May 2015

Review Article

The Azygos Lobe: An Unusual Anatomical Entity with Unusual Cases

Rasih Yazkan1 , Kadir Çeviker2 , Merve Güblü3

¹Department of Thoracic Surgery, ²Department of Cardiovascular Surgery, ³Medical Student, School of Medicine, Süleyman Demirel University, Isparta, Turkey



The knowledge of azygos lobe is important during thoracic surgical procedures. It is a rare anomaly in bronchopulmonary segmentation due to an unusual course of the azygos vein. There is no a pathological sense alone, if combined with other pathological events should be considered. We aimed to emphasize in this article the formation of the azygos lobe with described together pathologies in the literature.


Azygos Lobe; Azygos Vein; Anatomical

Corresponding Author: Rasih Yazkan, Department of Thoracic Surgery, School of Medicine, Süleyman Demirel University, Isparta, Türkiye. GSM: +905054835961 E-Mail:

How to cite this article: Yazkan R, Çeviker K, Güblü M. The Azygos Lobe: An Unusual Anatomical Entity with Unusual Cases. J Ann Eu Med 2015;3(2): 1-3.

Original Image

A Beverage Bottle in the Rectum: Original Image

Mustafa Burak Sayhan1 , Tamer Sagıroglu2 , Serhat Oguz2

1 Acil Tıp AD. 2 Genel Cerrahi AD, Trakya Üniversitesi Tıp Fakültesi, Edirne, Türkiye


A 51-year-old male patient was admitted to ED with the history of introducing a beverage bottle in the rectum and rectal bleeding. He gave history of similar attempts of using similar objects for alleviate constipation in past. Vital signs were within normal range. At physical examination; his abdomen was soft and not rigitidy. On inspection of his anus external piles were seen but no foreign body was evident on digital rectal physical examination. Foreign body was not palpable per abdomen. An anteroposterior radiograph of the pelvis showed the bottle in lower abdomen and pelvis (figure1). Rectal foreign body occurs rarely in emergency department [1,2]. Rectal foreign bodies can either be ingested orally or inserted anally [3] . Males are commonly affected than women [2,4]. The age of patients ranges from 16 to 80 years old [5]. There have been many publications in the literature on different rectal foreign objects [4]. The foreign rectal objects commonly reported were glass or plastic bottles, vibrators, vegetables, wooden and stones in different sizes and shapes [3,4]. The object length varied between 6 and 15 cm, and larger objects were more prone for complications such as mucosal lacerations, abscesses, bowel perforations [2,4,6]. Abdominal, pelvic and rectal pains, tenesmus, rectal bleeding and intestinal obstruction are the common presenting symptoms [1,7].


1.Demir MT, Baydin A, Ersözlü E, Güzel M, Özsoy S. A Rare Reason of Intestinal Obstruction: A Foreign Body in Rectum. J Clin Anal Med 2013; doi:10.4328/JCAM.2233. 2.Akhtar MA, Arora PK. Case of Unusual Foreign Body in the Rectum. Saudi J Gastroenterol 2009;15(2):131-2. 3.Karateke F, Das K, Ozyazici S, Menekse E, Koseoglu Z, Karcioglu O. Anorectal Injuries due to Foreign Bodies: Case Reports and Review of the Management Options. Case Rep Surg 2013; doi:10.1155/2013/809592. 4.Kumar M. Don’t forget your toothbrush! Br Dent J 2001;191(1):27-8. 5.Biriukov IuV, Valkov OV, An VK, Elu B, Dodina AN. Treatment of patients with foreign body rectum. Khirurqiia (Mosk) 2000;7(7):41-3. 6.Subbotin VM, Davidov MI, Abdrashitov RR, Rylov IuL, Sholin NV. Foreign bodies in rectum. Vestn Khir Im I I Grek 2000;159(1):91-5. 7.Albayrak D, İbiş AC, Hatipoğlu AR, İrfanoğlu ME. Rektumda yabancı cisim: üç olgu sunumu. Trakya Univ Tip Fak Derg 2007;24(3):240-3.

