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January 2015

Original Article

Relationship Between Mean Platelet Volume and Syncope

Metin Ozkan1, Cemil Kavalci2, Fevzi Yilmaz1, M. Evvah Karakılıç1, Bedriye Müge Sönmez1, Turan Turhan3, Cihat Yel1, Ali Demir4

1 Department of Emergency, Numune Training and Research Hospital, 2 Department of Emergency, Faculty of Medicine, Baskent University, 3 Department of Biochemistry, Numune Training and Research Hospital, 4 Department of Emergency, Yenimahalle State Hospital, Ankara, Turkey

DOI: 10.4328/ECAM.46


Aim: Syncope is 1-2% of emergency department incomes and 6% of hospitalizations. Despite the fact that all examinations are done, stil 40% of syncope’s etiology is unclear. In our study, our aim was to investigate the relationship between the mean platelet volume and the diagnosis of syncope to clearify the approach of syncope in the future. Material and Method: The survey has been conducted and the data were collected retrospectively between October 1, 2011 and June 30, 2012 within the 591 syncope patients and 523 trauma patients as control group. Demographics and clinics data of Syncope and control groups were compared. P<0.05 value was accepted statistically significant. Results: When syncope and control groups were compared, mean platelet volume values were significantly higher in syncope group (p<0.05). Platelet and hematocrit values were not significantly difference between the patients and control group (p>0.05). Discussion: MPV is a parameter for the diagnosis of syncope.


Syncope; Emergency; MPV

Corresponding Author: Cemil Kavalci, Baskent University Faculty of Medicine, Emergency Department, Ankara, Turkey. T.: +90 3122126868 E-Mail: cemkavalci@yahoo.com

How to Cite: Metin Ozkan, Cemil Kavalci, Fevzi Yilmaz, M. Evvah Karakılıç, Bedriye Müge Sönmez, Turan Turhan, Cihat Yel, Ali Demir. Relationship Between Mean Platelet Volume and Syncope. Eu Clin Anal Med 2015;3(1): 1-4

Analysis of Prognostic Factors in Patients Undergoing Curative Surgery for Esophageal Carcinoma


Tevfik Kaplan1 , Nesimi Günal2 , Gültekin Gulbahar3 , Özgür Karakurt3 , Rasih Yazkan4 , Bulent Koçer3 , Serdar Han1 , Erkan Yıldırım5 , Unal Sakıncı3

1 Department of Thoracic Surgery, Faculty of Medicine, Ufuk University, Ankara, 2 Department of Thoracic Surgery, Faculty of Medicine, Kirikkale University, Kirikkale, 3 Department of Thoracic Surgery, Ankara Numune Teaching and Research Hospital, Ankara, 4 Department of Thoracic Surgery, Faculty of Medicine, Suleyman Demirel University, Isparta, 5 Department of Thoracic Surgery, Faculty of Medicine, Bilim University, Istanbul, Turkey

DOI: 10.4328/ECAM.48


Aim: We analyzed the clinicopathological data of patients with esophageal carcinoma who underwent curative surgery and investigated the predictive prognostic factors affecting mortality and survival. Material and Method: A retrospective analysis of patients with esophageal cancer who underwent curative esophagectomy between 2001 and 2011 was performed and the clinicopathological factors were analyzed. Results: We identified a total of 119 patients who underwent radical esophagectomy. The mean age was 65.2 ± 12.87 years. The 30-day postoperative mortality was 5.0%. Multivariate analysis demonstrated that long-lasting symptoms (P = 0.0001), increased serum calcium levels (P = 0.019), high pT, high pN status, high stage, high grade (P = 0.001, P = 0.018, P = 0.003, P = 0.012) and low FEV1 levels (P < 0.0001) were associated with increased mortality. The 1, 3 and 5 year survival rates were 68.2%, 36.2% and 20.1% respectively and mean follow-up period is 22.46 ± 1.79 months. Based on multivariate analysis, pT, pN, stage, grade (P = 0.012, P < 0.0001, P < 0.0001, P < 0.0001) and tumor length (P = 0.018) were independent factors for the prognosis. Discussion: Our results showed that the tumor length greater than 4 cm were associated with poor prognosis. We suggest that for a better selection of patients for an appropriate treatment tumor length should be included in TNM staging of esophageal carcinoma.


