great interest titled “The success rate and safety of internal jugular vein catheterization under ultrasound guidance in infants undergoing congenital heart surgery”.
RE: The effect of atropine in preventing catheter-related pain and discomfort in patients undergoing transurethral resection due to bladder tumor: a prospective, randomized, controlled study reply
(Korean Pain Soc, 2020) Şahiner, Yeliz; Yağan, Özgür; Akdağlı Ekici, Arzu; Ekici, Musa; Demir, Emre
We would like to contribute to the recent critique responding to our article titled “The effect of atropine in preventing catheter-related pain and discomfort in patients undergoing transurethral resection due to bladder tumor: a prospective, randomized, controlled study” [1]. First, we also would like to thank our colleagues for their valuable contributions.
Koroner arter hastalığı ve sol plöroperikardiyal agenezi
(Bilimsel Tıp Yayınevi, 2016) Erol, Mehmet Emir; Yalçınkaya, Adnan; Diken, Adem İlkay; Çağlı, Kerim
Altmış üç yaşında erkek hasta üç damar koroner arter hastalığı tanısı ile departmanımıza yatırıldı. Preoperatif değerlendirilmesinde anormal bir bulguya rastlanmamıştır. Yapılan transtorasik ekokardiyografi (TTE)’de sol ventrikül EF’si %52 olarak hesaplanmış, kapak patolojisi ya da intrakardiyak defekt saptanmamıştır. Ayrıca TTE’de perikard hakkında patolojik bir bulgudan bahsedilmemiştir. Hastaya koroner arter baypas greftleme (CABG) operasyonu planlandı. CABG için hastaya genel anestezi altında mediyan sternotomi yapıldı. Sternotomi sonrasında hastanın kalbin sol tarafında perikardın ve akciğer plevrasının olmadığı, sol akciğerin kalp ile arada doku olmadan komşu olduğu fark edildi (Resim 1). Perikard sadece sağ ventrikül, aort ve pulmoner arter üzerinde normal şekilde devamlılık gösteriyordu (Resim 2). Hastaya üç baypas yapıldı. Hastaya perikard rekostrüksiyonu yapılmadı. Postoperatif dönemi sorunsuz geçen hasta postoperatif beşinci günde taburcu edildi.
The effect of red cell distribution width on mortality in partial hip replacement surgery (Authors’ reply) (Yazarın yanıtı)
(2015) Zehir, Sinan
Kırmızı kan hücresi dağılım genişliği tam kan sayımı tahlilinde ana parametrelerden biri ve aneminin ayırıcı tanısında kullanılır. Son zamanlarda çok sayıda araştırmada RDW ile birçok hastalık durumlarının ölüm oranı arasında doğrudan bir ilişki olduğu sonucuna varılmıştır.
Proximal occlusion of a sequential vein graft after 20 years
(2015) Yalçınkaya, Adnan; Diken, Adem İlkay; Erol, Mehmet Emir; Çiçek, Ömer Faruk
A 67-year-old man presented with chest pain of three-month duration that occurred with moderate effort 20 years after coronary artery bypass graft surgery using the left internal mammarian artery (LIMA) to the left anterior descending artery and a sequential saphenous vein graft (SVG) to the diagonal branch and obtuse marginal artery.
Saccular aneurysm of the aortic arch
(2014) Karavelioğlu, Yusuf; Ereren, Emrah; Yalçınkaya, Adnan; Diken, Adem İlkay
A 65 year old woman was admitted to our hospital with dyspne. She had a medical history of hypertension. Her blood presure was 156/107 mmHg under medication. Physical examination and routine blood tests were normal.
