Ahmet Ertürk

Evaluation of 968 children with corrosive substance ingestion

Background and Aims: The aim of the study was to evaluate the etiology, treatment, and prognosis in children who had presented at our clinic with corrosive substance ingestion and comparison of our results with the literature. Materials and Methods: The patients were put on nil by mouth and broad-spectrum antibiotics were administered. Oral fluids were started for patients whose intraoral lesions resolved and who could swallow their saliva. Steroids were not given, a nasogastric catheter was not placed, and early endoscopy was not used. Results: A total of 968 children presented at our clinic for corrosive substance ingestion during the 22-year period. The stricture development rate was 13.5%. Alkali substance ingestion caused a stricture development rate of 23%. A total of 54 patients required 1–52 sessions (mean 15 ±12) of dilatation. Conclusion: We do not perform early endoscopy, administer steroids, or place a nasogastric catheter at our clinic for patients who had ingested a corrosive substance. This approach has provided results similar to other series. We feel that determining the burn with early esophagoscopy when factors that prevent or decrease the development of corrosive strictures will be very important.

Is color Doppler a reliable method for the diagnosis of malrotation

PurposeThe gold standard for the diagnosis of malrotation is barium contrast study of the upper gastrointestinal system (UGCS), while color Doppler ultrasonography (CDUS) is another method used in the diagnosis. We investigated the value of CDUS for the diagnosis of malrotation in this study.MethodsUGCS images, CDUS images, plain abdominal images, demographic data, and symptoms of 82 patients who were investigated for presumed malrotation during a 7-year period were evaluated, retrospectively.ResultsAll patients underwent CDUS, and 18% of these patients were diagnosed with malrotation as the superior mesenteric vein was seen to be on the left of the superior mesenteric artery. We found that 16% of the 75 patients who underwent UGCS were diagnosed with malrotation. The sensitivity and specificity of CDUS in the diagnosis of malrotation was found to be 93.8 and 100%, respectively. The respective values for UGCS were 91.7 and 98.4%.ConclusionCurrent data in the literature and our results underline that UGCS may yield false-positive and false-negative results. Although CDUS was found to be a reliable method for the diagnosis of malrotation in our study, the limitations of UGCS are also recognized for CDUS. Prospective studies are needed to determine the more valuable method.

Laparotomi yapılan hastalarda brid ileus risk faktörleri ve tedavi yaklaşımlarının değerlendirilmesi

Amac: Postoperatif yapisikliklar intestinal obstruksuyona yol acmasi, reoperasyon durumlarinda abdominal eksplorasyonu zorlastirmasi, organ yaralanmalarina sebep olmasi nedeniyle hem hasta hem de hekimler icin onemli bir klinik durumdur. Bu calismada brid ileus gelisimine etki eden faktorlerin saptanmasi ve brid ileusdaki tedavi sonuclarinin degerlendirilmesi amaclanmistir. Gerec ve Yontemler: 2005-2010 yillari arasinda cesitli nedenlerle laparotomi yapilan hastalar brid ileus gelisimi acisindan retrospektif olarak degerlendirildi. Bulgular: Bu calismaya l aparotomi yapilan 3271 hasta dahil edildi. Apandisit en sik laparotomi endikasyonuydu (%66). 152 hastada (%4,6) postoperatif brid ileus gelistigi tespit edildi. Bunlarin %88’inin postoperatif ilk 6 ayda, %99’unun da ilk 3 yil icinde gelistigi goruldu. Yas ve cinsiyet ile brid ileus gelisimi arasinda iliski yoktu. Vakalarin %23’u kirli vasifta ameliyatlardi. Temiz, temiz kontamine ameliyatlardan sonra brid ileus gelisme orani %3,4 iken, kontamine ve kirli ameliyatlardan sonra bu oran %10,9 olarak bulundu. Batin icerisine dren yerlestirilmesinin brid ileus gelisimini etkilemedigi saptandi. Ameliyat suresi uzadikca postoperatif brid ileus gelisme oraninin arttigi tespit edildi. Ayrica ameliyatta Meckel divertikulu gibi ek patolojiler arastirilan hastalarda brid ileus gelisme oraninin 3 kat arttirdigi goruldu. Brid ileus gelisen hastalarin %61’i nonoperatif-konservatif yollarla tedavi edilirken %39’unda cerrahi girisim gerektigi tespit edildi. Sonuclar: Calismamizda batin icinde uygulanan ek girisimlerin, operasyon suresinin uzun olmasinin ve intraperitoneal kontaminasyonun brid ileus gelisimini artirdigi gosterilmistir. Bu konulara dikkat edilmesinin brid ileus gelisimini azaltabilecegi dusunulmustur. Cocuk yas grubunda uygun vakalarda konservatif tedavi ile daha yuksek oranlarda basari saglanabilecegi kanisina varilmistir.

Labial Fusion in Prepubertal Girls

Objective: Labial fusion is a common benign genital disorder in prepubertal girls. Herein we aim to identify the characteristics and treatment outcomes of patients with labial fusion who were diagnosed and treated at our hospital. Material and Methods: Girls with labial fusion who presented to our outpatient department were retrospectively reviewed for their age, complaints, use of topical estrogen treatment, recurrence rate, time of recurrence and complications. Results: A total of 334 patients with labial fusion were identified. The ages of the patients varied between forty days and 8.5 years. Both the vagina and urethra were covered by the labial fusion and only a small gap could be seen near the clitoris in 90% of patients. Additional urinary disorders and vaginal discharge caused by labial fusion were identified in 35% of the patients. Patients were treated with manual detachment of the fusion and topical estrogen creams. Recurrence rate was 25%. Recurrence rates were higher in patients with older age and additional problems. conclusion: Labial fusion is a common benign condition in prepubertal girls. But it can cause urinary disorders in patients and serious anxiety in parents. The treatment can be easier and the recurrence rates lower if it is prevented effectively or diagnosed earlier.

The Value of Plain Abdominal X-Ray and Ultrasound Imaging in Childhood Appendicitis

Objective: Abdominal pain is one of the most common causes of hospitalization in childhood. Here we aimed to evaluate the contribution of positive fi ndings in the upright abdominal x-ray and ultrasound imaging for the diagnosis of acute appendicitis in children admitted with abdominal pain. Material and Methods: The upright abdominal x-ray and ultrasound images of children who presented to our outpatient clinic with suspected acute appendicitis in 2010 were analyzed retrospectively. The patients were divided into 2 groups. The children with a fi nal diagnosis of acute appendicitis constituted group 1, while the patients who were operated on for suspected appendicitis and where the pathology examination was negative for appendicitis and children who required only observation in the hospital or as outpatient for suspected appendicitis made up group 2. Findings accepted to suggest a diagnosis of acute appendicitis on plain x-ray were air-fl uid level at the right lower quadrant, diffuse air-fl uid 1Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk Cerrahisi Kliniği, Ankara, Türkiye 2Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi, Radyoloji Kliniği, Ankara, Türkiye Ahmet ERTÜRK1, Ayşe KARAMAN1, Özlem BALCI1, İbrahim KARAMAN1, Yusuf Hakan ÇAVUŞOĞLU1, İsmet Faruk ÖZGÜNER1, Beytullah YAĞIZ1, Yasemin TAŞÇI YILDIZ2, Derya ERDOĞAN1 Çocuklarda Direkt Batın Grafi si ile Ultrason Bulgularının Apandisit Tanısındaki Değeri The Value of Plain Abdominal X-Ray and Ultrasound Imaging in Childhood Appendicitis