Yesim Edirne

Autologous blood pleurodesis: A good choice in patients with persistent air leak

AIM: The study compares the efficiency, side effects and complications of autologous blood pleurodesis with talcum powder and tetracycline. MATERIALS AND METHODS: This prospective study evaluated 50 patients with persistent air leak resulting from primary and secssondary spontaneous pneumothorax between February 2004 and March 2009. The patients inclussded 32 (64.0%) males and 18 (36.0%) females with a median age of 39 years (range 14-69 years). All cases had persistent air leak of more than seven days. Pleurodesis was performed using autologous blood in 20 (40.0%) patients, talc powder in 19 (38.0%) patients and tetracycline in 11 (22.0%) patients through a chest tube. Air leak cessation times after pleurodesis, side effects and pulmonary function tests (PFT) in the first and third months were measured. RESULTS: Recurrent primary spontaneous pneumothorax was the cause of persistent air leak in all cases. Air leaks were expiratory only in 54.0% of cases. We obtained a success rate of 75.0% using autologous blood, 84.2% using talc powder and 63.6% using tetracycline. Mean air leak termination interval was significantly (P < 0.001) shorter in patients treated with autologous blood in comparison to talc powder and tetracycline. We observed a significant (P < 0.05) decline in PFT in patients treated with talc powder compared with tetracycline and autologous blood. Vital capacity, FVC and FEV1 were significantly lower in patients treated with tetracycline compared with autologous blood. CONCLUSION: This study shows that autologous blood pleurodesis compared to talc powder and tetracycline is related with shorter leak cessation time and less pulmonary function decline in patients with persistent air leak. We think further randomized clinical trials of pleurodesis as treatment could increase its use in thorax surgery by demonstrating the safety and the efficacy of this procedure.

Landmine associated injuries in children in Turkey

This study aims to examine trends of injuries due to landmines and unexploded ordnance (UXO) and to determine problems during and after the treatment of children and adolescent victims in Turkey. Data from the records of 23 children injured from landmines and UXO were analyzed from April 2001 to October 2008. Cases consist of 21 (91.3%) males and two (8.7%) females with a mean age of 12.8 years. Cause of injury was landmine explosion in 20 (87.0%) and UXO in three (13.0%) cases. Injuries in upper and lower extremities were determined in eight (34.8%) children. Hand amputation was the result in 10 (43.5%) children where in two cases a leg, in one case an eye, in one case a hand and arm, in two cases a hand and leg, in one case an eye and a leg and in three cases a hand and eye were lost. One case of death was recorded from UXO with an autopsy performed. Contaminated areas in our region should be cleared according to international contracts to prevent injuries in children, centers providing rehabilitation services should be established and policies regarding social support for child victims should be ascertained.

Megacystis-microcolon-intestinal hypoperistalsis syndrome: a case report.

Megacystis Microcolon Intestinal Hypoperistalsis Syndrom (MMIHS) is a quite rare congenital and fatal disease which was firstly defined by Berdon and his colleagues. It appears through a widely enlarged bladder and microcolon and its cause is unknown (Berdon et al., 1976; Carmelo et al., 2005; Makhija et al., 1999; Loening-Baucke and Kimura 1999; Redman et al., 1984; Hsu et al., 2003; Yigit et al., 1996; Srikanth et al., 1993). The disease is found in females three or four times more than in males (Srikanth et al., 1993; Sen et al., 1993; Hirato et al., 2003). Most of the cases die within the early months of their lives (Yigit et al., 1996; Srikanth et al., 1993; Sen et al., 1993; Hirato et al., 2003). We present the case of a female newborn with antenatal ultrasound revealing intestinal mass and bilateral hydroureteronephrosis. The case was admitted for intestinal obstruction after birth.

Late recognized nail aspiration in a child: case report

Foreign body (FB) aspiration is common in children aged 0-3 years. Our case, a 2.5-year-old girl, presented with sudden onset of cough, fever and sputum; she had been treated twice for acute bronchitis four months ago. Resisting complaints led to an esophagoscopic examination in our Chest Surgery Clinic after a chest X-ray suggested FB in the esophagus, but no FB could be detected. A lateral chest X-ray revealed a FB with its sharp end targeting the trachea and its round end to the right hemithorax. Removal of the FB with forceps was not possible during rigid bronchoscopy. The FB was removed by thoracotomy and bronchotomy under general anesthesia. The removed FB was a nail measuring 6 cm in length. This case report should serve to stress the diversity of FB aspirations in childhood, the role of parental neglect, and that physicians should be aware of the possibility of FB in children with persistent cough.

A rare cause of childhood ileus: giant mesenteric lipoma and a review of the literature.

Mesenteric lipomas are benign tumors of mature fat cells. They are usually asymptomatic and create a clinical picture that depends on the localization and size of the lipoma. Although rare, unusually large mesenteric giant lipomas can cause partial or complete bowel obstruction. Lipomas resulting in partial bowel obstruction can present with symptoms such as intermittent abdominal pain and abdominal distention. With complete obstruction, a child can present with an acute abdomen. Treatment is the excision of the mass along with the affected portion of bowel. In this case study, a 2-year-old female presented with a bowel obstruction due to the presence of a giant mesenteric lipoma. Clinical features of 16 cases published in the English literature to date are presented.

İnmemiş testiste geç kalma nedenleri: iki çocuk cerrahisi merkezinin sonuçları

Sum mary Aim: We evaluated the age at surgery, family educational level and the physicians roles in cases of undescended testis operated in our clinic of age. Material and Method: A total of 463 patients operated for undescended testis were divided into two groups as older and younger than two years. An interview was conducted with 90 families from each group to query the family education level, how the diagnosis was made and by whom the diagnosis was made including the reasons for delay in the diagnosis, if any. Results: A total of 494 testes of 463 patients examined at the Pediatric Surgery Clinics of Denizli State Hospital and Ordu Obstetric and Pediatric Hospital between 2006 and 2011 were included in the study. The percentages of the patients older and younger than two years were 59.4% (n=275 patients, Group 1) and 40.6% (n=188 patients, Group 2), respectively. The parents were graduates of primary school in 67.2% of the cases and graduates of high school or university in 20% of the cases in the first group, while the respective percentages were 38.8% and 41.6% in the second group (p<0.05). In the first group, the parents stated that they were not aware of the problem in 86.6% of the cases, while it was stated that the child had been examined by other physicians for other reasons previously in 97.7% of the cases. Conclusions: An important reason for delay in diagnosis of undescended testis in our country may be due to low educational levels of families and the negligence of the physicians regarding the genital examination. (Turk Arch Ped 2013; 48: 44-47)

Epididymal cyst, a rare cause of pediatric childhood scrotal mass: case report.

Epididymal cysts are very rare benign cysts of the rete testis, ductuli efferentes or epididymis. They usually present in peripubertal males with scrotal pain or mass and can also be diagnosed incidentally during a physical examination. They can be seen at a rate of 5-14% depending on age of the children with a scrotal anomaly. The etiology is not fully known but they are seen more commonly (20%) in children whose mother received diethylstilbestrol during pregnancy. The diagnosis is with physical examination and ultrasonography. The cysts resolve spontaneously in most cases and can be therefore safely monitored unless they are very big or cause pain. Painful cysts may need to be excised. We present a 13-year-old case with an epididymal cyst who presented with a left scrotal mass and pain and had to undergo excision after 6 months of monitoring as the pain did not resolve.