[Show abstract][Hide abstract] ABSTRACT: Purpose:
Pulmonary hydatid disease is a significant health problem for children in endemic areas. Pulmonary hydatid disease is more frequent than hepatic hydatid disease in children. The aim of this study was to evaluate the characteristics of pulmonary hydatid disease for children in our province which is endemic for echinococcosis.
Patients and methods:
This study was performed retrospectively between 2007 and 2012 by reviewing the medical records of patients (≤17 years) who were diagnosed with pulmonary hydatid disease. The medical records of these patients were evaluated with respect to the demographic characteristics of patients, management strategies, length of hospital stay, and outcomes.
A total of 120 (52.9% boys and 46.3% girls) patients with the diagnosis of pulmonary hydatid disease were enrolled in this study. The mean age was 10.15 ± 3.93 years. The significant numbers of patients were admitted with a ruptured hydatid disease and managed with lung preservation. The mean follow-up was 11.3 ± 3.8 (3-24) months. Recurrence was detected in three patients during follow-up.
Pulmonary hydatid disease is usually symptomatic. Hydatid disease must be considered in differential diagnosis while evaluating thoracic lesions in endemic areas.
Full-text · Article · May 2014 · Pediatric Surgery International
[Show abstract][Hide abstract] ABSTRACT: Objective:
In recent years several techniques have been recommended for intussusception treatment. In this study, an evaluation was made of intussusception cases that presented at our clinic and had reduction applied together with saline under ultrasonography (USG) and cases, which were surgically treated.
Patients and methods:
A retrospective evaluation was made of the records of 72 cases treated for a diagnosis of intussusception between January 2010 and July 2012. Patients were evaluated demographics, clinical presentation, management strategy, during the hospitalisation and outcome.
A total of 72 cases which consists of 44 male and 28 female with age range between 5 and 132 months were treated with a diagnosis of intussusception. USG was applied to all cases on initial presentation. As treatment, hydrostatic reduction (HR) together with USG was applied to 47 cases. Of these, the HR was unsuccessful in 13 cases. Surgical treatment was applied to 38 cases. Of these cases, ileocolic intussusception was observed in 30 cases, ileoileal in seven cases and colocolic in one case. Meckel diverticulum was determined in five of these cases, polyps in two cases, lymphoma in two cases, lymph nodule in one case and 28 cases were observed to be idiopathic. There was no mortality in any case.
HR together with USG is a safe technique in the treatment of intussusception, which also shortens the duration of hospitalisation and significantly reduces the treatment costs.
No preview · Article · Apr 2014 · African Journal of Paediatric Surgery
[Show abstract][Hide abstract] ABSTRACT: The majority of renal injury secondary to blunt abdominal trauma can be successfully treated conservatively. In the present study, the clinical features and outcomes of children who presented with renal injury secondary to blunt abdominal trauma were evaluated.
This study was carried out retrospectively using data from children at the Department of Pediatric Surgery who were hospitalized for renal injury due to blunt abdominal trauma between 2000 and 2012. Patient characteristics, clinical presentation, management strategy, and outcome were evaluated.
Forty-one patients were hospitalized. The mean age of the patients was 10±4.85 years. The majority of renal injuries were grade 1 and 2. Falling was the cause of most renal injuries. All patients were initially treated conservatively. Three patients underwent acute surgical exploration for life-threatening renal bleeding (grade 4-5 injury). Nephrectomy was performed in 3 patients due to injury to the pedicle.
The conservative treatment of pediatric renal parenchymal injuries is safe and effective in children. Although the vast majority of renal injuries do not require surgical intervention, life-threatening renal bleeding, regardless of the grade of injury, should be treated surgically.
No preview · Article · Mar 2014 · Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES
[Show abstract][Hide abstract] ABSTRACT: The aim of this study is to assess the in vivo hemostatic effect of Ankaferd Blood Stopper (ABS) on rats using a tail bleeding model. Wistar rats were randomized into 4 groups of 9 each: group 1, control, no pretreatment, irrigated with saline; group 2, no pretreatment, irrigated with ABS; group 3, control, heparin pretreatment, irrigated with saline; and group 4, heparin pretreatment, irrigated with ABS. To control bleeding, compressive dressings were placed after instilling 1 mL of either ABS or saline to the bleeding area. Without heparin pretreatment, ABS shortened hemostasis time by 1.57 minutes and reduced the amount of bleeding by 0.85 g. With heparin pretreatment, ABS shortened hemostasis time by 3.29 minutes and reduced the amount of bleeding by 1.32 g. The ABS was more effective than saline irrigation for treating tail tip bleeding in rats, with or without heparin pretreatment, while also using a compressive dressing.
