Browsing by Author "Gunes, G."

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Management of Gastric Cancer With Liver Metastasis in a Pregnant Woman
(Yuzuncu Yil Universitesi Tip Fakultesi, 2017) Cim, N.; Karaman, E.; Toktas, O.; Gunes, G.; Elci, E.; Andıc, E.; Yildizhan, R.
The complaints and symptoms of gastric cancer are non-specific and many of these symptoms are frequently masked by factors related to normal pregnancy. A 38 year-old woman with G10P8A1 and at 31 weeks of pregnancy was admitted to a maternity outpatients’ clinic complaining of nausea, vomiting and constipation during the previous 4 days. On palpation a solid lesion of 1.5 cm was palpable in the subxiphoid region. A solid nodule with largest diameter of 5 cm was observed on the liver and suspected to indicate metastasis. Under endoscopic examination, ulcerovegetan, fragile and malignant mass that surrounded and narrowed the gastric antrum and extended to an angular notch was seen. The biopsy that was taken from lesion was revealed to be the result of a malignant epithelial tumor of poorly differentiated adenocarcinoma. During the explorative laparotomy, a tumoral mass with multiple peripheral lymphadenopathies was observed in the posterior gastric antrum, pancreas and colon median entry-invasive artery. Multiple metastases were present in the omentum and liver with a large amount of acid in the abdomen. The patient was considered inoperable due to the gastric cancer being in a terminal stage and adjuvant chemotherapy was planned. Early diagnosis and treatment is important for the prognosis of gastric cancer. The complaints and symptoms of gastric cancer are non-specific and many of these symptoms are similar to those seen during a normal pregnancy. If the same symptoms recur during pregnancy or there is a failure to respond to therapy, the gastrointestinal system should be evaluated endoscopically. © 2017, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Maternal and Fetal Outcomes in Caesarean Sections Repeated Fourth and Fifth Times
(Univ West indies Faculty Medical Sciences, 2021) Karaman, E.; Cim, N.; Cetin, O.; Oruc, H.; Gunes, G.; Yildizhan, R.
Objective: To evaluate the maternal and fetal outcomes associated with caesarean sections (CS) repeated fourth and fifth times. Methods: We performed a retrospective study of 110 patients undergoing CS repeated fourth and fifth times between May 2014 and May 2015. The patients were divided into two groups: group 1 had CS repeated four times (n = 90) and group 2 had CS repeated five times (n = 20), and the maternal and fetal outcomes of the groups were retrospectively evaluated. Results: There were no statistically significant differences between fourth and fifth CS groups with regard to the maternal age, gravida, body mass index, gestational age at birth, birth-weight, and Apgar scores at 5 minutes (p > 0.05). We found no significant differences between the fourth and fifth CS groups in terms of injury to peripheral organs, intra-abdominal adhesions, caesarean hysterectomy, uterine dehiscence or rupture, time during operation, length of hospital stay, and need for blood transfusions (p > 0.05). Compared with the elective cases, perioperative complications and length of hospital stay were significantly higher in the urgent group (p = 0.034 and p = 0.005). Conclusion: Women with CS repeated four or five times have increased risks for perioperative complications. Placenta previa with or without accreta and intra-abdominal adhesions seem to be the major causes of increased morbidity.