This study aimed to analyze the effects of quercitrin, which has anti-inflammatory properties, on bacterial translocation in inflammatory bowel diseases by using an experimental colitis model. Forty male Wistar-Albino rats were used in the study. Rats were divided into 4 groups (control, colitis, treatment 1 and 2 groups). The rats in the control group were given normal drinking water. In the colitis group, colitis was induced by 5% DSS in drinking water. The control and colitis groups underwent operation on Day 7. In the 2 treatment groups, 5% DSS was added to drinking water for the first 7 days and the groups were treated with quercitrin at the doses of 1 and 5 mg/kg/day for the following 10 days. Treatment groups operated on Day 18. Blood samples were taken for blood culture and left colectomy was performed. The inflammation in the colon was macroscopically and microscopically evaluated and graded. Tissue samples were taken (liver, spleen and mesenteric lymph nodes (MLN)) for tissue culturing in order to assess bacterial translocation. Tissue myeloperoxidase (MPO), serum tumor necrosis factor-alpha (TNF-α) and plasma endotoxin levels were measured. When the control and colitis groups were compared, observed that colitis was induced by DSS (p < 0.05). When the colitis and treatment groups were compared, it was found that quercitrin had a significant therapeutic effect (p < 0.05). In the experimental colitis model established by using DSS, treatment with quercitrin resulted in a histopathological improvement and reduction in biochemical parameters, inflammation and in bacterial translocation (p < 0.05).

BACKGROUND: In our study, we aimed to compare the complication rates of patients presenting with acute cholecystitis and undergoing surgery at the time of hospitalization (early cholecystectomy) and delayed cholecystectomy and also to examine whether the severity of cholecystitis has an effect on the timing of cholecystectomy. METHODS: The study was planned retrospectively and the approval of the ethics committee of our hospital was obtained. The patient files of the patients who were admitted to our tertiary hospital with acute cholecystitis were accessed through the hospital archive system. The patients were divided into two groups, those who were admitted to the emergency department for acute chole-cystitis and who underwent early cholecystectomy and delayed cholecystectomy. The Tokyo 2018 acute cholecystitis guideline was used to determine the severity of acute cholecystitis. Pre-operative and post-operative data of the patients were examined and their complications were evaluated. RESULTS: The data of 158 patients who met the inclusion criteria were retrospectively analyzed. Compared with delayed chole-cystectomy, complication rates increased in patients who underwent early cholecystectomy (8.1% and 32.2%, respectively, p<0.001). According to the Tokyo 2018 guideline, patients with acute cholecystitis were grouped as Tokyo 1, 2, and 3; and of Tokyo 1 patients, more complications were observed in those who underwent early cholecystectomy (22.6% and 4.2%, respectively, p=0.004). When the complications were examined, it was observed that pulmonary embolism, pneumonia, intra-abdominal abscess development, sepsis, and wound infection were significantly higher in those who were operated early. When the factors affecting complications are examined, having a Tokyo score of 2 and above (OR: 4.161), high creatinine levels (OR: 5.496), and presence of additional disease (OR: 4.238) increase the risk of developing complications. CONCLUSION: More complications occur after cholecystectomy in patients with Tokyo 2 and above, when compared with patients with Tokyo 1. It was observed that more complications developed in patients with Tokyo 1 cholecystitis who were operated in the early period. Further studies are needed to determine the effect of acute cholecystitis severity in determining the timing of cholecystectomy.

Background: Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation: A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions: Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.

Hydatid cyst disease is a zoonotic disease caused by the transmission of Echinococcus granulosus, which is in the cestode class, to humans during the larval period. This disease causes serious problems by affecting public health and national economy as an important parasitic disease, especially in many developing countries. Liver cyst cysts can be complicated according to their diameter and location. Complication rate reaches 60%. The leading complications are bile duct involvement and related complications. Bile duct problems should be solved first in cysts associated with biliary tract. ERCP and endoscopic sphinterotomy can be performed. Here we discussed the treatment and management of a 35-year-old patient with hydatid cyst that opened into the biliary tract with ERCP, who presented to the emergency room with fever and signs of infection. Keywords:endoscopic cyst evacuation, cholangitis, endoscopic retrograde cholangiopancreatography

Background: Triple-negative breast cancer (TNBC) is defined as tumors without estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression. This cancer is associated with higher rates of recurrence risk when compared to other subtypes of breast cancers. In this study, we aimed to explore the basic clinicopathological characteristics, prognosis, and recurrence patterns of TNBC patients. Methods: In the current study, forty-five TNBC female patients operated on for breast cancer in the General Surgery Clinic of Kayseri City Training and Research Hospital between 2016 and 2021 were included and retrospectively evaluated. Results: The percentage of TNBC was 12% of the 502 breast cancer patients who could access all three pieces of receptor information. The mean age of the patients was 58.9±15.2 years (27-90), and the mean BMI was 30.4±5.17 (21.5-40.6). It was observed that the most common histological subtype was invasive ductal carcinoma, and at the time of diagnosis, 11 patients were stage 1 (24.4%), 31 patients were stage 2 (68.8%), 2 patients were stage 3 (4.4%), and 1 patient was stage 4 (2.2%). During the follow-up period, 11 patients (24,4%) developed metastasis and the most common sites were the brain and bones. The mean time from diagnosis to metastasis was 20.7±5.75 (12-29) months. The 3-year disease-free survival was 62%, and the 3-year overall survival (OS) was 70%. Conclusion: TNBCs are cancers with varying prevalence, poor prognosis, and limited treatment alternatives. The prevalence of TNBC in our center was found to be lower than the literature rates and consistent with the literature, the lymph node stage was related to poor OS and disease free survival (DFS).