Ebru Ozturk

Ultrasonographic findings in ceftriaxone: associated biliary sludge and pseudolithiasis in children.

Purpose: To prospectively evaluate the incidence of biliary sludge and pseudolithiasis in children treated with ceftriaxone. Material and Methods: Thirty‐three children (14 girls, 19 boys) treated with ceftriaxone for prophylaxis (n = 13) or for an infection (n = 20) were included in this study. The incidences of biliary sludge and pseudolithiasis were investigated using ultrasonography. The ultrasonographic evaluations were performed prior to and on the 4th–5th days and on the 8th–10th days of treatment. The patients who had biliary sludge or pseudolithiasis were followed up with ultrasonographic evaluation periodically until these pathological phenomena disappeared. Results: Ceftriaxone was administrated intravenously at a dosage of 100 mg kg−1 day−1. Serial gallbladder sonograms were performed before treatment and on the 4th–5th and 8th–10th days of therapy. Nineteen children developed pseudolithiasis and sludge in the gallbladder, and all were asymptomatic. No significant differences were found between the patients with normal versus abnormal sonographic findings in regard to gender, age, duration of the therapy, oral restriction except the presence of surgery (P<0.005). Conclusion: The combination of oral restriction and surgical procedures may be a causal factor in ceftriaxone‐associated biliary pseudolithiasis. It is emphasized that when gallstone and/or sludge are detected in the gallbladder in children by ultrasonographic examination, the administration of ceftriaxone must be sought beyond other causative factors.

Case Report: A Dramatic Response to Ketotifen in a Case of Eosinophilic Gastroenteritis Mimicking Abdominal Emergency

Eosinophilic gastroenteritis (EGE) is an uncommon benign disease characterized by eosinophilic infiltration of the gastrointestinal (GI) tract. It affects adults as well as infants and children (1). It commonly involves the antrum of the stomach and proximal small bowel (2). However, the large bowel may occasionally be involved (3). The etiology of the disease is unknown, but tissue injury in EGE has been shown to correlate with the presenting number of activated degranulated eosinophils (4). The usual symptoms in EGE are abdominal pain, altered bowel habits, diarrhea, nausea and vomiting, and weight loss (5). Although steroid treatment is associated with a high relapse rate, it is the mainstay of therapy, which usually reveals a good response (6). We report a 30-year-old female who presented with symptoms of an acute abdominal picture and was diagnosed with EGE that responded dramatically to ketotifen therapy.

Pneumatization of the inferior turbinates: incidence and radiologic appearance.

Objective: The objective of this work was to determine the incidence and radiologic appearance of pneumatized inferior turbinates (PITs). Methods: Pneumatized inferior turbinates were investigated among 2500 consecutive cases with coronal paranasal sinus computed tomography (CT) scans that were performed for different reasons between 2000 and 2004. Results: Ten new PIT cases diagnosed with CT were identified. Pneumatization was diagnosed in 2 patients aged 7 and 14 years. Therefore, this is the first time that PIT has been described in the pediatric age group. Complete or incomplete pneumatizations were unilateral in 7 cases and bilateral in 3 cases. In bilateral PIT cases, pneumatizations were asymmetric. In 2 cases, only bulbous parts of the inferior turbinates (ITs) were involved. Inferior turbinate expansion related to pneumatization was not observed in any case. In cases with maxillary sinus communication, axial CT sections revealed a defect on the medial wall of the maxillary sinus. Conclusions: The incidence of PIT was found to be 1 in 250 cases. It is suggested that most PIT cases may be a result of articulation defects between the maxillary process of the palatine bone and the maxillary bone. In such a situation, the maxillary process of the palatine bone and the nasal process of the maxillary bone, which form the medial wall of the maxillary sinus at the IT level, can attach to the IT separately.