Challenges in the diagnosis of renal tuberculosis
(Elsevier (Singapore) Pte Ltd, 2015) Gözdaş, Hasan Tahsin; Çalışkan, Selahattin
[No abstract available]
Guideline and treatment algorithm for burn injuries
(Turkish Association of Trauma and Emergency Surgery, 2015) Yastı, Ahmet Çınar; Şenel, Emrah; Saydam, Mutlu; Özok, Geylani; Çoruh, Atilla; Yorgancı, Kaya
As in many other countries, burn injuries are a challenging healthcare problem in Turkey. Initial management of burn patients is very important for future morbidity and mortality. Therefore, the Turkish Ministry of Health prepared “National Burns Treatment Algorithm” aided by the Scientific Burns Council. The basic aim of this algorithm is to guide physicians in the treatment of burn victims until they reach an experienced burns center. The content of this algorithm is first aid, initial management, resuscitation, and transfer policy. The Council started to work on this algorithm in 2011. Various consultants, including general surgeons, pediatric surgeons, aesthetic, plastic and reconstructive surgeons, anesthesiologists, and intensive care physicians, revised the first draft and it was sent to eight education and research hospitals of the Ministry of Health, four universities, and seven non-governmental organizations. In the last quarter of 2012, the algorithm was finalized and approved by the Scientific Council, after which, it was approved by the Ministry of Health and published. © 2015 TJTES.
Variant case of sturge-weber syndrome
(Türk Nöroloji Derneği, 2018) Eliaçık, Sinan
Dear Editor, A 17-year-old male was admitted to hospital with epileptic seizures. It was learnt that he had seizures since he was aged one year. He had no febrile seizures and his neuromotor development was normal. In his seizures, which lasted less than one minute, his eyes and head deviated to the right and sometimes licking and mouth automatisms were added. It was learnt that his number of seizures sometimes increased and seizures evolved to secondary generalized seizures. It was learnt from his family that he had not used valproic acid regularly for the last one year and he could not receive regular examinations because of socio-economic reasons.
Evaluation of short term outcomes of transportal femoral cross pin fixation in anterior cruciate ligament reconstruction
(SAGE Publications Ltd, 2014) Zehir, Sinan; Şahin, Ercan; Çalbıyık, Murat; Kalem, Mahmut; İpek, Deniz; Songür, Murat
Objectives: Many fixation techniques are currently in use for femoral side graft fixation at ACL reconstruction surgery. Short term success following ACL reconstruction highly depends on fixation strength of the graft. In this study we report short term results of anterior cruciate ligament reconstruction using double hamstring tendon autograft using double cross pin for femoral tunnel fixation. Methods: Between years 2009 and 2013, 51 male adult anterior cruciate ligament injury cases treated surgically, in a single center, with at least one year follow up were investigated. Professional athletes, multi-ligamentous instability cases, cases requiring meniscus repair or further treatment for chondral injuries and cases with concomitant medial and lateral meniscus lesions were not included in the study. Femoral tunnel was prepared anatomically through accessory medial portal, opened medially and distally. Reconstruction was performed using double loop hamstring tendon autograft. Femoral side was fixed using double cross pin, whereas tibial side was secured using single biodegradable interference screw and titanium staple. No external immobilization method such as brace was administered. Patients were encouraged to bear weight as tolerated. Standard physiotherapy was instructed to all patients postoperatively. All cases were evaluated clinically at the end of at least one year follow-up. Clinical and functional evaluation consisted of pivot shift and Lysholm, International Knee Documentation Committee (IKDC) scores and Tegner activity evaluation systems. Results: Mean age was 28.4 (18-39) years. Mean time between the injury and reconstruction was 13 (3-21) weeks. Average duration of surgery was 48 (35-70) minutes. No case of graft failure or posterior cortical fracture was encountered. In two cases, infection was treated successfully with local debridement and antibiotics with retention of the graft. At the end of follow-up period, none of the cases demonstrated positive pivot shift test. Pre-operative and follow-up Lysholm scores were 58.3±6.7 and 87.1±5.3 (p<0.001) respectively. Pre-operative IKDC scores were evaluated as C at 37 cases and D at 14, whereas, follow-up IKDC scores were evaluated as A at 42 cases, B at 8 and C at 1 case. Pre-operative and follow-up Tegner scores were 3.7±0.6 and 6.7±0.4 (p<0.001) respectively. Conclusion: Although fixation strength of transcondylar graft fixation techniques has been questioned over loop systems with cortical fixation, it was reported that transcondylar fixation causes less tunnel widening at long term. Our study revealed successful short term results, with femoral tunnel preparation using accessory medial portal and double cross pin femoral fixation, allowing early weight bearing and rehabilitation without graft and fixation failure. © The Author(s) 2014.