Esophageal Cancer; Mortality; Survival; Tumor Length

Corresponding Author: Tevfik Kaplan, Department of Thoracic Surgery, Ufuk University School of Medicine, 06520, Balgat, Ankara, Türkiye. T.: +90 3122044201 F.: +90 3122872390 E-Mail: tevfikkaplan@yahoo.com

How to Cite: Tevfik Kaplan, Nesimi Günal, Gültekin Gulbahar, Özgür Karakurt, Rasih Yazkan, Bulent Koçer, Serdar Han, Erkan Yıldırım, Unal Sakıncı. Analysis of Prognostic Factors in Patients Undergoing Curative Surgery for Esophageal Carcinoma. Eu Clin Anal Med 2015;3(1): 5-9

Case Report

Intrathoracic Osteolipoma

Leyla Nesrin Acar1, Erkmen Gülhan1, Pınar Bıçakçıoğlu1, Arzu Ertürk2, Funda Demirağ3

1 Department of Thoracic Surgery, 2 Department of Chest Diseases, 3 Department of Pathology, Atatürk Chest Diseases and Thoracic Surgery Research and Training Hospital, Ankara, Turkey

DOI: 10.4328/ECAM.43


Lipomas are the most common benign soft tissue tumors. Although lipomas often appear in subcutaneous locations, they may develop in any part of the body. Intrathoracic osteolipomas and the malignant degeneration of osteolipomas are very rare. However, surgical resection is required for the diagnosis and treatment of lipomas. Complete resection is the only definitive treatment and the only way of preventing relapse. In this paper, we present a literature review and a rare intrathoracic osteolipoma case for which we performed a surgical resection.


Osteolipoma; Intrathoracic Lipoma; Surgery

Corresponding Author: Leyla Nesrin Acar, Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Research and Training Hospital, 06280, Keciören, Ankara, Turkey. T.: +90 3125677000/7256 F.: +90 3123552135 E-Mail: acar8106@gmail.com

How to Cite: Leyla Nesrin Acar, Erkmen Gulhan, Pinar Bicakcioglu, Arzu Erturk, Funda Demirag . Intrathoracic osteolipoma. Eu Clin Anal Med 2015;3(1): 10-2.

Original Image

The Value of Lateral Decubitis Abdominal X-Ray in the Diagnosis of Perforation

Afsin Emre Kayipmaz, Cemil Kavalci, Dilek Suveren

Department of Emergency, Faculty of Medicine, Baskent University, Ankara, Turkey


A 72-year-old male home-care patient was admitted to our emergency department with complaint of decreased oral intake. His past history was notable for an unnamed muscle disorder, glaucoma and panic attack. Physical examination showed descreased bowel sounds and abdominal distention. The laboratory investigations showed an increased White Blood Cell count (32920 cells/ µl) and C-Reactive Protein level (270 mg/L). A lateral decubitis abdominal x-ray was performed due to immobilization of patient. A free air was observed in the x-ray (figure 1). Then, contrast-enhanced computed tomography was carried out and showed sigmoid colon perforation. In the study of Bansel et al. X-ray demonstrated pneumoperitoneum in 89.2% of 1723 patients and they said: ”Plain radiography is one of the first-line investigation technique, especially in developing countries where limited availability of resources” [1]. Moriwaki et al. determined bedside ultrasonography had sensitivity of 85% and a specificity of 100% in patients with serious abdominal pain and intraperitoneal free fluid [2]. Chiu et al. showed while erect chest radiograph had a sensitivity of 85.1%, left decubitus abdominal plain film had 98% in the diagnosis of free fluid [3]. Taking plain radiographs in the lateral decubitus position remains as one of the first-line diagnostic tests for immobile patients in emergency department.


