Irenej Cigit

Primary Spontaneous Pneumothorax in Pediatric Patients: Our 7-Year Experience

BACKGROUND Primary spontaneous pneumothorax in children is a significant clinical problem. The majority of these patients will require immediate surgical therapy, such as tube thoracostomy. PATIENTS AND METHODS We conducted a retrospective review of 16 patients with a diagnosis of primary spontaneous pneumothorax over a period of 7 years. RESULTS In the last 7 years, we had 16 patients with spontaneous pneumothorax. Patient age ranged from 11 to 18 years (median, 15.4). We had 12 boys and 4 girls. Pneumothorax occurred on the right side in 9 patients, on the left side in 6 patients, and on both sides in 1 patient. The first choice of treatment was tube thoracostomy. The main symptoms were chest pain, shortness of breath, and cough. In all patients, we made X-ray and computed tomography scan. In 10 children, we detected apical bullas; in 2 patients, we found giant bullas in the lower part of the lung. In 4 patients, we did not find any pathologic signs on the lung. Two patients with spontaneous pneumothorax had tube drainage without recurrence. Eleven patients were operated on with video-assisted thoracoscopic surgery (VATS). Three patients were operated with open thoracotomy. Two of them had giant bullas, and 1 patient had recurrence after VATS. One patient had pneumothorax on both sides of the pleural cavity. DISCUSSION VATS is an effective, safe method for spontaneous pneumothorax in children. In 11 children with pneumothorax, we made a wedge resection of the apical part of the lung with an endostapler device plus mechanical pleurodesis.

Huge dermoid cyst of the spleen

Primary splenic cysts are uncommon lesions of the spleen. Splenic cysts are classified as primary or secondary on the basis of presence or absence of an epithelial lining. The primary cysts are further subdivided as parasitic or non-parasitic. The congenital non-parasitic cysts are rarely met in clinical practice and it constitutes approximately 10% of all splenic cysts. Congenital cysts are true cysts with an epithelial. Secondary cysts are in most cases posttraumatic. Patient at admission had lower abdominal pain and splenic cyst was asymptomatic. In routine abdominal pain investigation we found cyst of the spleen in diameter 2 cm. We made serodiagnostic tests for echinococcosis which were negative. After 3 years she came with left upper quadrant enlargement with tangible abdominal mass, increasing abdominal girth, decrease of appetite and sometimes vomiting. CT scan showed cyst enlargement in diameter 8x6 cm. Operative treatment was necessary and splenectomy was done. However, splenectomy remains a relatively safe procedure, associated with few complications and avoiding any future problems.

Frantz Tumor - Pseudopapillary Cystic Neoplasm of the Pancreas in Children: Report of Two Patients

Pseudopapillary cystic neoplasm of the pancreas (Frantz tumor) is rare slow growing tumor with low malignant potential usually affecting young women. PCN have good prognosis in case of radical removal. Tumor was described for the first time by Frantz in 1959. A retrospective clinical analyses was made of two patients with PCN admitted in our hospital in the last 10 years. A 16 year old girl admitted in our hospital with intermittent abdominal pain lasting for 3 years. Abdominal ultrasound and CT-scan showed the presence of the tumor in a head of pancreas. Excision was performed. A 13 year boy came to routine US because frequent urological infection. Abdominal US and after CT are showed the presence of the tumor in a neck of pancreas. Excision was performed. In both of patients metastases were not noticed. The follow up period was 9 years in female patient and 2 years in male patient, Surgical resection of PCN affords an excellent prognosis without other ways of treatments.