Injury of the infrapatellar branch of the saphenous nerve during hamstring graft harvest: Comparison of two different incision
(SAGE Publications Ltd, 2014) Sipahioğlu, Serkan; Zehir, Sinan; Baykara, İslam; Bilge, Ali
Objectives: Sensory disturbance around the surgical incision due to injury of the infrapatellar branch of the saphenous nerve (IPBSN) can be seen in the anterior cruciate ligament (ACL) reconstruction after the operation. In this research, we aimed to compare the incidence, extent of sensory loss, its clinical effect and natural course caused by two different skin incisions used for autogenous hamstring graft harvest during ACL reconstruction. Methods: Seventy eight patients who underwent hamstring graft harvest during ACL reconstruction participated in the study. Among the 78 patients, vertical incision for 36 patients and oblique incision for 42 patients were used for graft harvest. The area of the sensory loss was documented at 6 weeks, 3 months and 6 months follow-ups. A blunt pin was used for pin prick examination starting from proximal end of the incision and the patient was asked to note the point of change in sensation from normal to abnormal. The abnormal points were joined and digital photographs of hypesthesia were taken and analysed by computer for area detection. The length of incision and subjective complain of sensory loss were also noted. Results: The patients’ age and incision length between the two groups had no significant difference. At 6 weeks, vertical incision was associated with persistent sensory loss in 77% (28/36) cases which was significantly higher when compared to the oblique incision (19/42). The measured area of hypesthesia was significantly higher in vertical incision (42.4±22.3 cm2) than that in oblique incision (9.3±15.3 cm2) at 6 weeks. On further follow-ups at 3 and 6 months, the area of hypesthesia gradually shrunk in size. The recovery pattern was from distal to proximal in direction. Also, subjective cutaneous anaesthesia was higher in vertical incision (15/36, 41%) than oblique incision (6/42, 14%) at 6 months. Conclusion: Injury to the IPBSN can be seen during hamstring graft harvest. Vertical incision has maximum incidence of IPBSN injury. Oblique incision with less risk of nerve damage may be better for graft harvesting in ACL reconstruction. Area of hypesthesia gradually reduces with time and even recovers totally. Sensory loss does not impair normal daily activities in most of these patients. As a possible complication, nerve injury and its benign prognosis should be explained to the patient before surgery. © The Author(s) 2014.
Opening wedge high tibial osteotomy using tricalcium phosphate wedge: Preliminary results
(SAGE Publications Ltd, 2014) Zehir, Sinan; Çalbıyık, Murat; Şahin, Ercan; Kalem, Mahmut; Songür, Murat; İpek, Deniz
Objectives: High tibial osteotomy is a standard procedure indicated for early medial sided osteoarthritis in varus knees. In this study, we present the early results of high tibial open wedge osteotomy cases using beta-tricalcium phosphate as a graft substitute and Otis-c plate. Methods: Between years 2010 and 2013, 47 cases of (34F, 13 M) medial compartmental gonarthrosis with genu varum deformity treated with high tibial osteotomy, were evaluated with at least one year follow-up, preoperatively both clinically and radiologically. Clinical evaluation involved functional assessment and pain evaluation using Lysholm and visual analog scale (VAS) scores, including knee range-of-motion. Radiological evaluation included medial joint space measurements on weight bearing knee radiographs with measurements of varus angle and posterior tibial slope. Surgical procedure included standard arthroscopy followed by medial sided opening wedge osteotomy with correction of the varus deformity using ?