Mete Kaya

Omphalocele, exstrophy of cloaca, imperforate anus and spinal defect (OEIS Complex): A case report

Omphalocele, exstrophy of cloaca, imperforate anus and spinal defect (OEIS Complex) is an extremely rare combination of serious defects, which was firstlydescribed by Carey and colleagues. Surgical repair of cloacal exctrophy in patientswith OEIS complex can be performed at one stage, but it can also be performedsafely as staged to minimize the potential complications. In this case report, weaimed to present our early approach to the OEIS complex.

Feasibility of repair of distal penile hypospadias as a day-case surgery

ObjectiveThe aim of this study was to present the outcomes of children with distal hypospadias who were operated on outpatient basis. MethodsAtotal of 47 consecutive children underwent surgical repair of distal hypospadias in our department. Urethroplasties were performed by the following techniques: stentless meatal advancement-glanuloplasty (MAGPI) or glans approximation procedure (GAP) for glanular hypospadias (14) and tubularized incised plate (TIP) urethroplasty for coronal, subcoronal and midpenil hypospadias with an indwelling urethral catheter or short stent (33). The indwelling urinary catheters were managed by the double diaper technique. Patients were discharged within 6 h after operation. Dressings and catheters were removed on the postoperative day 2 and 6, respectively. ResultsVoiding difficulty and urinary retention on early postoperative period were observed in 8 patients. Except meatal stenosis in 4 cases and meatal retractions in 2 cases, there were no major complications in any of our patients during the follow-up period, no postoperative fistula or urethral stricture. ConclusionIn children, repair of distal penile hypospadias on outpatient basis is feasible. Catheters, urethral stents, drug therapy and dressing are not justifications for hospitalization in such cases.

Extralobar pulmonary sequestration as a cause of recurrent pulmonary hemorrhage in a neonate.

Pulmonary sequestration is acystic or solid congenital lung malformation comprised of non functional lung tissue that does not communicate with the normal tracheobronchial tree and has a systemic arterial blood supply. There are two forms of sequestration: intralobar and extralobar. Its treatment is surgical resection. Here we presented a case of premature neonate with extralobar pulmonary sequestration who had respiratory failure and recurrent pulmonary hemorrhage. Following surgery, the patient showed significant clinical improvement.

A genital hair tourniquet syndrome: Case report and review of the literature

The genital hair tourniquet syndrome in children is an uncommon condition. Herein, a case of 9- year - old girl with a clitoral hair tourniquet is described, and review of the literature of genital tourniquets is presented, with a discussion about potential etiology by current literature.

Persistent mullerian duct syndrome in a child: case report and review of literature

Herein we report of a case of persistent mullerian duct syndrome diagnosed on laparoscopy. Current knowledges and management are discussed.

Management of the patients with persistent Müllerian duct syndrome: Is the ultimate goal testicular descent?

Objective Persistent Müllerian duct syndrome (PMDS) is a rare congenital disease characterized by the presence of rudimentary Müllerian structures within an intra-abdominal or hernial sac in a virilized male, often presenting as undescended testes. In this study, we aim to present a series of the PMDS patients who were managed by orchiopexy without removal of Müllerian remnants (MR). Material and methods Between May 2010 and June 2017, we treated six cases diagnosed as PMDS in our department. Laparoscopy and gonadal biopsy were performed in all patients, and vessel ligation was done in four patients for the first session of Stephen-Fowler orchiopexy. After initial diagnosis, genetic analyses and endocrine investigations were performed. Demographic and clinical features of the patients, operative methods and follow-up data were analyzed retrospectively. Results Mean age of the patients was 5.5 years. Three boys had undergone inguinal surgery due to hernia or undescended testis, while others were diagnosed during laparoscopic investigation of nonpalpable testis. As a definitive operation, testes and MR were completely removed in an adult patient, and the remaining patients were treated with laparoscopic or open orchiopexy with or without utero-cervical splitting and the MRs were left in situ. Two testes atrophied during follow-up period. Conclusion The goal of the approach in PMDS patients is to preserve testes, as well as carry them to their natural location. Leaving the MR in place is a suitable option for blood circulation of the testes but the long-term results are still unknown.

Anorectal Laceration due to Crush Injury: A Case of Rarity

A 4-year old male patient met with run over injury as he fell from a moving tractor while riding. He sustained multiple injuries including laceration of right inguinoscrotal area, extending into perineum with disruption of perineal body and external anal sphincter with separation of anus. Urethra was intact but retracted deep into pelvis. Pelvic ring was disrupted and bony spicules of fracture pelvic bone were visible in the wound.(Figure 1). Hemogram and blood biochemical profile were in normal limits. Ultrasonography (US), X-rays and computed tomography (CT) revealed no intraabdominal organ injury. Fracture at the right ischio-pubic rami was noted. Urethrocystography showed type I urethral injury.

A prenatally diagnosed gastric duplication cyst connecting the pancreatic duct and paraspinal region

The gastrointestinal duplication of stomach is uncommon congenital anomalies of gastrointestinal tract. Herein a rare case of gastric duplication with newborn is being reported. A 14-day-old term female baby was admitted to our clinic with intermittent bilious vomiting and abdominal distention. In evaluation, abdominal cystic mass was detected in the left upper quadrant. The cyst which was attached to both the pancreatic duct and spinal cord was removed totally by laparotomy. A histologic examination showed gastric duplication cyst. The postoperative course was uneventful. There were no any complications at the 8-month follow-up period. This rare entity should be included in the differential diagnosis of cystic masses of the gastrointestinal tract and treated surgically by complete resection due to the risk of malignant transformation and other complications. This is the first case report that the gastric duplication cyst has a connection with both the pancreatic duct and spinal cord.

Symptomatic simple renal cyst managed by laparoscopic unroofing in a child

Simple renal cysts (SRC) in children are uncommon, usually asymptomatic, and discovered incidentally during investigation for other urinary or abdominal symptoms. The management of SRC in children depends on the symptoms and imaging. Patients can be followed by ultrasonography or other imaging or may be decided an intervention. The available procedures for the treatment of symptomatic cysts are percutaneous aspiration with or without sclerotherapy and open or laparoscopic approaches of the lesions. Only a few small series have been published SRC in children, and is not sufficient data available regarding laparoscopic approach. In this case report, we present a case of symptomatic SRC who underwent laparoscopic unroofing.

Ergonomic varicocele ligation: Laparoscopic intracorporeal knot-tying

Introduction/aimMany surgical and radiological techniques have been introduced for treating varicoceles. The goal of surgical treatment of varicocele is to occlude the refluxing venous drainage to the testis while maintaining the normal testicular function. The aim of this study was to present our initial experience in laparoscopic varicocele treatment using intracorporeal knot-tying with available laparoscopic instruments. Materials and methodsA retrospective file review of the patients who were treated with laparoscopic intracorporeal knot-tying between May 2010 and July 2014 was carried out. The patients were evaluated as regards age, symptoms, and clinical grade of varicocele. All patients were diagnosed through physical examination and color Doppler ultrasound, which measured the diameter of spermatic veins and retrograde flow in spermatic veins after the Valsalva maneuver. ResultsThe mean operative time was 35±8 min. There was no intraoperative complication, and all patients had uneventful postoperative courses. Patients were discharged from hospital on the same day after surgery. No recurrent varicocele, testicular atrophy, postoperative hydrocele, or ematoma were observed. ConclusionOur preliminary results indicate that laparoscopic varicocele ligation carried out with intracorporeal knot-tying is safe and effective and produces cosmetically better results. Therefore, it is a suitable procedure in both pediatric and adolescent patients.