Predictor of Hirschsprung-associated enterocolitis: A regression analysis: Hirschsprung-associated enterocolitis

Aim: To identify independent predictors for Hirschsprung-associated enterocolitis (HAEC) through regression analysis of various clinical factors. Method: This retrospective study examined clinical, surgical, and diagnostic data of patients treated for Hirschsprung's disease (HD), evaluating the impact of various factors like aganglionic segment length and postoperative complications. Results: We analyzed data from 161 patients with HD. Surgical interventions were split between the Rehbein procedure at 47.2% (n=76) and transanal endorectal pull-through (TEPT) at 52,8% (n=85). The median age at diagnosis was 7 [3-12.5] months. The average length of the aganglionic segment measured 25 [20-30] cm distributed as follows: ultrashort segment (16.9%, n=27), rectosigmoid (47.5%, n=76), descending colon (18.8%, n=30), splenic flexure (12.5%, n=20), transverse colon (3.7%, n=6), and ascending colon (0.6%, n=1). Preoperative enterocolitis was observed in 33.1% (n=53). Postoperative enterocolitis occurred in 28.1% (n=45). Additional interventions included rectal botox injections (2.5%, n=4), myectomies (3.1%, n=5), and re-do surgeries (3.1%, n=5). Anastomotic strictures were noted in 5.6% (n=9) of the cases. Upon analyzing patients who presented with HAEC in the preoperative period, it was determined that the length of the aganglionic segment (p=0.001, OR: 1.07) and the age at diagnosis (p=0.003, OR: 1.03) were independent risk factors for HAEC. A positive correlation was found between Length of aganglionic segment and number of preoperative HAEC (p=0.002, r=0.405). Conclusion: In our study, it was observed that long-segment Hirschsprung's disease and a delayed age at diagnosis are risk factors for Hirschsprung-associated enterocolitis

Unusual Presentation of Duplex Kidneys: Ureteropelvic Junction Obstruction

Aim. Ureteropelvic junction obstruction (UPJO) is rarely associated with a duplex collecting system. We review this unusual anomaly in terms of presentation, diagnostic evaluation, and surgical management. Method. We retrospectively reviewed the medical records of patients diagnosed with a duplex system with UPJO. Result. Sixteen patients (6 girls, 10 boys) with 18 moieties were treated surgically and four patients were treated conservatively. The median age at surgery was two years (range, 2 months to 7 years). The lower pole and upper moiety were affected in 12 and two kidneys, respectively, and both were affected in two patients. The anomaly was right-sided in 12 moieties and left-sided in six. The duplication was incomplete in seven patients and complete in nine. The mean renal pelvis diameter at the time of surgery was 25.6 (range 11-48 mm) mm by USG. The mean renal function of the involved moiety was 28.3% before surgery. Management included pyelopyelostomy or ureteropyelostomy in six moieties, dismembered pyeloplasty in eight moieties, heminephrectomy in four cases, and simultaneous upper heminephrectomy and lower pole ureteropyelostomy in one patient. Conclusion. There is no standard approach for these patients and treatment should be individualized according to physical presentation, detailed anatomy, and severity of obstruction

Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey

Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children