- tricalcium phosphate graft substitute and fixation of the osteotomy site using Otis-C plate and locking screws. All patients were evaluated at the end of minimum one-year follow-up period. Results: Mean age of the patients was 56,7 (50- 65) years and mean follow-up period was 24,5 (12- 44) months. Mean duration of surgery was 47,4±10.2 minutes. No case of nonunion, delayed union, neurovascular injury or iatrogenic fracture was encountered. Two cases developed deep vein thrombosis and one case developed superficial wound infection managed successfully by local debridement with retention of implants and antibiotics. Mean duration of union was 13,4±2.7 weeks. Mean preoperative and follow-up range-of-motion were measured as 131±8.9 and 129±9.1 respectively with no statistical difference. Preoperative and follow-up VAS scores showed significant difference as 7.6±1.76 and 2.3±1.08 respectively (p=0.001). Also Lysholm scores improved significantly at the end of the follow-up period (43.23±4.01 vs. 76.3±3.7 p<0,001). Radiological evaluation revealed mean correction angle of 10.84±2.70 degrees at follow-up. Mean posterior tibial slope was measured relatively unchanged (8.6±1.70° degrees preoperatively versus 8.2±2.30° follow-up). Medial joint space width measurements showed a significant increase (pre-op 3.7±1.6 mm. versus 4.6±1.32 mm. at the follow-up (p<0.001)). Conclusion: Medial opening wedge osteotomy for treatment of early medial compartment gonarthrosis in varus knees is still a valuable option. Our short term preliminary results using beta-tricalcium phosphate wedge graft substitute and Otis-c plate-screw osteosynthesis revealed satisfactory short term clinical and radiological results with acceptable complication rates. © The Author(s) 2014.
Subacromial tenoxicam injection in the treatment of impingement syndrome
(SAGE Publications Ltd, 2014) Çift, Hakan; Ünlü Özkan, Feyza; Şeker, Ali; İşyar, Mehmet; Ceyhan, Erman; Mahiroğulları, Mahir
Objectives: As subacromial bursa injection is widely used for pain relief and functional improvements in patients with periarticular shoulder disorder, we aimed to present our results of subacromial tenoxicam injection in the treatment of impingement syndrome. Methods: Patients presented to the Department of Orthopaedics and Traumatology, Istanbul Medipol University with the primary complaints of shoulder pain from January 2012 to June 2013 were selected. Those who met the following inclusion criteria were finally considered: 1) who had a clinical sign of a painful arc and positive in Hawkins test and/or Neer impingement sign; 2) who had a precise rotator cuff injury including partial cuff tears, or subacromial bursitis detected during ultrasonography or MRI. The exclusion criteria were as follows: 1) who underwent shoulder surgery; 2) who had full thickness rotator cuff rupture; 3) who had hemiplegic shoulder pain; and 4) who displayed any suspected fracture on X-ray or had a recent shoulder trauma; 5) who showed limited active ROM and stiffness due to adhesive capsulitis. Thirty one shoulders out of thirty patients were treated with subacromial tenoxicam injection. Ten of them were left shoulders. Fifteen of the patients were women.. Patients had a mean age of 51.6 (30-73). Patients were evaluated 4 times. Before the first injection, 1 week after the first injection, 2 weeks after the second injection and 3 weeks after the third injection. In every injection 20 mg tenoxicam was performed. Results: In order to relieve the pain; two patients were given only one injection, thirteen patients were given two injections and “3 injections protocol” were done to fifteen patients. The mean pre- and posttreatment VAS scores were 7.9 (between, 7-9) and 2.7 (between, 2-4) points respectively. The average pre and posttreatment DASH scores were 59.41 (between, 45-80) and 14 (between, 8.3-25.8) points respectively. The mean pre and posttreatment range of motion were 106.1 (between, 80-130 and 170i7 (between, 140-180) degrees respectively. Differences between all pre- and post-treatment parameters were statistically significant (p<0.05). Conclusion: Tenoxicam is a cheap NSAID and an analgesic of the oxicam class, is closely related to proxicam, and has a long half-life, which enables it to be administrated once daily. It also readily penetrates the synovial fluid and intraarticular intravenous administration provides superior postoperative analgesic benefits. Tenoxicam also has the ability to prevent adhesion formation. Besides it has no detrimental effect on cartilage structure. It can be safely administrated intraarticularly. Given the positive therapeutic effects of subacromial tenoxicam injection, it can be used as an alternative treatment option. © The Author(s) 2014.