1. Bansal J, Jenaw RK, Rao J, Kankaria J, Agrawal NN. Effectiveness of plain radiography in diagnosing hollow viscus perforation: study of 1,723 patients of perforation peritonitis. Emerg Radiol 2012; 19(2): 115-9. 2. Moriwaki Y, Sugiyama M, Toyoda H, Kosuge T, Arata S, Iwashita M, Tahara Y, Suzuki N. Ultrasonography for the diagnosis of intraperitoneal free air in chest-abdominal pelvic blunt trauma and criticalacute abdominal pain. Arch Surg 2009;144(2):137-41. 3. Chiu YH, Chen JD, Tiu CM, Chou YH, Yen DH, Huang CI, Chang CY. Reappraisal of radiographic signs of pneumoperitoneum at emergency department. Am J Emerg Med 2009; 27(3): 320-7.

Corresponding Author: Afsn Emre Kayipmaz, Baskent University, Faculty of Medicine, Emergency Department, Ankara, Turkey. T.: +90 3122126868 (6706) E-Mail: aekayipmaz@hotmail.com

How to Cite: Afsin Emre Kayipmaz, Cemil Kavalci, Dilek Suveren Artuk. The value of lateral decubitis abdominal x-ray in the diagnosis of perforation. Eu Clin Anal Med 2015;3(1): DOI:10.4328/ECAM.45.

Battery Swallowing: Original image

Kayipmaz Afşin Emre, Taneri Birand, Kavalci Cemil

Department of Emergency, Faculty of Medicine, Baskent University, Ankara, Turkey


A 5-year-old male patient presented to our emergency department complaint of accidently swallowing a battery one hours ago. In his medical history there was no any illness and drug use. He has a regular heart rate of 100 bpm, his blood pressure was 100/75 mmHg and respiration rate was 16 breathes per minute. On physical examination, there was no symptom. Battery was seen in abdomen X-ray (figure 1). Patients were included in the polyclinic follow-up. Next day the abdomen xray showed that battery was moved forwards (figure 2). Foreign bodyswallowing occurs usuallly in children and in specific high-risk groups of adults [1,2]. In the literature, there was seen ingestion of coin, battery, needle, bottle, glass etc. foreign bodies are frequently encountered in the gastrointestinal system [2-4]. While sharp objects and batteries are surgically removed, blunt objects like coins are expected to be discarded with defecation [5]. We wait thrown to battery with defecation.


1.Ozsarac M, Demircan A, Sener S. Glass Foreign Body in Soft Tissue: Possibility Of High Morbidity Due to Delayed Migration. J Emerg Med 2011;41(6):e125-8. 2. Zippi M, Febbraro I, De Felici I, Mattei E, Pica R, Traversa G, et al. Foreign bodies in the upper gastrointestinal tract. (Personal experience). Clin Ter 2007;158(4):291-5. 3. Sayhan MB, Gokdemir MT, Kavalci C. An unusual foreign body: A pendant. J Pak Med Assoc 2010;60(7):600. 4.Çobanoğlu U, Aşker S, Sayır F. Esophageal Foreign Bodies. JCAM doi: 10.4328/JCAM.2538 5. Telford JJ. Management of ingested foreign bodies. Can J Gastroenterol 2005;19(10):599-601

Corresponding Author: Kayipmaz Afşin Emre, Baskent University Faculty of Medicine, Emergency Department, Ankara, Turkey. T.: +90 312 212 6868 E-Mail: aekayipmaz@yahoo.com

How to Cite: Afsin Emre Kayipmaz, Birand Taneri, Cemil Kavalci. Battery swallowing: original image. Eu Clin Anal Med 2015;3(1): DOI:10.4328/ECAM.42.