[Show abstract][Hide abstract] ABSTRACT: Trauma is the most important etiology of morbidity and mortality among children. Penetrating injuries to the thorax and abdomen are extremely rare in children. In the present study, we compared the characteristics of patients, management, and outcomes of penetrating thoracic and abdominal trauma in children.
Data from children who were hospitalized for penetrating injuries of the thorax and abdomen from 2006 to 2012 were evaluated retrospectively. These injuries were evaluated with respect to patient details, clinical presentation, circumstances of trauma, management, and outcomes.
Eighty-four patients were hospitalized for penetrating injuries to the thorax and abdomen. The mean age was 10.3 ± 3.79 years. Patient injuries comprised 26 gunshots injuries and 58 stabbing injuries. Thirty-one patients were wounded in the thorax, 43 were wounded in the abdomen, and 10 were wounded in both the thorax and abdomen. Thirty-one patients had undergone surgical interventions, while the other 53 were managed conservatively. The mean hospital stay was 4.41 ± 6.84 days.
The incidences of penetrating abdominal and thoracic trauma did not differ significantly. Penetrating injuries may be successfully managed by conservative therapy.
No preview · Article · Jun 2013 · Pediatric Surgery International
[Show abstract][Hide abstract] ABSTRACT: Our study retrospectively evaluates and compares the characteristics of lung and liver hydatid disease (HD) in children. This retrospective study was performed between 2007 and 2012 using the medical records of patients aged ≤17 years of age who had liver and/or lung HD. They were evaluated using the demographic characteristics of the patients, clinical presentation, hospital stay and outcome. A total of 252 cysts were identified in 152 of the patients. The incidence of HD increased with age and the majority of patients were older than 9 years. Overall, lung HD was more complicated and symptomatic than liver HD on initial admission.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to investigate the effectiveness of hyaluronic acid on the prevention of esophageal damage and stricture formation after experimental caustic (alkaline) esophageal injury in rats.
Twenty-one Wistar albino rats were randomly divided into three groups. A caustic esophageal burn was created following the Gehanno model: Group l (n=7) underwent operation, but no injury; Group 2 (n=7) was injured and left untreated; and Group 3 (n=7) was injured and treated with hyaluronic acid, first topically and then orally by gavage (2×0.3mL; 12.5mg/mL for 7days). The caustic esophageal burn was created by instilling 25% NaOH into the distal esophagus. All rats were euthanized on day 22 for evaluation. The efficacy of hyaluronic acid treatment was assessed histopathologically and biochemically via blood determination of the total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), and sulfhydryl group (SH) and lipid hydroperoxidase (LOOH) levels. Statistical analyses were performed.
Weight gain was significantly lower in Group 2 than in the other two groups (P<0.05). The mean stenosis index, histopathologic damage score, TAS, TOS, OSI, and SH and LOOH levels were higher in Group 2 than in the other two groups. The mean stenosis index, inflammation, TAS, SH and OSI in Group 2 were significantly different than those in the other two groups (P<0.05).
Hyaluronic acid treatment is effective in treating damage and preventing strictures after caustic esophageal burn in rats.
No preview · Article · Apr 2013 · Journal of Pediatric Surgery
[Show abstract][Hide abstract] ABSTRACT: Purpose:
Bicycling is a well-liked sporting activity in which many children participate, and bicycle accidents are one of the most common causes of abdominal injuries in children. We evaluated the characteristics and outcomes of abdominal injuries due to bicycle accidents in children.
Patients and methods:
This study was carried out retrospectively on children at the Department of Pediatric Surgery who were hospitalized for abdominal injury due to a bicycle accident, from 2008 to 2012. Abdominal injury-related bicycle accidents were evaluated with respect to patient characteristics, clinical presentation, management strategy, and outcome.
