Anorektal malformasyonlu olgularda klinik deneyimimiz: 115 olgunun analizi

Objective: In this study, we aimed to evaluate our results on children with anorectal malformations (ARM) and associated anomalies. Methods: A total of 115 children who treated and followed in our clinic between 2000 and 2006 were retrospectively evaluated. Physical examination including perineal region, laboratory exams, abdominal X-ray, ultrasonography, echocardiography, and voiding cystourethrography when necessary were done to determine the type of ARM and associated anomalies. The patients were classified according to type of ARM and other pathologies. Results: Of the patients, 40.8% had high type ARM, 31.3% had low type, 17.3% had intermediate type, 9.5% had ectopic anterior located anus, and 0.86% had cloacal malformation. Associated anomalies were seen in 48.6% of patients. Associated anomalies were most commonly seen in high type of ARM patients (59.5%). Colostomy was performed in 80 patients; right transverse loop colostomy was performed in 56 (70%) cases, while high sigmoid colostomy was performed in 24 remaining cases. Stoma prolapse was developed in 17.8% of patients who underwent right transverse loop colostomy. Conclusion: It is crucial to examine perineal area carefully during the first admission and follow-up to determine the type of ARM and associated anomalies. It is beneficial to perform ultrasonography, echocardiography, distal colostogram, X-ray, and voiding cystourethrography when necessary. High divergent sigmoid colostomy may decrease complication rate in ARM patients

Amyand's hernia complicated with acute appendicitis: A case report and literature review

Amyand's hernia is the presence of the appendix within an inguinal hernia sac. It is a rare condition, occurring in 1% of inguinal hernia patients. The clinical presentation varies depending on the extent of appendix inflammation. Amyand's hernia is difficult to diagnose clinically. However, imaging studies are valuable for both its diagnosis and detection of the associated complications. Here, we report a case of Amyand's hernia in a 3-year-old male child who presented with a history of right inguinal tenderness, pain, and swelling. An operation revealed a hernia sac containing the inflamed appendix; hence, an appendectomy was performed along with a right inguinal herniotomy

Effect of gallic acid on liver injury during obstructive cholestasis after bile duct ligation in rat

Aim: To investigate the hepatoprotective, anti-inflammatory and antioxidant effects of gallic acid (GA) against obstructive cholestasis (OC) -induced liver damage in rats. Methods: Thirty female Sprague-Dawley rats were divided into three groups. Group 1 (n=10) was the sham-operated group. In group 2 and group 3, hepatoduodenal ligament dissection was performed after laparotomy. Once the common bile duct was made apparent, it was ligated with 4/0 silk surgical suture and cut between both sutures. Group 2 (n=10) was the control group. Group 3 (n=10) was the GA group. GA (50 mg/kg) was administered by oral gavage daily for 10 days. At the end of the experiment on day 10, the rats were anesthetized. Fibrosis, inflammation, ductal proliferation and necrosis were evaluated histopathologically. Serum levels of AST, ALT, TBIL, DBIL, LDH and GGT levels were determined. In the serum and liver, TAS, TOS, MDA, TNF-α, IL-1, IL-6, and IL 10 levels were evaluated.         Results:  When group 2 and group 3 were compared histopathologically, fibrosis and inflammation were significantly lower in group 3. In group 3, all LFTs (except DBIL), liver and serum IL-6, IL-1, TOS, MDA, and TNF-α levels were significantly lower than group 2, whereas IL-10 and TAS values were increased. Conclusion: Findings of this research indicate that GA may be effective against OC-induced liver damage in a rat model. We presume that the beneficial effects of GA are closely associated with its antioxidant and anti-inflammatory activities. Therefore, we think that using GA   can save us time before resorting to the surgical method

Megameatus with intact prepuce (MIP) hypospadias variant applicated tubularized incised plate (TIP) urethroplasty: A rare case report

A megameatus with intact prepuce (MIP) is an unusual variant of an anterior hypospadias that accounts for 3% of hypospadias repairs. It is characterized by a widely splayed coronal or subcoronal meatus, a deep glanulargroove, a normally conformed prepuce, and no chordee.In this case, good cosmetic and functional outcomes, such as achievement of a straight urine stream and patient satisfaction, were achieved using the tubularized incised plate (TIP) procedure. However, each case of MIP is unique, and a suitable procedure should be tailored to individual cases

Jejuno-ilealna perforacija i volvulus uzrokovani višekratnim gutanjem magnetnih stranih tijela

Foreign body ingestion is a common problem in children, but magnet ingestion is relatively rare. However, when it occurs, it tends to have a high rate of complications. This is a case report of a 3-year-old child who swallowed multiple magnetic toys, subsequently developing jejunoileal perforation and volvulus. This case report indicates that it is best to surgically remove multiple ingested magnets without delay to avoid intestinal perforation, fistula, and other complications such as volvulus.Gutanje stranog tijela čest je problem u djece, no gutanje magneta je relativno rijetko. Međutim, kad se to dogodi obično je praćeno visokom stopom komplikacija. U ovom prikazu slučaja opisuje se trogodišnje dijete koje je progutalo mnoštvo magnetnih igračaka, što je izazvalo jejuno-ilealnu perforaciju i volvulus. Ovaj prikaz slučaja pokazuje da je najbolje bez odlaganja kirurški odstraniti takve progutane magnete kako bi se izbjegla perforacija crijeva, fistule i druge komplikacije kao što je volvulus

The value of hematological inflammatory parameters in the differential diagnosis of testicular torsion and epididymo-orchitis in children

