Distinctive features of early onset colorectal cancer. A tertiary hospital experience.

PURPOSE: The colorectal cancer rate under the age 50 years tends to increase, and we aimed to identify the general features of early-onset colorectal cancer and the differences between cancer in younger and older patients. METHODS: The patients with colorectal cancer who underwent surgery between 2016 and 2021 were included. The subjects were divided into two groups by age under and over 50. Demographic, clinical, and pathological features of early- onset colorectal cancer were identified retrospectively. RESULTS: 226 patients were included in our study, and 36 (15.9%) of them were under 50 years old. The mean age of the patients in the early-onset colorectal cancer group was 43.1±5.9 years. Most of the young patients were male, similar to the elderly CRC group. The tumors in the EOCRC group were significantly located left site (86.1% vs. 66.8%) compared to elderly CRC. Most of the tumors were medium or poorly differentiated (80.6%). The numbers of removed lymph nodes were significantly higher in the EOCRC group compared to the elderly CRC group (p<0.05), and postoperative complications were detected lower in EOCRC. CONCLUSIONS: The incidence of EOCRC continues to increase. There is no information about the exact reason for this increase. Comprehensive studies are needed to reveal general characteristics, genetic background, and predisposing factors in cancer formation and figure out the increase in the incidence. KEY WORDS: Colorectal Cancer, Hereditary Colorectal Cancer, Early Onset, Young Adults.

Laboratory markers used in the prediction of perforation in acute appendicitis.

BACKGROUND: In this study, we aimed to evaluate the laboratory markers used in the diagnosis of acute appendicitis (AA) and present the parameters that can be used to predict acute perforated appendicitis. METHODS: The cases who underwent an appendectomy in our clinic between September 2018 and March 2020 were evaluated retrospectively. A total of 530 patients who met the study criteria were included in the study. Patients were divided into two groups according to the presence of an intraoperative perforation. Non-complicated appendicitis patients formed Group-1, and perforated appendicitis patients formed Group-2. The demographic, clinical, and laboratory characteristics of the patients were compared. RESULTS: The number of non-complicated patients in Group 1 was 443, while there were 87 (16.4%) patients in Group 2 who had perforated appendicitis. The mean age of the patients in the normal appendicitis group was 29.90±10.51 years, and the mean age of the patients in the perforated appendicitis group was 36.32±14.58 years. In the normal appendicitis group, 257 (58%) of the patients were male, 186 (42%) were female, while in the perforated appendicitis group, 38 (43.7%) were male, 49 (56.3%) were female. In the perfo-rated appendicitis group, white blood cell (WBC) value was 16.19±4.71 (p<0.001), C-reactive protein (CRP) value was 146.28±113.59 (p<0.001), total bilirubin value was 0.71±0.36 (p<0.001), and neutrophil-lymphocyte ratio (NLR) was 10.85±6.25 (p<0.001). CONCLUSION: We believe that the WBC, total bilirubin, CRP, and NLR values obtained within this study, which is tested in the rapid and easily accessible blood tests in routine examinations that can contribute to the prediction of perforation.

Primary Soft Tissue Hydatid Cysts

Objective: Hydatid cyst disease is a helminthic infection caused by Echinococcus granulous, which is encountered with cysts in many organs, especially the liver and lungs. Soft tissue and intramuscular hydatid cyst are rare even in endemic countries. It is challengig to distinguish subcutaneous and intramuscular hydatid cysts from soft tissue tumors. This study aimed to present the clinical features of primary soft tissue hydatid cyst cases without liver and lung hydatid cyst in the Southeast Anatolian region, where hydatid cyst disease is endemic. Methods: Patients admitted to the Sanliurfa Training and Research Hospital General Surgery and Orthopedics and Traumatology Outpatient Clinic between September 2018 and December 2019 with complaints of pain and/or swelling under the skin and soft tissue were evaluated. After the examinations, the records of the patients who were operated on with a pre-diagnosis of hydatid cyst and whose histopathologic evaluation was reported as a hydatid cyst were reviewed retrospectively. Results: Eight patients were included in the study. The mean age of the patients was 39.75±14.80 years. Lesions were located in neck (12.5%), left thoracic posterior area (25%), gluteus (25%), thigh (12.5%), right upper quadrant of abdominal wall (12.5%), and under the right clavicle (12.5%). When imaging methods were examined, ultrasonography was performed in 7 patients (87.5%), chest computed tomography was performed in 1 patient (12.5%), and magnetic resonance imaging was performed in 2 patients (25%). Conclusion: Diagnosis of hydatid cyst should be considered in the differential diagnosis of soft tissue tumors in countries of endemic regions for hydatid cyst disease such as Southeastern Anatolia Region, Turkey.

A Rare Cause of Acute Appendicitis: Enterobius vermicularis

Acute appendicitis is the most common intra-abdominal pathology that requires emergency surgery in general surgery clinics. The aetiology of acute appendicitis includes both infectious and non-infectious causes. Although parasitic diseases are rare in developed countries, they are more common in developing countries. The association between acute appendicitis and parasitic infections is unclear, and whether parasites are the cause of acute appendicitis is still under debate. In addition, many appendix parasites are encountered after appendectomy. In this study, we report a rare case of acute appendicitis caused by Enterobius vermicularis.

Acute appendicitis in pregnancy.

BACKGROUND: Acute appendicitis is the most common cause of non-obstetric acute abdomen in pregnant women. We examined the patients who were admitted to our emergency department with abdominal pain and diagnosed with acute appendicitis in the light of the literature. METHODS: Seventeen pregnant patients with acute appendicitis who were admitted to the emergency department of Sanliurfa Training and Research Hospital between the years of 2016-2019 were retrospectively analyzed using an electronic recording system. Our patients were evaluated concerning age, gestational week, clinical status, the operation performed, ultrasonography results, pathology results, presence of additional diseases, laboratory results and hospital stay length. RESULTS: The mean age of our patients was 25.5 (18-41) years. Three patients were in the first trimester (17.6%), 11 patients were in the second trimester (64.8%), and three patients were in the third trimester (17.6%) at the time of admission. All of our patients had abdominal pain. Acute appendicitis was detected in 11 patients, while it was not detected in six patients on the USG examination. Two patients having term delivery underwent caesarean section with concurrent appendectomy. The mean hospital stay length was 2.9 (2-5) days. Histopathologically, 13 (86.7%) of our operated patients were diagnosed with appendicitis. No additional problems were observed in the mothers and infants in the postoperative period. CONCLUSION: Acute appendicitis should be considered as a non-obstetric pathology in pregnant patients admitted to the emergency department with abdominal pain. We think that it is important for both maternal and infant health to examine this condition, which shows differences concerning clinical course and physical examination, with a meticulous and multidisciplinary approach.

A Rare Case; Hydatid Cyst of the Breast

Hydatid cyst is a helminthic infection caused by Echinococcus granulosus that we encounter in various organs, especially in the liver and the lungs. Hydatid cyst of the breast is seen very rarely even in regions where the disease is endemic. In this article, we aimed to present a female patient who presented with complaints of a mass in her right breast, was diagnosed as having hydatid cyst as a result of physical examination and radiological imaging methods, and was treated.