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Air leak syndrome after endoscopic retrograde cholangiopancreatography:A rare and fatal complication

World Journal of Gastroenterology 2015年第15期21卷 4770-4772页

作者： Bulent Yilmaz emir charles roach Seyfettin Koklu Onur Aydin Ozan Unlu Yusuf Alper Kilic Department of Gastroenterology Hacettepe University School of Medicine Department of General Surgery Hacettepe University School of Medicine

Endoscopic retrograde cholangiopancreatography(ERCP) is a state of the art diagnostic and therapeutic procedure for various pancreatic and biliary problems. In spite of the well-established safety of the procedure, there is still a risk of complications such as pancreatitis, cholangitis, bleeding and perforation. Air leak syndrome has rarely been reported in association with ERCP and the optimal management of this serious conditioncan be difficult to establish. Our group successfully managed a case of air leak syndrome following ERCP which was caused by a 3cm Stapfer type I perforation in the posterolateral aspect of the second part of the duodenum and was repaired surgically. Hereby, we describe the presentation and subsequent therapeutic approach.

关键词： Air leak syndrome Endoscopic retrogradecholangiopancreatography Complication Perforation Stapfer

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Lesser celandine(pilewort) induced acute toxic liver injury: The first case report worldwide

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World Journal of Hepatology 2015年第2期7卷 285-288页

作者： Bulent Yilmaz Bar?? Yilmaz Bora Akta? Ozan Unlu emir charles roach Department of Gastroenterology School of Medicine Hacettepe University Department of Gastroenterology Diskapi Yildirim Beyazit Education and Research Hospital

Lesser celandine, also known as Ranunculus ficaria, is a herbaceous perennial plant that commonly utilizes piles and is taken either internally or used *** causality assessment of several reports provided evidence for the existence of Greater Celandine hepatotoxicity. However, there hasn't been any case report published thus far, about lesser celandine induced liver injury. Here, we present a case of 36-year-old woman admitted to the hospital with acute hepatitis and jaundice on her sclera with no history of drug abuse or alcohol consumption. However, the patient had a recent history of lesser celandine extract consumption for hemorrhoids, for about 10 d, prior to the admission. Viral hepatitis, autoimmune hepatitis, and drug induced toxic hepatitis were ruled out by further imaging studies and laboratory analysis. Using the Council for International Organizations of Medical Sciences scale, the type of liver injury was assumed as hepatocellular and was scored as 7 which shows probable causality. Immediate discontinuation of lesser celandine extract resulted in rapid decrease of the elevated enzymes. Herbs have been reported to cause liver injury and therefore should be suspected in the case of acute hepatitis with an unknown etiology. This case is important to be the first to explain hepatotoxicity caused by lesser celandine. Physicians should consider lesser celandine as a causative agent for hepatotoxicity.

关键词： Celandine Acute liver toxicity Hepatitis Pilewort Herb

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Skin cancer in immunosuppressed transplant patients: Vigilance matters

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World Journal of Hepatology 2015年第4期7卷 717-720页

作者： Ozan Unlu emir charles roach Alexis Okoh May Olayan Bulent Yilmaz Didem Uzunaslan Abdullah Shatnawei Department of Pathobiology Cleveland Clinic Cleveland OH 44106 United States Department of Gastroenterology Cleveland Clinic Cleveland OH 44106 United States Department of Endocrine Surgery Cleveland Clinic Cleveland OH 44106 United States Department of Internal Medicine Fairview Hospital Cleveland Clinic Cleveland OH 44106 United States Department of Gastroenterology Hacettepe University School of Medicine 06230 Ankara Turkey

Liver transplantation(LT) is a widely-accepted, definitive therapy of irreversible liver diseases including hepatitis C, alcoholic liver disease and metabolic liver disease. After transplantation, patients generally use a variety of immunosuppressive medications for the rest of their lives to prevent rejection of transplanted liver. Mortality after LT is mainly caused by recurrence of alcoholic hepatitis which is mostly seen in the patients who resume heavy drinking. On the other hand, de-novo malignancies after LT are not seldom. Skin cancers make up 13.5% of the de-novo malignancies seen in these patients. Malignancies tend to affect survival earlier in the course with a 53% risk of death at 5 years after diagnosis. We aimed to report a case who underwent LT secondary to alcoholic liver disease and developed squamous cell carcinoma of the skin eighteen years after transplantation. In summary, transplant recipients are recommended to be educated on self examination for skin cancer; health care providers should be further suspicious during routine dermatological examinations of the transplant patients and biopsies of possible lesions for skin cancer is warranted even many years after transplantation.

关键词： Alcoholic liver disease Skin cancer Nonsquamous Liver transplantation Sirolimus

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