Adnan Aslan

Severe ischemia of the glans penis following circumcision : A successful treatment via pentoxifylline

Abstract Severe ischemia or necrosis of glans penis is rare. We report the case of an 11‐year‐old boy with severe glanular ischemia occurring 24 h after circumcision. This was successfully treated with pentoxifylline injection for 5 days, and while the black color of the glans penis changed to brownish at 48 h, appearances were close to normal at 5 days. The patient did not require any surgical intervention, and was discharged without sequelae. We suggest that pentoxifylline might be considered as a treatment of choice for severe ischemia of glans penis.

Sacrococcygeal Teratoma Showing Organoid Differentiation: Report of a Case

We present the case of a neonate with a sacrococcygeal teratoma showing organoid differentiation. A 5-day-old baby girl was transferred to our hospital with a large sacrococcygeal mass. Ultrasonography revealed a few well-limited fluid-filled lesions, indicating that the teratoma had cystic components. During surgery, a sac containing 30 cm of small bowel loops was found in the tumor. The bowel segment was supplied by a mesentery-like structure originating from teratoid tissue. Histopathological examination verified a benign mature teratoma with fully developed small bowel loops. The tumor was defined as a sacrococcygeal fetiform teratoma. The terminological, structural, and clinical aspects of this unusual tumor are discussed, with a review of the English literature.

An uncommon association relating to cloacal maldevelopment: Bladder agenesis, anorectal atresia, and absence of vulva, vagina, and uterus

The authors report on a newborn girl with complex urogenital and hindgut abnormalities. Urogenital anomalies consisted of absence of vulva and vagina, uterine and urethral atresias, bladder agenesis with ectopic ureteric opening, and bilateral pelvic ectopic kidneys. In addition, the baby had anorectal atresia without fistula as a hindgut anomaly. Herein, clinical evaluation and embryological review are made to explain the concomitant occurrence of these rare malformations.

A rare case of esophageal atresia with gastric outlet obstruction.

Although the combination of gastric outlet obstruction and esophageal atresia is rarely seen in neonates, it has been well described. We report the case of a 5-day-old newborn with esophageal atresia and tracheoesophageal fistula associated with complete gastric outlet obstruction due to a mucous plug. As the patient had intense gastric distention, severe respiratory distress requiring ventilatory therapy and complete pyloric obstruction in radiograms, emergency gastrostomy was performed before definitive operation. Definitive treatment consisted of tracheoesophageal fistula ligation and primary esophageal anastomosis. Exploratory laparotomy during the same session revealed a normal pyloric canal, completely obstructed by a firm mucous plug. The plug was removed by pylorotomy, and a pyloroplasty was performed to ease gastric evacuation. Postoperative feeding problems suggested gastric dysmotility as the possible cause for the mucous plug obstruction.

The repair of a large duodenal defect by a pedicled gastric seromuscular flap

PurposeThe aim was to evaluate the efficacy of a pedicled gastric seromuscular flap for the closure of a large duodenal defect.MethodsA large defect of the second duodenal part was repaired by a gastric seromuscular flap. Of 35 rats, 9 rats were euthanized at 2 weeks, 12 rats at 2 months, and 14 rats at 4 months for the histopathological evaluation of the patch and normal duodenum (control) adjacent to the patch.ResultsAll rats survived. The patch was completely covered by neomucosa in all of the 4-month rats, and in 8 of the 12 2-month rats. The villous height of the neomucosa was significantly higher in the 4-month rats in comparison to the other rats (P < 0.001). However, a normal duodenum had higher villi than in that of the patches (P < 0.001). The crypt density of the neomucosa was significantly increased in the 4-month rats in comparison to the 2-week and the 2-month rats (P < 0.001 and P < 0.05 group, respectively). The crypt density was higher in the controls than in the neomucosa covered patch of the 2-week and the 2-month rats (P < 0.001 and P < 0.05, respectively). The crypt depth of the neomucosa increased significantly in the 4-month rats and in the controls versus the 2-week rats (P < 0.05).ConclusionThe new mucosal barrier overlaying the patch appeared to be satisfactory. This technique, which has not been described previously, is likely to be useful for the repair of the large duodenal defect.