Rıfat Peksöz

and 3 more

Objective: Abdominal hernia repair is a common surgery, with 15% of patients presenting as incarcerated hernias. In these cases, early diagnosis of intestinal ischemia and necrosis is crucial for mortality and morbidity. Biomarkers that can predict ischemia or necrosis status are vital. In this study, we aimed to reveal the roles of basic blood parameters in determining ischemia or necrosis status. Methods: The patients were divided into three groups as normal bowels (Group I: 24 patients), intestinal ischemia without necrosis (Group II: 31 patients), and Group III who underwent bowel resection because of necrosis (10 patients). Patients’ demographic characteristics and blood parameters were retrospectively analyzed. Results: 65 patients operated for incarcerated abdominal hernias. There was no significant difference between the groups in terms of age, sex, comorbidity, or complications (p>0.05). The highest length of stay was observed in Group III (p<0.001). There were significant differences between the groups in terms of serum white blood cell (WBC), neutrophil, lymphocyte (LYM), neutrophil-lymphocyte ratio (NLR), urea, creatinine, total bilirubin, indirect bilirubin, lipase, C-reactive protein (CRP), and CRP/LYM levels (p<0.05). Conclusion: Preoperative WBC, neutrophil, NLR, urea, creatinine, and total bilirubin levels can be used to predict the onset of intestinal ischemia. Serum creatinine, total bilirubin, indirect bilirubin, phosphorus, lactate dehydrogenase (LDH), and lipase levels can be used for bowel resection.

Serkan KARAISLI

and 1 more

Background: Small-bowel obstruction (SBO) is a common emergency worldwide and adhesions are the main cause. Oleaster-leafed pear (Pyrus elaeagnifolia Pall.) is an endemic wild pear species in Anatolia. The wild pear fruits are consumed for the treatment of diarrhea in traditional medicine in Turkey. Here, we aimed to describe SBO caused by excessive consumption of wild pear and compare clinical features of it with those in adhesive SBO. Methods: The medical records of patients who were followed with a diagnosis of SBO between May 2018 and September 2019 were reviewed. Patients with wild pear-related SBO (Group 1) and patients with adhesive SBO (Group 2) were included in the study. Patient characteristics, blood parameters and clinical features were compared. Results: A total of 74 patients including 16 in Group 1 and 58 in group 2 were included. Amount of wild pear consumed was median 600 grammes (range, 450-800 gr). The median age in Group 1 and Group 2 was 55 and 60.5, respectively. History of previous SBO was more common in Group 2 (p=0.032). Increased levels of WBC, CRP and BUN were significantly more frequent in Group 2 (all p<0.05). Group 1 was associated with a shorter duration of complaints and faster recovery (all p<0.05). Surgical intervention was required for six patients (10.3%) in only Group 2. Conclusion: The potential adverse effects of over-consumed traditional medicines should be kept in mind. Questioning the last food consumed before the complaints start may be a clue for food-induced SBO.