Arthroscopic lateral retinacular ligament release in patellofemoral pain syndrome: Comparing the techniques of electrocautery or scissors
(SAGE Publications Ltd, 2014) Başaran, Teoman; Atay, Ahmet Özgür; Doral, Mahmut Nedim; Başaran, Pınar Özge
Objectives: Arthroscopic lateral retinacular release in patellofemoral pain syndrome Comparing the amount of hemorrhage and times of release between electrocautery and a new techniques for arthroscopic lateral release with scissors Methods: 77 patients included in this prospective randomized controlled study. Inclusion Criteria: 1. Over the age of fourteen and have anterior knee pain syndrome 2. Tightness in lateral part of knee 3. Despite receiving conservative treatment for 6 months, patients who have anterior knee pain complaints Exclusion Criteria: 1. Diseases that prolong bleeding time 2. Drugs that prolong bleeding time 3. Abnormal APTT-INR levels 4. Patients underwent anterior cruciate reconstruction surgery 5. Patients underwent microfracture surgery 6. Patients underwent meniscus repair surgery 7. Patients underwent synovectomy -- Due to inflammatory diseases and synovial chondromatosis is excluded from the study. In this study 77 (25M 52W med age 50,14 ± 14,17) patients divided into three groups which was similar in age and sex. All patients underwent standard arthroscopic surgery for patellofemoral knee sydrome and meniscal debridement 1. Group 1 (Control) (n:10) LRL was preserved 2. Group 2 (Scissors) (n:33) LRL was released with Scissors 3. Group 3 (Electrocautery) (n:34) LRL was released with Electrocautery Results: There was no difference between the groups in terms of socio-demographic characteristics. All lateral ligaments releases were performed under tourniquet. The release is not considered to be complete unless the patella can be stood on its medial edge without difficulty. In all patients, surgery duration was recorded. To calculate the amount of bleeding the blood in the drainage tube was recorded for 24 hours after surgery. For 67 patients based on clinical examination at surgery and in the immediate postoperative period, all releases were felt to be adequate. For all groups total bleeding at 24 h postoperatively is the statistically same (p:0.850). In first 8 hours the amount of bleeding is more in scissors group (p:0.002). Lateral release time is longer in electrocautery group (380 seconds) than in scissors group (24 seconds). In release with electrocautery sometimes we used additional techniques scissors and scalpel for enough release. There was no difference between groups in terms of complications such as deep vein thrombosis, hemarthrosis or severe complications. Conclusion: In this study the amount of bleeding was the same in the groups but surgery duration was longer in electrocautery group. Our new technique for intraarticular arthroscopy guided lateral retinacular release uses with scissors which is simple, effective, rapid, and have resulted a few surgical complications such as superficial skin infection which responds oral antibiotics. Electrocautery is difficult and needs experience. © The Author(s) 2014.