Fifty-nine patients were hospitalized for abdominal injuries related to a bicycle accident. The mean age of the patients was 11.48 ± 3.6 years. Most patients had an imprint of the handlebar edge on their abdomen. The most common abdominal organ injury due to a bicycle accident was laceration of the liver. Most patients were treated conservatively. Surgery was performed in 14 (24.1 %) patients. Hospital stay was 1-68 (mean 4.34 ± 11.6) days.
Abdominal injuries following a bicycle accident are frequent, serious, and preventable. Most patients were treated conservatively. Bicycle injuries can be prevented.
No preview · Article · Feb 2013 · Pediatric Surgery International
[Show abstract][Hide abstract] ABSTRACT: Injury due to foreign body (FB) aspiration and/or ingestion is a common and serious pediatric emergency. Foreign body injury (FBI) most commonly occurs in children younger than 6 years, and the incidence of FBI has increased in recent years. The aim of the present study was to evaluate and compare the characteristics of FBI due to ingestion and aspiration.
Data from patients who were hospitalized for FB ingestion and/or aspiration and underwent rigid bronchoscopy and esophagoscopy from 2008 to 2011 were retrospectively evaluated. Foreign body in the upper aerodigestive tract was evaluated with respect to the characteristics of patients, clinical presentation, management strategy, the outcome, and features of FB.
A total of 192 patients admitted for FB ingestion or aspiration in the pediatric surgery department were evaluated. The mean age was 40.97 (SD, 35.73) months. The majority of patients were younger than 4 years. Foreign bodies were mainly located in the upper esophagus for ingested FBs (60.8%), whereas for aspiration 43% of FBs were in the main right bronchus. A total of 4 patients died. The hospitalization period of patients admitted for FB aspiration was longer than that of patients with FB ingestion. Surgery was performed in 4 patients. The most commonly ingested FBs were coins, whereas seeds were the most commonly aspirated.
Prevention is the key to dealing with FBIs. Because the frequency of foreign bodies is higher in underdeveloped countries, education of parents regarding the dangers and prevention of aspiration and ingestion is important.
No preview · Article · Jan 2013 · Pediatric emergency care
[Show abstract][Hide abstract] ABSTRACT: Objective: The outcomes of button battery lodgment in the esophagus in children can be life threatening. Management of this injury after button battery removal is controversial. The aim of the present study was to compare the relevant studies in the literature with our experience of cases with a button battery lodged in the esophagus. Material and Methods: This retrospective study was conducted in all individuals who were referred for ingestion of a foreign body and who underwent eosophagoscopy at the Department of Pediatric Surgery between January 2007 and May 2012. Each operative report was reviewed to determine whether a button battery was present. Cases with a button battery lodged in the esophagus were reviewed regarding patient characteristics, clinical presentation, management strategy, outcome, and button battery features. Results: Sixteen patients (10 males, six females; age, 2-99 months; mean age, 34.81±25.23 months) were admitted due to a button battery lodged in the esophagus. The majority of patients were aged <6 years. The time to diagnosis was between 1 h and 7 days. Ingestion of the button battery by ~44% of the patients was not witnessed. The majority of button batteries were lodged in the proximal esophagus (43.7%). Eight patients had esophageal injuries at various stages. Six patients had a normal esophagus. Two patients developed a tracheo-esophageal fistula and both died. The mean duration of hospitalization was 6.8 days. Conclusions: A button battery lodged in the esophagus in children is an urgent condition. In such cases, urgent endoscopic removal and a close follow up is required.
No preview · Article · Jan 2013 · Turkiye Klinikleri Journal of Medical Sciences
[Show abstract][Hide abstract] ABSTRACT: Background and Aim Injury due to foreign body (FB) aspiration and/or ingestion is a common and serious pediatric emergency. FB injury (FBI) most commonly occurs in children less than six years, and the incidence of FBI has increased in recent years. The aim of the present study was to evaluate and compare the characteristics of FBI due to ingestion and aspiration.