Aim: To investigate the value of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in differentiating acute scrotal conditions. Methods: A total of 60 patients, including 30 epididymo-orchitis and 30 testicular torsions, diagnosed and treated in our clinic between January 1, 2010 and December 2022, were included in the study. The patients were divided into two groups; group 1 (testicular torsion = TT) and Group 2 (epididymo-orchitis = EO). The age, diagnosis, and hemogram parameters of the patients were evaluated. Results: Both Group 1 and Group 2 consisted of 30 patients each. The mean ages of group 1 and 2 were 13.7, and 11.2 years, respectively (p>0.05). When compared to the group 2, NLR was higher in the group 2 (p<0.05). There was no statistically significant difference between the groups in terms of PLR value (p >0.05). ROC analysis was performed for NLR. According to the ROC analysis; at a cut-off value of 2.92, the sensitivity was 51% and the specificity was 87%, AUC (0.79; CI: 0.694 - 0.896). Conclusion: TT and EO can be diagnosed using inflammatory markers such as NLR. However, additional prospective studies are neede

Protective effects of cordycepin on the histopathological changes and oxidative stress induced by hepatic ischemia/reperfusion in rats

Aim: To investigate the effects of cordycepin on the histopathological changes and oxidative stress induced by hepatic ischemia/reperfusion (I/R) in rats. Method: Forty male Wistar rats were randomly divided into 4 groups as group I (sham, n=10), group II (control, n=10), group III (I/R-untreated, n=10) and group IV (I/R-cordycepin, n=10). Liver ischemia was induced for 30 min then reperfusion was allowed for 1 h. At the end of the experiment, liver specimens and blood samples were taken for histopathological and antioxidant evaluations, and biochemical analysis. Results: The levels of IL6, IL-1β, and TNFα in the serum and liver tissues were higher in the I/R-untreated group compared to the I/R-cordycepin treated group. In the I/R-cordycepin group, serum MDA levels were decreased compared with the I/R-untreated group. The I/R-cordycepin treated group showed an increase in TAS levels, and a decrease in TOS levels compared with I/R-untreated group. The histopathological injury score were significantly lower in the I/R-cordycepin treated group compared to the I/R-untreated group.  In the I/R-untreated group, the integrity of the hepatocyte cell lines deteriorated. Mononuclear inflammatory cells infiltrated the parenchyma regions, the sinuses dilated and there was diffuse congestion Preoperative treatment with cordycepine reduced histopathological abnormalities. Conclusion: Cordycepin has demonstrated significant hepatoprotective effects against I/R injury induced in rats through TAS elevation and reduction of TOS, MDA and proinflammatory cytokines

The utility of acoustic radiation force impulse imaging in diagnosing acute appendicitis and staging its severity

PURPOSEThe aim of this study was to investigate the feasibility of using acoustic radiation force impulse (ARFI) imaging to diagnose acute appendicitis.METHODSAbdominal ultrasonography (US) and ARFI imaging were performed in 53 patients that presented with right lower quadrant pain, and the results were compared with those obtained in 52 healthy subjects. Qualitative evaluation of the patients was conducted by Virtual Touch™ tissue imaging (VTI), while quantitative evaluation was performed by Virtual Touch™ tissue quantification (VTQ) measuring the shear wave velocity (SWV). The severity of appendix inflammation was observed and rated using ARFI imaging in patients diagnosed with acute appendicitis. Alvarado scores were determined for all patients presenting with right lower quadrant pain. All patients diagnosed with appendicitis received appendectomies. The sensitivity and specificity of ARFI imaging relative to US was determined upon confirming the diagnosis of acute appendicitis via histopathological analysis.RESULTSThe Alvarado score had a sensitivity and specificity of 70.8% and 20%, respectively, in detecting acute appendicitis. Abdominal US had 83.3% sensitivity and 80% specificity, while ARFI imaging had 100% sensitivity and 98% specificity, in diagnosing acute appendicitis. The median SWV value was 1.11 m/s (range, 0.6–1.56 m/s) for healthy appendix and 3.07 m/s (range, 1.37–4.78 m/s) for acute appendicitis.CONCLUSIONARFI imaging may be useful in guiding the clinical management of acute appendicitis, by helping its diagnosis and determining the severity of appendix inflammation

Absolute White Blood Cell Count and Neutrophil-Lymphocyte Ratio May Predict the Need for Double- J Stent Insertion in Ureteral Stones in Children: A Comparative Study

Objective: Our goal was to determine whether or not a double-J (DJ) stent insertion is required in cases of ureteral stones based on the absolute white blood cell (WBC) counts, neutrophillymphocyte ratio (NLR), absolute monocyte counts, and other laboratory markers. Materials and Methods: The patients were divided into two groups as those who did (Group 1), and did not (Group 2) need DJ stent insertion. The age, symptoms, diagnosis, hemogram parameters, and treatment results of the patients were evaluated. Results: Forty-nine percent (n=44) of the patients were female and 51% (n=46) were male. The groups did not differ in terms of age and gender (p>0.05). A higher incidence of hematuria was observed in Group 1 (p<0.05). WBC (p<0.05), NLR (p<0.05), and monocyte counts (p<0.05) were found to be higher in Group 1. In the ROC analysis; WBC and NLR were found to be two predictive markers for the need for DJ stent insertion. At a cut-off value of 12.6 x 109/L, WBC had 37% sensitivity, and 81% specificity (AUC: 0.67; 95% CI: 0.54-0.80), and at a cut-off value of 3.8, NLR had 65% sensitivity, and 76% specificity (AUC: 0.70; 95%CI: 0.57-0.82) in predicting the need for a DJ stent insertion. Reoperation was not required in any case. Conclusion: In cases of ureteral stones, the absolute WBC count and NLR may help determine the requirement (if any) for a double-J stent insertion