Chronic anal fissure (CAF) is a common anorectal disorder associated with severe pain and impaired quality of life. Botulinum toxin A (BTA) injection has emerged as a minimally invasive alternative to lateral internal sphincterotomy; however, data regarding high-dose Dysport® protocols and the clinical relevance of booster injections remain limited. This retrospective single-center observational study was conducted at the General Surgery Clinic of Mersin City Training and Research Hospital. Patients treated for CAF between January 1, 2025, and December 1, 2025, were identified through institutional medical records. Sixty consecutive patients were screened; 10 were excluded because they did not attend follow-up visits, and 50 patients with complete follow-up data were included in the final analysis. All patients received a standardized 75 IU Dysport® injection targeting the internal anal sphincter. At the first follow-up reassessment, a booster injection was considered when either <50% reduction in visual analog scale (VAS) pain score or incomplete fissure healing was present. Pain severity was assessed using the VAS, and fissure healing was evaluated clinically and anoscopically. Outcomes were analyzed. The mean age was 45.8 ± 12.3 years, and 28 patients (56%) were men. The mean VAS pain score decreased from 7.80 ± 0.99 (95% confidence interval [CI]: 7.52–8.08) at baseline to 3.18 ± 0.85 (95% CI: 2.94–3.42) at 1 month and 1.00 ± 0.67 (95% CI: 0.81–1.19) at 3 months. Repeated-measures analysis of variance demonstrated a statistically significant reduction in pain over time ( F [2, 98] = 1512.68, P < .001, partial η ² = 0.969). Healing was observed in 34/50 patients (68.0%, 95% CI: 54.2–79.2) at 1 month and 45/50 patients (90.0%, 95% CI: 78.6–95.7) at 3 months. Booster injections were required in 30/50 patients (60.0%, 95% CI: 46.2–72.4). Recurrence was observed in 5/50 patients (10.0%, 95% CI: 4.3–21.4) during follow-up; these patients subsequently underwent lateral internal sphincterotomy. Transient mild incontinence occurred in 3/50 patients (6.0%, 95% CI: 2.1–16.2) and resolved with conservative management. High-dose Dysport® injection appears to be a safe and effective minimally invasive option for the short-term treatment of CAF. A booster-based stepwise strategy may improve outcomes in selected patients before escalation to surgery.

Ogilvie sendromu organik bir neden olmaksızın kolonun psödoobtrüksiyonu olarak tanımlanan nadir görülen ve tedavi edilmediğinde kolonda iskemi ve perforasyona neden olabilen bir hastalıktır. Bu çalışmada 6 Şubat 2023 tarihinde meydana gelen Kahramanmaraş merkez üssü olan deprem sonrası enkaz altından kurtarılıp hastanemize sevk edilen ve Ogilvie sendromu tanısı konulan hastaların tanı, tedavi ve takip sonuçları değerlendirildi. Deprem bölgesinden Mersin Şehir Eğitim ve Araştırma Hastanesine sevk edilen ve takiplerinde Ogilvie sendromu tanısı konulan 23 hasta retropektif olarak incelendi. Hastalar yaş, cinsiyet, tanı yöntemi, tanı sırasında tam kan sayımı, karaciğer fonksiyon testleri, böbrek fonksiyon testleri, elektrolit düzeyleri, eş zamanlı ek patolojiler, takip süreci ve tedavileri incelendi. Ogilvie sendromu tanısı konulan 23 hastanın 21 tanesi konservatif olarak tedavi edildi. 2 hasta opere edildi. 23 hastanın 12 (%52,17)’si erkek, 11 (%47,83)’i kadındı. Hastaların tanı konulduğunda lökosit ortalaması 14,11 ± 5,41 olup normal değerin üstünde idi. İyonize kalsiyum değeri ortalaması 0,95 ± 0,14 mmol/L olarak tespit edildi ve normal değerin altında idi. Deprem gibi multitravmaya sebep olacak felaketlerde gelişecek fraktürler yanında enkaz altında immobil kalması ve hipotermi maruziyeti Ogilvie sendromu gelişimini kolaylaştırmaktadır. Erken tanı ile konservatif tedavi başarı oranı yüksektir.

Objective: In this study, it was aimed to report the diagnosis, treatment and follow-up results of patients who came to the hospital with complaints of abdominal pain and were diagnosed with Mesenteric Panniculitis (MP) by Abdominal Computed Tomography (ACT). Method: 32 patients diagnosed with MP by ACT were examined retrospectively. The patients' age, gender, admission leukocyte count, CRP values, comorbidities, medications prescribed at discharge, and relapse status were evaluated. Results: Of the 32 patients included in the study, 11 were male (34.4%), 21 were female (65.6%), and they had a mean age of 58.75±12.31 years. The average leukocyte value at first admission was 8240±2530 /mm³, CRP average 24.93±47.39 mg/L, neutrophil percentage was not above 80% in any patient. No patients were hospitalized. Recurrence was occurred in 2 (6.25%) patients (after 6 months and 28 months). No malignancy were during follow-up. Conclusion: MP was diagnosed with ACT. No biopsy was required for diagnosis. Medical treatment was sufficient, no surgical procedure was performed on the patients.

Purpose: The aim of this study was to report the diagnosis, treatment and follow-up results of patients operated with the diagnosis of abdominal wall endometriosis and to investigate its preventability. Materials and Methods: This retrospective study included 33 patients who underwent surgery for abdominal wall endometriosis between 2021 and 2024. Diagnostic processes, treatment and follow-up results of the patients were evaluated. Patients were analyzed in terms of age, during from the last pelvic surgery to endometriosis excision, endometriosis location, endometriosis size, mesh use and recurrence. Results: 33 patients were included in the study and the mean age was 32.91±5.64 years. Endometriosis lesions were detected at the Pfannenstiel incision line in all patients, 32 of them had a history of cesarean section and 1 patient had a history of oophorectomy. The lesions were located in the right corner in 19 patients, in the left corner in 12 patients and in the midline of the incision line in 2 patients. Follow-up period was 47.24±25.07 months and no recurrence or hernia was observed in any of the patients. Conclusion: Abdominal wall endometriosis is a preventable complication, and it is necessary to avoid using the remaining vicryl in the fascia during uterine closure during cesarean section and to prevent intraoperative contamination.