Methods Data from who were hospitalized for FB ingestion and/or aspiration and underwent rigid bronchoscopy and esophagoscopy from 2008–2011 were retrospectively evaluated. FB in the upper aerodigestive tract (ADT) was evaluated with respect to the characteristics of patients, clinical presentation, management strategy, the outcome, and features of FB.
Results A total of 192 patients admitted for FB ingestion or aspiration in the pediatric surgery department were evaluated. The mean age was 40.97±35.73 months. The majority of patients were fewer than four years of age. FB were mainly located in the upper esophagus for ingested FB 60.8 %, while for aspiration 43% of FB were in the main right bronchus. A total of four patients died. The hospitalization period of patients admitted for FB aspiration was longer than that of patients with FB ingestion. Surgery was performed in four patients. The most commonly ingested FB were coins, while seeds were the most commonly aspirated.
Conclusion Prevention is the key to dealing with FBI. Since the frequency of foreign bodies is higher in under-developed countries, education of parents regarding the dangers and prevention of aspiration and ingestion is important.
Preview · Article · Oct 2012 · Archives of Disease in Childhood
[Show abstract][Hide abstract] ABSTRACT: Background
The authors describe a new procedure to prevent omental wrapping in continuous ambulatory peritoneal dialysis.
Four boys with end-stage renal diseases underwent laparoscopic omental folding with intracorporeal suturing and a double-cuffed catheter was pulled through into the abdominal cavity using a trocar site and positioned. Peritoneal dialysis was initiated immediately after surgery.
No intraoperative complications occurred. All catheters functioned well postoperatively. After a median follow-up period of 48 months, the results revealed no catheter malfunction or any abdominal complication.
Laparoscopic omental folding is feasible in children, but further well-designed prospective studies are needed to evaluate the advantages of our technique.
No preview · Article · Oct 2012 · European Surgery
[Show abstract][Hide abstract] ABSTRACT: Background and Aim Button battery (BB) ingestion is potentially a life-threatening condition for children and has increased continuously in recent years. BBs lodged in the esophagus may cause serious complications and even death. The aim of the present study was to compare the relevant studies in the literature to our results of cases in which a BB was lodged in the esophagus.
Methods The present study retrospectively analyzed 16 patients who ingested BBs that lodged in the esophagus. Data were collected from medical charts at the pediatric surgery department during 2007–2011. Ten male (62.5%) and six female patients aged 2–99 months (mean age ± SD, 34.81±25.23 months) were evaluated. Cases were studied for time and location of the battery in the esophagus, presenting symptoms, diagnostic evaluation, complications, and outcomes.
Results Children who ingested BBs were all < 6 years of age (14) (87.4%). The most common clinical complaint of the patients was history of swallowing and diysphagia. Eight patients suffered from corrosion at different stages, 2 had an eosophageal perforation and tracheoesophageal fistula. Two patients were death releated complication of BB ingestion. Nine (56.3%) patients had BB ingestion history before admission to the clinic. All BBs were from toys and were lithium BBs of >15 mm circumference.
Conclusions BB ingestion is an important condition in children. An endoscopic examination and removal must be performed urgently for a BB lodged in the esophagus.
Preview · Article · Oct 2012 · Archives of Disease in Childhood
[Show abstract][Hide abstract] ABSTRACT: Patients with a vaginal mass (large Bartholin's duct cyst) associated with a contralateral renal cyst and hydroureteronephrosis are unable to urinate. While occasionally seen in adults, Bartholin's duct cyst is rare in neonates. The origins of Bartholin's and Gartner's cysts can be traced to the mesonephric duct. Given the rarity of these cysts, there is significant confusion regarding their diagnosis, management, and prognosis. Here, we present the first report of an interlabial mass as a Bartholin's duct cyst in a neonate. The treatment of vaginal cysts is also discussed.
No preview · Article · Jun 2012 · Journal of pediatric and adolescent gynecology
[Show abstract][Hide abstract] ABSTRACT: This prospective study evaluated serum total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI), along with the Revised Trauma Score (RTS) and Injury Severity Score (ISS), as predictors of clinical outcome in the early post-traumatic period in patients with multiple blunt trauma (MBT).
The study included 52 patients admitted to the emergency department with MBT and 40 age- and sex-matched healthy control subjects.
