A Review of 2625 Isolated Hydrocele Cases in Children

Introduction: Inguinal hernias and hydroceles are the most frequently performed procedures in pediatric surgery departments. In this study, we aimed to define the spontaneous regression rate in different types of  hydroceles, the regression age, the timing of surgery, and the optimal treatment approaches for each hydrocele type in cases with isolated hydroceles in children.Material &Methods: This historical cohort study included 2625 patients which were admitted between January 2004 and December 2012. The hydroceles were classified as: ‘non-communicating hydroceles’, ‘communicating hydroceles’, ‘spermatic cord hydroceles’ and ‘abdomino-scrotal hydroceles’ (ASH). Patients were divided into two groups with regard to their ages at diagnosis as follows: those presenting in the newborn period and before 24 months of age (Younger– Group 1) and those presenting after 24 months of age (Older – Group 2). Determining the type of isolated hydrocele, the decision making for follow-up or surgery, and the follow-up period were conducted by 7 attending pediatric surgeons and 6 residents. Results: In Group 1, 93% of 1086 non-communicating hydroceles, 40% of 158 cord hydroceles, and 15% of 34 communicating hydroceles resolved during the follow-up, and the remaining patients with each type of hydrocele underwent surgery. In Group 2, 8.7% of 183 non-communicating hydroceles resolved during the follow-up.Conclusion: The primary treatment of patients with isolated hydrocele should be decided regarding the type of hydrocele, along with age at admission, and accordingly, conservative or surgical treatment should be considered

11-Year Experience with Gastroschisis: Factors Affecting Mortality and Morbidity

Objective: The aim of the study was the evaluation of patients treated with a diagnosis of gastroschisis and to establish the factors which affected the morbidity and mortality. Methods: Twenty-nine patients, managed for gastroschisis during 2000-2010 were reviewed retrospectively. Patients were analysed in respect to gestational age, birth weight, associated anomalies, type of delivery, operative procedures, postoperative complications, total parenteral nutrition (TPN) related complications. The factors affecting mortality and morbidity were determined. Findings: Associated abnormalities were present in 24% of the patients. Eleven patients underwent elective reduction in the incubator (Bianchi procedure) without anesthesia. Eight patients had delayed reduction with silo and ten patients had primary closure. Although the type of delivery had an effect on morbidity but not mortality, gestational age, birth weight, and the operative procedure performed had no effect on morbidity or mortality. Duration until tolerance of oral intake, and of TPN and hospitalization were found to be statistically significantly shorter in the group of babies delivered by cesarean section. Conclusion: In our study the most important cause of mortality was the abdominal compartment syndrome and multi-organ failure in the early years. Long hospitalization periods and sepsis were the main causes of mortality in recent years

A Case of Atypical (Cellular) Congenital Mesoblastic Nephroma Presenting with High Serum Levels of Neuron Specific Enolase in Neonatal Period

The most common causes of abdominal mass are neuroblastoma, germ cell tumors, hepatoblastoma and congenital mesoblastic nephroma. Congenital mesoblastic nephroma (CMN) accounts for more than 90% of all renal tumors seen in the first three months of life. Total nephrectomy is curative. Neuron-specific enolase is a glycolytic enzyme that is localized primarily to the neuronal cytoplasm. Its sensitivity is especially high for neuroblastoma and small cell lung cancer. In this paper, we report a newborn with abdominal mass that was firstly considered as neuroblastoma due to calcifications observed on ultrasonography and high levels of serum neuron-specific enolase. After histopathological evaluation of the lesion, the patient was diagnosed as having atypical (cellular) congenital mesoblastic nephroma. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 223-6