Corresponding Author: Mustafa Burak Sayhan, Trakya Üniversitesi Tıp Fakültesi Acil Tıp AD. Edirne, Türkiye. GSM: +905327000095 E-Mail:

How to Cite: Mustafa Burak Sayhan, Tamer Sagıroglu, Serhat Oguz. A beverage bottle in the rectum: original ımage. J Ann Eu Med 2015; DOI:10.4328/AEMED.44

Traumatic Viscerothorax Mimicking Giant Lung Bullae

Muhammet Sayan1 , Ali Çelik2

1 Department of Thoracic Surgery, Aksaray State Hospital, Aksaray, 2 Department of Thoracic Surgery, Gazi University School of Medicine, Ankara, Turkey


A 60 year-old man admitted to emergency clinic with palpitation and dyspnea complaints. His past medical history included car accident and pelvic fracture. Chest x-ray revealed suspicious a large lung bullae and chest computed tomography scan was performed. Totally viscerothorax was detected on chest CT scan(Figure 1). Nasogastric tube was inserted and operating room was prepared but the patient did not accepted the surgical procedure. Traumatic viscerothorax is migration of abdominal viscera especially stomach and colon into the thoracic cavity through the ruptured diaphragm [1]. The clinical and radiological findings of viscerothorax may simulate giant lung bullae.Viscerothorax should be considered in the differantial diagnosis of giant lung bullae. Because management of the both condition is very different. Viscerothorax is a emergency situation and emergency surgery is required following the nasogastric tube placement [2].


1.McCann B, O’Gara A. Tension viscerothorax: an important differential for tension pneumothorax. Emerg Med J 2005;22(3):220-1. 2.Ahn S, Kim W, Sohn CH, Seo DW. Tension viscerothorax after blunt abdominal trauma: a case report and review of the literature. J Emerg Med 2012;43(6):451-3.

How to Cite: Muhammet Sayan, Ali Çelik. Traumatic viscerothorax mimicking giant lung bullae. J Ann Eu Med 2015; DOI:10.4328/AEMED.47

A Case of Posterior Mediastinum Localized Aberrant Thyroid Resected with Collar Incision

Rasih Yazkan¹, Kadir Çeviker², Mahmut Bülbül³

¹Göğüs Cerrahisi ABD, ²Kalp ve Damar Cerrahisi ABD, ³Genel Cerrahi ABD, Tıp Fakültesi, Süleyman Demirel Üniversitesi, Isparta, Türkiye


Corresponding Author: Rasih Yazkan, Göğüs Cerrahisi Anabilim Dalı, Tıp Fakültesi, Süleyman Demirel Üniversitesi, Isparta, Türkiye. GSM: +905054835961 E-Mail:

How to Cite: Rasih Yazkan, Kadir Çeviker, Mahmut Bülbül. A Case of Posterior Mediastinum Localized Aberrant Thyroid Resected with Collar Incision. J Ann Eu Med 2015; DOI: 10.4328/AEMED.52 

Spontaneous Rib Fracture Improved with Callus Following Acute Severe Cough in Pregnancy

Rasih Yazkan

Göğüs Cerrahisi Anabilim Dalı, Tıp Fakültesi, Süleyman Demirel Üniversitesi, Isparta, Türkiye


Fracture healing is an exceptional wound healing response in which the repair process takes place with production of new bone tissue. There are three consecutive and interconnected phases, these phases are inflammatory response, repair and remodeling phases [1]. Coughing is usually self limited and uncomplicated but sometimes can be with complications, one of these complications is rib fracture. Cough induced rib fracture was reported in the literatüre due to the chronic obstructive pulmonary disease [2]. In this report, we present a case of spontaneous rib fracture ımproved wıth callus followıng acute severe cough ın pregnancy. A 42 year old female presented to our department with left posterolateral chest pain, the patients have had acute pneumonia with severe coughing attacks simultaneously chest pain in the eighth month of pregnancy. On physical evaluation, she had seriously tenderness and felt hard callus over her left lower chest wall. There was no history of any thoracic trauma. A chest x-ray revealed but not detected any fracture, a chest computed tomography revealed spontaneous fracture of the left ninth and tenth rib with callus (Figure 1, 2). The Patient was followed with analgesic treatment and not observed any complications in follow up. In conclusion; Cough induced rib fractures is a rare complication during pregnancy. Repetitive mechanical stress due to the high intrathoracic and intraabdominal pressure during pregnancy may be the risk factors due to coughing.

Corresponding Author: Rasih Yazkan, Göğüs Cerrahisi ABD, Tıp Fakültesi, Süleyman Demirel Üniversitesi, Isparta, Türkiye. GSM: +905054835961 E-Mail:

How to Cite: Rasih Yazkan . Spontaneous rib fracture ımproved wıth callus followıng acute severe cough ın pregnancy. J Ann Eu Med 2015; DOI: 10.4328/AEMED.54