A Rare but Serious Complication of Ladd's Procedure: Recurrent Midgut Volvulus

An eighteen-month-old boy who had undergone a Ladd's procedure for malrotation in the newborn period presented with acute onset of nausea, vomiting, rectal bleeding, and confusion. Laparotomy revealed midgut volvulus, mesenteric lymphadenopathy and massive chylous ascites. Recurrent midgut volvulus following Ladd's procedure is extremely rare but should be borne in mind in cases of persistent or recurrent gastrointestinal symptoms. Timely surgery is necessary to avoid intestinal gangrene and decrease morbidity and mortality related to consequences of midgut volvulus

Complications of the two major operations of Hirschsprung's disease: A single center experience

This study was designed to determine and compare the results of the Duhamel and Swenson procedures. The hospital records of patients who had undergone the Swenson or Duhamel operation over a 17-year period were reviewed and the patients were contacted for a final evaluation. The early and late complications of these operations were defined and compared. It was determined that the Swenson operation had been performed in 138 patients and the Duhamel in 59. Among the various complications, such as wound infection, dehiscence, anastomotic leak, adhesive intestinal obstruction, pelvic abscess, intraabdominal abscess, mucosal prolapsus, anastomotic stricture and fistulas, only the anastomotic stricture showed significantly higher percentages in patients who had undergone the Swenson procedure. When urinary incontinence, enterocolitis, soiling and constipation were considered, there was no significant difference between these two groups. There was one death in the Swenson group and none in the Duhamel group. The authors suggest the Duhamel operation as a simpler and safer method for the treatment of Hirschsprung's disease

Complications of total implantable access ports and efficacy of Taurolidine-citrate lock solution against catheter-related infections

Background: Totally, implantable access ports (TIAPs) are used for long standing venous catheterization. This study was designed to present our experiences of the TIAPs applications and efficacy of Taurolidine-citrate lock solution (TCLS) against catheter-related infections. Materials and Methods: We evaluated records of the 108 patients implanted with 112 TIAPs, which had been performed using heparin solution or TCLS between 2005 and 2013. Results: Duration of exposure to TIAPs was 17-2051 days (median: 411 days). The primary diagnoses were solid tumours (n = 57), lymphoma (n = 23), haematologic diseases (n = 23), nephrotic syndrome (n = 4), Hirschsprung disease (n = 1). The right external jugular vein was most frequently used vascular access route (72.3%). Mechanical complications were observed in four cases. TIAPs were removed due to remission in 19 cases and infection in 19 cases. Median time from implantation and to the development of infection was 60 days. Heparin solution had been used for care in 33 ports, whereas heparin and TCLS had been used in 79 ports. Based on statistical comparison, use of TCLS was considered to be an important factor for preventing infection (P = 0.03). Conclusion: We consider that TCLS reduces infection prevalence so TIAPs would be used more extensively and effectively to prevent infections

Karaciğer tümörleri ve cerrahi deneyimlerimiz

Kliniğimizde bir yıl içerisinde karaciğer tümörü netanısı ile izlenen hastaların bulguları sunulmaktadır. Gereç ve Yöntem: Kliniğimizde 1 yıl içerisinde 6 olgu (3 hepatoblastom, 1 hepatosellüler karsinom, 1 metastatik karaciğer kitlesi -opere Wilms' tümörü- ve 1 embriyonel rabdomiyosarkom) izlenmiştir. Bu çalışmada hastaların bulguları geriyedönük olarak taranmıştır. Bulgular: 4'ü erkek ikisi kız olan hastaların yaşları 4 ay ile 6 yaş arasındaydı. Hastaların tümü tümör belirteçleri, dopler ultrasonografi ve bilgisayarlı tomografik hepatik anjiyografi ile değerlendirildi. 4 hastada kitle tam olarak çıkarıldı. Hepatoblastoma tanılı bir hastaya canlı vericiden karaciğer nakli yapıldı. Hepatoblastomlu diğer bir hasta ise kemoembolizasyon sonrasında kemoterapi programına alındı. Sonuç: Çocukluk çağı karaciğer tümörleri ameliyat öncesi bilgisayarlı tomografik hepatik anjiyografi ile ayrıntılı olarak değerlendirilmelidir. Bu hastaların cerrahi sağaltımları deneyimli bir cerrahi ekip tarafından uygun ameliyathane donanımı olan merkezlerde yapılmalıdır. Karaciğer nakli, metastazı olmayan ve çıkarılamayan tümörlerde uygulanması gereken cerrahi sağaltım olmalıdır. Here, we present our one year experience in patients with liver tumors. Patients and Method: 6 patients' data (1 hepatoblastoma, 1 hepatocellular carcinoma, 1 metastatic liver mass -previously operated for Wilms' tumor- and 1 embryonal rabdomyosarcoma) were investigated retrospectively. Results: Four of the patients were male and the others were female. Ages were changed between 4 months and 6 years. All patients were investigated with tumor markers, hematological and biochemical analysis, Doppler ultrasonography and computerized tomographic hepatic angiography. Tumor was totally resected in four patients. One patient underwent live-donor partial liver transplantation. One patient with hepatoblastoma is still receiving preoperative chemotherapy. Conclussion: It is quite important to define the tumor borders with computerized tomographic hepatic angiography. We believe that liver tumor surgery should be performed by experienced surgeons in well-equipped centers. Liver transplantation is the treatment of choice in unresectable non-metastatic tumor

