Osman Faruk Şenyüz

Albendazole therapy in the treatment of hydatid liver disease.

Abstract Hydatid disease, a common health problem in Turkey as in many countries, should be included in the differential diagnosis of all patients presenting with a cystic mass in the abdominal or thoracic cavity. Previously, surgery had been the main form of treatment. But with the introduction of preoperative medication with albendazole, treating this disease medically is now growing in popularity. We report herein the findings of ten patients with two lung and 20 liver hydatid cysts ranging from 3 to 20 cm in diameter, who were successfully treated with medical therapy. Multiple organ involvement and multiple cysts in an organ are the main indications for medical treatment with albendazole, but the indications should not be limited to certain situations such as small-sized cysts, since even huge-sized cysts responded well to the therapy in this series.

Fetus in fetu or giant epignathus protruding from the mouth.

A huge and extremely organoid mass, protruding from the mouth of a newborn and causing respiratory embarrassment, was resected. It was difficult to make a clear distinction whether this mass was fetus in fetu or a highly organoid epignathus dealing with the findings obtained from its gross and histological examination of the mass.

Hydatid disease of the liver in childhood.

Abstract The records of 100 children with hydatid disease were reviewed retrospectively from 1978 to 1997; 43 were girls and 57 were boys. The mean age was 9.14 years; 61 patients had 124 hepatic cysts. Presenting symptoms were asymptomatic abdominal masses, found masses incidentally during ultrasonography (US), or acute abdomen. Plain X-ray films, US, or computerized tomography (CT) are sufficient for diagnostic evaluation in endemic areas. In the differential diagnosis, laboratory investigations such as the Casoni and Weinberg tests, indirect hemagglutination, eosinophilia, and ELISA were also used. These tests may give negative results, however, in some patients with hydatid disease. The mean follow-up time was 10.5 years (range 1–18 years), the mean duration of hospitalization 7 days. The complication rate was 3.6%. Mortality was 3.27% and occurred after the administration of formaldehyde and hypertonic scolicidal agents. Hydatid disease of the liver can be treated medically in selected patients; conservative surgical approaches that save as much parenchyma as possible, such as partial cystectomy and capitonnage, are indicated in the other cases.

Wandering spleen in childhood: A report of three cases

Wandering spleen is a rare cause of abdominal pain in children, and an accurate diagnosis is seldom made preoperatively. A splenectomy is the treatment of choice in cases of splenic torsion and infarction, while in patients with chronic symptoms splenopexy may also be attempted. We herein report three patients with wandering spleen, of whom two presented with acute torsion of the splenic pedicle and one demonstrated an asymptomatic mobile abdominal mass. In the first case splenopexy was attempted, but during follow-up the spleen was found to have undergone atrophy. The presentation, diagnostic procedures, and treatment modalities in pediatric wandering spleen are reviewed.

The impact of share wave elastography in differentiation of hepatic hemangioma from malignant liver tumors in pediatric population

OBJECTIVE In children it is crucial to differentiate malignant liver tumors from the most common benign tumor, hepatic hemangiomas since the treatment strategies are quite different. We aimed to evaluate the efficiency of shear wave elastography (SWE) technique in differentiation of malignant hepatic tumors and hepatic hemangiomas. METHODS Twenty patients with hepatic tumor were included in our study. Two radiologists performed SWE for 13 patients with malignant hepatic tumors including hepatoblastoma (n=7), hepatocellular carcinoma (n=3), metastasis (n=2), embryonal sarcoma (n=1) and 7 patients with hepatic hemangioma. All of our patients were between the age of 1 and 192 months (mean age: 56.88 months). Receiver operating characteristic analysis was achieved to evaluate the diagnostic accuracy of SWE and to determine the optimal cut-off value in differentiation hepatic hemangioma from malignant hepatic tumors. RESULTS The mean SWE values (in kPa) for the first observer were 46.94 (13.8-145) and 22.38 (6.6-49.6) and those for the second observer were 57.91 (11-237) and 23.87 (6.4-57.5), respectively for malignant hepatic tumors and hepatic hemangiomas. The SWE values of malignant hepatic tumors were significantly higher than those of hepatic hemangioma (p=0.02). The inter-observer agreement was almost perfect (0.81). The area under the receiver operating characteristic curve of SWE for differentiating the hepatic hemangioma from malignant hepatic tumors was 0.77 with a sensitivity of 72.7% and a specificity of 66.7% at a cutoff value of 23.62 with 95% confidence interval. CONCLUSION Shear wave elastography can be helpful in differentiation of malignant hepatic tumors and hepatic hemangioma.