The overall MBT patient mortality was 32.7% (17/52). There was no significant association between age and mortality in MBT patients, but there was a negative correlation between mortality and RTS, and a positive correlation between mortality and ISS. TOS levels were significantly higher in nonsurvivors compared with survivors. There was no correlation between TAS or OSI and survival. ISS and RTS showed positive and negative correlations with TOS level, respectively, but neither was significantly related to TAS or OSI.
These findings suggest that TOS, as an early oxidative stress biomarker, may be an objective alternative criterion to the ISS and RTS for managing patients with MBT during the early period following traumatic injury.
Full-text · Article · Feb 2012 · The Journal of international medical research
[Show abstract][Hide abstract] ABSTRACT: Anal fissure (AF) is a common perianal condition in children. Although adult patients with AF have been treated successfully using diltiazem, it has not been studied in children. The present randomized, prospective, double-blind study assessed the response, side effects, and recurrence of diltiazem.
Ninety-three children with AF were randomly divided into three groups. Each group received topical ointment. Group GTN received 0.2% glyceryl trinitrate, group L received 10% lidocaine, and group D received 2% diltiazem ointment.
Eighty-two patients completed the 12-month study. At the end of the first 8-week course, the healing rate in group D was significantly higher than that of the other groups (p < 0.0001, χ (2) = 19.82). Nonresponders received a second course of the same treatment. Group D showed significantly higher healing rates than the other groups (p < 0.05, χ (2) = 7.227) at the end of the second 8-week course. The group D recurrence rate was significantly different than that of the other groups (p < 0. 002, χ (2) = 12.79).
Diltiazem application is effective and safe for the treatment of AF in children, and has a low recurrence rate. The smooth dose-concentration curve causes minimal side effects.
Full-text · Article · Jan 2012 · Pediatric Surgery International
[Show abstract][Hide abstract] ABSTRACT: Purpose: The current study was designed to determine the common mechanisms of blunt perineal trauma (BPI) and associated injuries in paediatric patient. The initial management and outcome concerning such injuries are discussed. Materials and methods: The hospital records of 28 paediatric patients who were treated surgically between April 2004 and November 2010 because of BPI were reviewed retrospectively. The initial clinical examination under conscious sedation (EUCS) in each patient was performed by both an experienced emergency physician and a paediatric surgeon to obtain a complete physical examination. Results: Among the 28 paediatric patients, twenty-two girls and six boys, aged 2 to 12 years experienced BPI. Fall onto a rough surface was the main cause for BPI in 21 patients (75%) and the rest had a motor vehiclepedestrian crash. Five patients had concomitant anal or rectal injuries. There were concomitant urinary tract injuries in eight patients of whom three had combined lacerations or contusions of the perineum and disruption of the posterior urethra. There was concomitant complete rupture of proximal urethra from bladder in one patient. The remaining 4 patients with urinary tract injuries suffered from periurethral lacerations. The fifteen patients without anorectal or urethral injuries had concomitant vaginal or vulvar lacerations. Conclusion: All paediatric patients who sustained severe BPI should be checked for multi-system trauma and those undergone routine EUCS to evaluate the extent of concomitant injuries should pay particular attention to the anorectal and urogenital tracts. Primary repair of such injuries is often recommended as the initial treatment of choice.
No preview · Article · Sep 2011 · Hong Kong Journal of Emergency Medicine
[Show abstract][Hide abstract] ABSTRACT: Minor blunt neck injury from childhood trauma is a relatively common condition which can be potentially life-threatening in only rare circumstances. Pneumomediastinum may develop in up to 10% patients who have sustained blunt cervical or thoracic trauma and may be a significant cause of morbidity and mortality in affected individuals because of the associated damage to the oesophagus, larynx or trachea. Management of this condition varies from conservative approach with close observation and antibiotherapy to surgical interventions, depending on the extent and severity of aerodigestive injuries. We present a paediatric blunt neck trauma accompanied by subcutaneous emphysema and pneumomediastinum secondary to a bicycle accident (neck striking the handlebar). Its radiologic appearance, clinical presentation, and the options for initial management in the emergency department (ED) are reviewed.
Full-text · Article · Jul 2011 · Journal of the Pakistan Medical Association