Haluk Sarihan

Acquired tracheo-esophageal fistulas caused by button battery lodged in the esophagus

Esophageal impacting of button batteries must be distinguished from impacting of other foreign bodies because of their severe complications. We present a 2.5-year-old girl who had an acquired tracheo-esophageal fistula (TEF) caused by a calculator battery lodged in her esophagus. We also review the literature and assess the applicability of multislice CT and its possible advantages in children with acquired TEF.

Oral teratoma: a case report and literature review

Teratomas are true neoplasms composed of tissues from all three germinal layers. They have an unknown origin and eccentric microscopic appearance. Teratomas arising from the oral cavity are rare in the newborn; only 13 cases have been reported in the literature. We describe a male neonate with an oral teratoma originating from the anterior hard palate that was successfully treated with surgery.

Rare clinical presentation mode of intestinal malrotation after neonatal period : Malabsorption-like symptoms due to chronic midgut volvulus

Abstract Background : Many different and non‐specific clinic presentation modes of malrotation anomalies (MA) have been reported after neonatal period. The authors describe four children with MA presented with malabsorption‐like clinical features.

Nonoperative management of intra-abdominal bleeding due to blunt trauma in children: the risk of missed associated intestinal injuries.

Abstract Nonoperative management of intra-abdominal bleeding (IAB) from blunt injuries in children has been advocated for many years. Nonoperatively managed patients, however, are at risk for missed associated intestinal injuries. To evaluate this question, we reviewed the charts of 120 children who had traumatic IAB; 106 were initially managed nonoperatively and observation failed in 2. Fourteen underwent emergency operation. Forty patients had isolated liver and/or splenic injuries while the others had injuries associated with several organs. During observation peritonitis developed in 3 patients and further radiologic examinations failed to confirm an intestinal injury. Diagnostic peritoneal lavage demonstrated contaminated blood and fecal particles from injured intestines in 3 patients; they underwent emergency operation at 10, and 26 h after admission. There was no mortality or morbidity associated with delayed treatment. These data suggest that the majority of patients with IAB may be successfully treated nonoperatively, but associated intestinal injuries should be suspected in all cases.

A rare case of truncal duplication

A rare case of truncal duplication is presented in which the infant had an extra truncus with well-formed extremities, a hypoplastic thorax, and a small abdomen. The truncus was attached to the infant from the thorax to the umbilicus. Successful separation of the truncus and reconstruction of the thoracoabdominal wall defect were performed in the neonatal period.

A case of ureteral triplication associated with ureteropelvic junction obstruction

Ureteral triplication is one of the rarest malformations of the upper urinary tract. The association of ureteral triplication and obstruction is even rarer. We report a case of ureteral triplication associated with hydronephrosis due to ureteropelvic junction (UPJ) obstruction at the middle pole ureter. To our knowledge, such a malformation has not been described previously.

Oxidative, inflammatory and immunologic status in children with undescended testes

Background:  In order to better understand the pathogenesis of risk of future sub‐/infertility in children with undescended testes (UDT), we designed this prospective study to examine the oxidative stress, inflammatory response and autoimmunity in children with UDT. We examined the concentrations of malondialdehyde (MDA), interleukin‐6 (IL‐6) and antisperm antibodies (ASA) in children with UDT and healthy controls.

Diagnostic difficulties in children with coexisting pelvi‐ureteric and vesico‐ureteric junction obstruction

To assess the diagnosis of children with coexisting pelvi‐ureteric junction (PUJ) and vesico‐ureteric junction (VUJ) obstruction, and the management of such patients, as having these two anomalies in the same ureter creates serious diagnostic difficulties, but any delay in diagnosis might cause a deterioration of renal function and affect the success of surgery to correct either anomaly.

Intestinal mesenteric involvement with plexiform neurofibroma in neurofibromatosis type 1

Correspondence: Mustafa İmamo ğ lu, Department of Pediatric Surgery, Karadeniz Technical University, Faculty of Medicine, 61080 Trabzon, Turkey. Email: mimamoglu61@yahoo.com Received 27 February 2004; revised 22 December 2004; accepted 28 February 2005. Neurofi bromatosis type 1 (NF1), von Recklinghausen’s disease, is a common type of neurogenetic disease in which affected individuals develop benign and malignant tumors with an increased frequency. In this disease, gastrointestinal involvement occurs in 10 – 25% of patients and includes solitary or multiple neurofi bromas, leiomyomas, and rarely plexiform neurofi broma (PNF). The last is almost always congenital lesions that can gradually grow to a large size, and are the most common cause of morbidity in the NF1 population. In gastrointestinal involvement, jejunum and stomach are the most frequently involved sites of PNF, followed by the ileum and duodenum. The colon and mesentery are rarely affected. Since the mesenteric involvement is mostly occult, this may lead to delayed diagnosis and increased morbidity. 1 – 3 We report a panmesenteric PNF with multiple segmental involvement of the intestinal wall in a girl with NF1 that presented with a 3 year history of vague abdominal pain and failure to thrive. We also reviewed the clinical presentations, diagnoses and treatment approaches of similar cases in the pediatric literature.

Congenital epulis. Case report.

A newborn baby boy weighing 3100 g was found to have a pinky red solid mass 3 x 2.5 x 2 cm arising from the anterior ridge of the maxilla. This caused difficulty in feeding, and looked ugly. The mass was excised under local anaesthetic when he was 2 days old and histological examination showed congenital epulis. He also had a stage II congenital goitre. His hypothyroidism was treated with L-thyroxine sodium and he was well with no sign of recurrence of the tumour at the age of 1 year.