Spontaneous splenic rupture in a patient with congenital afibrinogenemia.

Afibrinogenemia is a rare bleeding disorder which is observed with an incidence of 1:1 000 000. It is an autosomal recessive disease and occurs as a result of mutation in one of the three genes which code the three polypeptide chains of fibrinogen. Basic clinical findings include spontaneous bleeding, bleeding after minor trauma or due to surgery. Splenic rupture in afibrinogenemia has been reported only in 6 cases so far. In this article, we present a 15-year old congenital afibrinogenemia patient with spontaneous splenic rupture.

Total intestinal aganglionosis with involvement of the stomach

Total intestinal aganglionosis is the rarest form of Hirschsprungs disease, with absence of ganglia from the duodenum to the rectum. In addition to those cases reported in the literature, a neonate with total intestinal aganglionosis with involvement of the stomach is presented. Diagnosis of this extensive form of Hirschsprungs disease is a major problem. These patients lie beyond the scope of present surgical expertise, and the outcome is universally fatal.

A case of wandering spleen causing urinary symptoms after correction of a posterolateral diaphragmatic hernia.

Abstract A 12-year-old girl who had had an operation for a posterolateral diaphragmatic hernia was admitted to the hospital because of enuresis. Physical examination and radiologic studies revealed the spleen behind the urinary bladder, left-sided hydronephrosis, and a high volume of residual urine. The hydronephrosis and residual urine resolved immediately following splenectomy.

Type IV laryngotracheoesophageal cleft extending to mainstem bronchus in a child with multiple anomalies

A case of a total laryngotracheoesophageal cleft with extension to the right mainstem bronchus is reported. It was associated with brachyesophagus, intrathoracic microgastria, bilateral tri-lobed lungs, an extrapulmonary sequestration on the right, dextrocardia, cardiac anomalies, asplenia, a common bowel mesentery, and situs inversus.

ÇOCUKLUK ÇAĞI TÜMÖRLERİNİN AKCİĞER METASTAZLARINA CERRAHİ YAKLAŞIM

Amac: Cocukluk cagi solid tumorlerinin akciger metastazlarinda klinigimizin cerrahi yaklasiminin degerlendirilmesidir. Olgular ve Yontem: Akciger metastazi nedeniyle 1978-2016 arasinda basvuran ve cerrahi girisim yapilan olgular geriye donuk olarak incelendi. Yas, cinsiyet, primer tani, akciger metastazinin ortaya cikis zamani, cerrahi tedavi yontemi, patolojik tani ve takip acisindan degerlendirme yapildi. Primer tumoru kontrol altina alinan, baska uzak organ metastazi olmayan ve akciger metastazi icin cerrahi tedavi uygulanan olgular calismaya alindi. Bulgular: Onsekiz olgunun (K/E:11/7) yas ortalamasi 8,1 yil (1,5-14 yas) idi. Primer tumorler; Wilms tumoru (n:9,%50), Ewing sarkomu (n:3,%17), osteosarkom (n:2,%11), hepatoblastom (n:1,%5,5), fibrosarkom (n:1,%5,5), rabdomyosarkom (n:1,%5,5) ve endodermal sinus tumoru (n:1,%5,5) idi. Olgularin 4’unde ilk basvuru aninda akciger metastazi mevcuttu. Onaltisinda metastazin ortaya cikis zamani ortalama 16, 5 ay (7ay-4 yil) idi. Radyolojik degerlendirme tum olgularda preoperatif donemde akciger grafisi ve bilgisayarli tomografi (BT) ile yapildi. Onsekiz olguya toplam 23 torakotomi yapildi. Yirmibir wedge rezeksiyon, 1 lobektomi, 1 lobektomi ve kot rezeksiyonu uygulandi. Patolojik incelemede cikarilan lezyonlarin 3’u inflamatuar reaksiyon olarak degerlendirildi. Toraks dreni alinma suresi ortalama 5,2 gun(3-8), hastanede kalis suresi 7,3 gun(5-10 gun) idi. Cerrahi girisime bagli komplikasyon gorulmedi. Takipte 6 olgu ilerleyici primer hastalik nedeniyle kaybedildi. Sonuc: Cocukluk cagi tumorlerinde akciger metastazlari basvuru sirasinda ve/veya takipte gorulebilir. Cerrahi tedavisinde sinirli rezeksiyon yeterli gorunmektedir. Torakotomi bu olgularda tum lezyonlarin degerlendirilmesini saglamaktadir ve guvenle uygulanmaktadir. Radyolojik incelemeler tumor metastazini desteklese de kesin tani patolojik inceleme ile konulmaktadir.