Posterior cruciate ligament reconstruction using single-bundle achilles allograft with open tibial inlay fixation
(SAGE Publications Ltd, 2014) Zehir, Sinan; Elmalı, Nurzat; Çalbıyık, Murat; Taşdemir, Zeki; Sağlam, Fevzi
Objectives: PCL reconstruction research has shown that the tibial inlay and transtibial tunnel procedures offer similar biomechanical results. The purpose of this study was to evaluate the early results of PCL reconstruction using a single-bundle Achilles allograft and tibial inlay fixation. Methods: We retrospectively studied 14 patients who had undergone PCL reconstruction using the direct tibial inlay fixation technique from 2009 to 2013, with a mean follow-up of 13.4 months. (6-28 months). The patients were 11males and 3 females with an average age of 29.2 years (17-41 years). Ipsilateral femoral shaft fractures were determined in 2 cases, ipsilateral trochanteric fracture in 1 case and popliteal artery injury in 1 case. Surgery was performed within 2-4 weeks. Spanning-joint external fixation was applied to 2 patients because of gross instability with failure to maintain reduction in a brace. Combined reconstructions involving the posterolateral corner (9/14), anterior cruciate ligament (ACL (11/14)), or medial collateral ligament (MCL (1/14)) were performed. All PCL reconstructions were performed with Achilles allograft. In 1 case with arterial injury, the repair was made by a cardiovascular surgeon. In 2 case, deep infection developed, which was controlled with debridement and antibiotic treatment. Superficial peroneal nerve injury in 1 case was treated with tenolysis in the 6th month, then partial healing was seen at 18 months. In all patients, the preoperative posterior drawer (PD) examination was positive. All patients were evaluated with preoperative and postoperative examination and x-rays. The International Knee Documentation Committee (IKDC) evaluation was applied to all patients at the final follow-up. Results: Postoperative PD examination demonstrated the following: 0 (normal) in 4 patients, 1+ in 7 patients, and 2+ in 3 patients, compared to the preoperative PD of 3+ or greater in all patients. Preoperative IKDC objective evaluation rated all knees as severely abnormal based on instability. The final follow-up objective IKDC evaluation distribution was as follows: A, 4 knees; B, 6 knees; C, 3 knees and D, 1 knee, compared to D in all 14 knees preoperatively. The average final follow-up IKDC subjective score was 74.1 (20-100). Conclusion: Despite transtibial PCL reconstruction being advocated by several authors, it has technical difficulties of the arthroscopic approach to the posterior compartment of the knee. In the open inlay technique, posterior arthrotomy allows accurate placement of the tibial PCL insertion, avoiding the killer curve and more closely duplicating the normal PCL anatomy. Based on our initial experience with this technique at early follow-up, we continue to use the tibial inlay technique as our preferred technique for isolated or combined reconstruction of the PCL. © The Author(s) 2014.
Is acquired arterial-venous fistula related to Kaposi sarcoma?
(Elsevier Espana S.L., 2017) Eser, Barış; Yayar, Özlem; Doğan, İbrahim; Baş, Yılmaz
Kaposi's sarcoma (KS) is a rare inflammatory neoplasia originating from angiogenic vascular endothelial cells.1 Human herpes virus-8 (HHV-8) is considered as a possible cause. KS is often observed in immunocompromised patients such as organ transplant or acquired immunodeficiency syndromes.2 However, although not typical immunosuppression occurs in uraemic patients, various immunologic abnormalities occur.3
The core of the matter: Using pathology instead of ultrasound to measure prostate volume
(Canadian Medical Association, 2014) Çalışkan, Selahattin
Read the article by Sfoungaristos and colleagues1 with great interest. The authors reported that prostate-specific antigen (PSA) density represents a strong predictor for Gleason score upgrade after radical prostatectomy. I have some points of concern with this study.
Choosing the best surgical technique in prostate cancer: It depends on the surgeon
(Canadian Medical Association, 2014) Çalışkan, Selahattin
Read the article by Gagnon and colleagues1 with great interest. Some points of this study are controversial. Firstly, the groups are not homogenous for comparision of open and robotic assited prostatectomy. While 43% of the patients were low risk in the robotic group, only 23% of the patients were low risk in the open group and there were significantly more patients in the high-intermediate and high-risk open group. According to the biopsy results, Gleason score 6 was significantly more and 8 was significantly lower in the robotic group.
Idiopathic varicosity of the abdominal wall
(Journal of Clinical and Analytical Medicine, 2015) Diken, Adem İlkay; Yalçınkaya, Adnan; Kekilli, Murat
Sıklıkla inferior vena kavanın patolojilerine eşlik eden abdominal kollateral venöz yapılara klinikte sıklıkla rastlanmaktadır. Olgumuz olan 73 yaşında bayan hasta genel durum bozukluğu nedeniyle hastaneye başvurdu...

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