Karaciğer tümörleri ve cerrahi deneyimlerimiz

Kliniğimizde bir yıl içerisinde karaciğer tümörü netanısı ile izlenen hastaların bulguları sunulmaktadır. Gereç ve Yöntem: Kliniğimizde 1 yıl içerisinde 6 olgu (3 hepatoblastom, 1 hepatosellüler karsinom, 1 metastatik karaciğer kitlesi -opere Wilms' tümörü- ve 1 embriyonel rabdomiyosarkom) izlenmiştir. Bu çalışmada hastaların bulguları geriyedönük olarak taranmıştır. Bulgular: 4'ü erkek ikisi kız olan hastaların yaşları 4 ay ile 6 yaş arasındaydı. Hastaların tümü tümör belirteçleri, dopler ultrasonografi ve bilgisayarlı tomografik hepatik anjiyografi ile değerlendirildi. 4 hastada kitle tam olarak çıkarıldı. Hepatoblastoma tanılı bir hastaya canlı vericiden karaciğer nakli yapıldı. Hepatoblastomlu diğer bir hasta ise kemoembolizasyon sonrasında kemoterapi programına alındı. Sonuç: Çocukluk çağı karaciğer tümörleri ameliyat öncesi bilgisayarlı tomografik hepatik anjiyografi ile ayrıntılı olarak değerlendirilmelidir. Bu hastaların cerrahi sağaltımları deneyimli bir cerrahi ekip tarafından uygun ameliyathane donanımı olan merkezlerde yapılmalıdır. Karaciğer nakli, metastazı olmayan ve çıkarılamayan tümörlerde uygulanması gereken cerrahi sağaltım olmalıdır. Here, we present our one year experience in patients with liver tumors. Patients and Method: 6 patients' data (1 hepatoblastoma, 1 hepatocellular carcinoma, 1 metastatic liver mass -previously operated for Wilms' tumor- and 1 embryonal rabdomyosarcoma) were investigated retrospectively. Results: Four of the patients were male and the others were female. Ages were changed between 4 months and 6 years. All patients were investigated with tumor markers, hematological and biochemical analysis, Doppler ultrasonography and computerized tomographic hepatic angiography. Tumor was totally resected in four patients. One patient underwent live-donor partial liver transplantation. One patient with hepatoblastoma is still receiving preoperative chemotherapy. Conclussion: It is quite important to define the tumor borders with computerized tomographic hepatic angiography. We believe that liver tumor surgery should be performed by experienced surgeons in well-equipped centers. Liver transplantation is the treatment of choice in unresectable non-metastatic tumor

Huge Neck Masses Causing Respiratory Distress in Neonates: Two Cases of Congenital Cervical Teratoma

Congenital cervical teratomas are rare and usually large enough to cause respiratory distress in the neonatal period. We present two cases of congenital huge cystic neck masses in which distinguishing cervical cystic hygroma and congenital cystic teratoma was not possible through radiologic imaging techniques. Experience with the first case, which was initially diagnosed and treated as cystic hygroma by injection sclerotherapy, led to early suspicion and surgery in the second case. The masses were excised completely and histopathologic diagnoses were congenital teratoma in both patients. Our aim is to review congenital huge neck masses causing respiratory distress in early neonatal life to highlight this dilemma briefly with these interesting cases. Copyright (C) 2014, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved