Mustafa İmamoğlu

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.

Contribution of MRI to ultrasound in the diagnosis of fetal anomalies.

To evaluate the contribution of MRI to ultrasound (US) in the diagnosis of fetal anomalies.

Eosinophilic Pancreatitis Mimicking Pancreatic Neoplasia

Eosinophilic pancreatitis (EP) is a rare disease. It typically occurs in the setting of either eosinophilic gastroenteritis or the hypereosinophilic syndrome. Isolated eosinophilic infiltration of the pancreas is less common. EP usually presents as a pancreatic tumour with abdominal pain and/or obstructive jaundice. The diagnosis is often not made until after pancreatic resection under suspicion of a pancreatic tumour. The case of a 14-year-old boy whose initial presentation was suggestive of a pancreatic tumour is reported. Radiological evaluation revealed a pancreatic mass suggestive of a pancreatic tumour obstructing the duodenum and common bile duct. The patient underwent surgery and a gastrojejunal anostomosis, tube cholecystostomy and biopsy were performed with no postoperative complications. The diagnosis of EP was established after surgical biopsy. The biopsy specimen revealed prominent eosinophilic infiltration. Serum immunoglobulin E levels were elevated. The patient was treated with oral prednisolone (40 mg/day). After two months of oral steroid therapy, clinical manifestations rapidly improved and peripheral eosinophilia subsided. Computed tomography scan revealed remission of the pancreatic mass-like lesion.

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.

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.

Acute Alterations in Biochemistry, Morphology and Contractility of Rat Isolated Urinary Bladder via Increased Intra-Abdominal Pressure

Objective: To determine the acute effects of increased intra-abdominal pressure (IAP) on the biochemistry, morphology and contractility of the rat isolated urinary bladder using an experimental laparoscopy model. Methods: We divided 24 adult female Sprague–Dawley rats into three groups. The control group (group I) was not subjected to increased IAP. In groups II and III, IAPs of 10 and 20 mm Hg, respectively, were established by carbon dioxide pneumoperitoneum for 60 min. Thirty minutes after desufflation, the rat urinary bladder dome was removed for in vitro pharmacological investigation, measurement of malondialdehyde (MDA) levels and histopathological examination. Statistical comparisons between groups were performed. Results: Tissue MDA levels in groups II and III were significantly higher than in the control group. In group II, only the lamina propria was significantly damaged. However, the epithelium, lamina propria, and serosa were significantly damaged in group III. Acetylcholine potentiated contractions in both IAP groups. Increased responses to electrical field stimulation in the IAP groups were significant only in group II. Conclusions: In this experimental model, 10 and 20 mm Hg of IAP induced by pneumoperitoneum increased MDA levels and caused important changes in the morphology and contractile response of the urinary bladder.

The effect of CO2 insufflation-desufflation attacks on tissue oxidative stress markers during laparoscopy: a rat model

OBJECTIVE To determine the effects of sudden intra-abdominal pressure (IAP) changes on the terminal ileum in a pneumoperitoneum model. DESIGN An experimental controlled study. SETTING University hospital in Turkey. ANIMAL(S) Thirty-two adult female Sprague-Dawley rats. INTERVENTION(S) The rats were divided into four groups. Group 1 was not subjected to IAP. In group 2, IAP insufflation was performed continuously to keep the IAP at 10 mmHg. Groups 3 and 4 underwent an insufflation-desufflation procedure: group 3 was fluctuated 5 times, and group 4 was fluctuated 10 times within the pneumoperitoneum period of 60 minutes. Thirty minutes after the desufflation, the terminal ileum was removed for the measurement of tissue malondialdehyde (MDA) values and histopathological examination. MAIN OUTCOME MEASURE(S) The tissue MDA values and histopathological damage scores. RESULT(S) The tissue MDA values in the IAP groups (groups 2, 3, and 4) were significantly increased when compared with those of the control group. The mean MDA value in group 4 was higher than that in groups 2 and 3. Histopathologic oxidative damage scores in the mucosa and submucosal layers were significantly higher in groups 2 and 3, compared with those of the control group. However, the highest histopathologic damage scores were observed in group 4. CONCLUSION(S) Unexpected desufflation-insufflation even at normal IAP levels during laparoscopy leads to significant oxidative stress-induced damage in the terminal ileum.

Sclerosing haemangioma arising within extralobar pulmonary sequestration

Extralobar pulmonary sequestration is a rare anomaly of abnormal pulmonary tissue without any communication to the bronchial tree. Sclerosing haemangioma is a rare lung tumour, generally seen in middle-aged women. The combination of these two rare pathologies has not been previously reported. We describe the CT and CT angiographic findings of sclerosing haemangioma arising within an extralobar pulmonary sequestration in a 2-year-old girl.

Use of dexmedetomidine to prevent pulmonary injury after pneumoperitoneum in ventilated rats.

Purpose: This study examined the effectiveness of dexmedetomidine in preventing lung injury resulting from pneumoperitoneum in a ventilated rat model. Methods: Animals (n=18) were allocated randomly into 3 groups: control group, no pneumoperitoneum; sham group, pneumoperitoneum with intra-abdominal pressure of 12 mm Hg for 60 minutes; and dexmedetomidine group, dexmedetomidine administration 30 minutes before pneumoperitoneum. The rats were rested for 30 minutes after abdominal deflation. Then, blood samples were obtained for plasma malondialdehyde and ischemia-modified albumin (IMA) analyses. Tissue samples were taken for histopathologic examination and malondialdehyde analysis. Results: Compared with the control group, the sham group had a significantly higher level of plasma IMA. Pretreatment with dexmedetomidine significantly reduced the IMA level. Histopathologically, tissues from sham rats exhibited moderate or severe tissue damage, compared with control tissues. Dexmedetomidine-treated rats showed significantly less tissue damage than sham rats. Conclusions: Dexmedetomidine prophylaxis resulted in significantly less IMA production and significantly less neutrophil infiltration, thereby helping to protect the lungs from injury after pneumoperitoneum.