Intraabdominal infections

Intraabdominal infeksiyonlar (İAİ) akut apandisit gibi basit bir abdominal infeksiyondan ciddi sonuçları olan barsak infarktına kadar uzanan heterojen bir grup cerrahi alan infeksiyonunu tanımlar. İAİ’lar toplumdan kaynaklı veya sağlık bakımı ile ilişkili olabilir. İAİ olan hastalarda erken tanı, kaynak kontrolü ve uygun amprik tedavi ile morbidite ve mortalite önlenebilir. Bu yazıda erişkin ve çocuklarda gözlenen İAİ’ların tanı ve tedavi özellikleri güncel rehberler ışığında derlenmeye çalışılmıştır.Intraabdominal infections (IAI) defined a heteregous group of surgical site infections ranging from a simple abdominal infection such as acute appendicitis, to an intestinal infarct with severe consequences. IAI may be seen either community acquired or health-care related. Mortality and morbidity can be prevented by early diagnosis, source control and appropriate ampric treatment. It is aimed to review the diagnostic and treatment features of IAI in adults and children with the light of current guidelines

Neonatal perforated appendicitis in incarcerated inguinal hernia in the differential diagnosis of testis torsion

Appendicitis in newborns is uncommon and difficult to diagnose. Reports on neonatal appendicitis subsequent to inguinal hernia incarceration are exceptionally rare. We present the case of a 26-day-old infant with perforated appendicitis due to incarceration of a right inguinal hernia, mimicking right testicular torsion

A premature infant with H-type tracheoesophageal fistula demonstrated by scintigraphic technique

Purpose: Congenital tracheoesophageal fistula (TEF) without esophageal atresia is commonly known as "H" type. This is extremely rare in infants. The rarity of the condition, its nonspecific symptomatology, and limitations in its demonstration by contrast radiology and endoscopy contribute to delays between first presentation and confirmation of the diagnosis. Our aim was to demonstrate a congenital H-type tracheoesophageal fistula by using Tc-99m sulfur colloid scintigraphy

Pharmacokinetics and pharmacodynamics of aprepitant for the prevention of postoperative nausea and vomiting in pediatric subjects

Background/purpose: This multicenter, randomized, partially-blinded phase IIb study evaluated the pharmacokinetics (PK)/pharmacodynamics, safety, and tolerability of aprepitant in pediatric subjects for the prevention of postoperative nausea and vomiting (PONV)

Long-termoutcomes of six patients after partial internal biliary diversion for progressive familial intrahepatic cholestasis

Background: Partial internal biliary diversion (PIBD) is an alternative approach for the treatment of devastating pruritus in patients with progressive familial intrahepatic cholestasis (PFIC). In these patients quality of life can be improved and progression of liver disease can be delayed while waiting for liver transplantation. The aim of our study was to evaluate six patients with PFIC who have undergone PIBD in long-term follow-up

Mediastinal Masses In Children: Experience With 120 Cases

Primary mediastinal malignancies are rare tumors and can originate from any mediastinal organ or tissue such as thymic, neurogenic, lymphatic, germinal, ormesenchymal. The authors reviewed all cases of primary pediatric mediastinal masses diagnosed over a 25-year period to determine the pattern of presentation, the histology, and the outcome of the surgical treatment. In this study, 120 primary pediatric mediastinal mass cases diagnosed between 1985 and 2011 are retrospectively evaluated according to their age, sex, symptoms, anatomical location, surgical treatment, and histopathological evaluation. The median age of the patients was 5.8 years. There were 34 benign and 86 malign tumors. Thirty patients were asymptomatic. Common symptoms in the patients were cough, dyspnea, fatigue, fever, abdomen pain, back pain, and neurological symptoms. According to their origins, they were presented as neurogenic tumors (38.3%), lymphomas (18.3%), undifferentiated sarcomas (15%), germ cell tumors (7.5%), and the other tumors (22%) thymic pathologies, lymphangiomas, rhabdomyosarcomas, lipomas, hemangiomas, and Wilms' tumor. Complete resection of the tumor was performed in 86 patients, partial resection of the tumor was the intervention in 11 patients. In 23 patients, biopsy was undertaken. Because of the high incidence of asymptomatic or nonspecific presentation such as the upper airway disease, the presentation of a mediastinal mass in children may be challenging. Neurogenic tumors or lymphomas are indicating surgery, if possible complete resection, for both benign and malignant conditions. Although surgery is the mainstay of therapy for most mediastinal tumors, an experienced multidisciplinary approach is necessary

Effects of iloprost, a stable prostacyclin analog on experimental neonatal necrotizing enterocolitis model Deneysel yenidoǧan nekrotizan enterokolit modelinde stabil prostasiklin analoǧu olan iloprost'un etkisi

Aim: Necrotizing enterocolitis (NEC) is a common clinical emergency of gastrointestinal system in the neonatal period. Pathological findings are characterized by inf-lammation and coagulation necrosis. It is well known that ilioprost, a stabile prostacyclin analogue, has vasodilator, anticoagulant and cyto-protective effects. We aimed to evaluate the effects of iloprost on experimental neonatal NEC. Material and Method: 30 Wistar Albino rat pups aged 1-8 hours were separated into three groups. Group I (control group) was not stressed with any factor. Group II was stressed with hypoxia by breathing of 100 % CO2 for 5 minutes and with exposure to cold at +4°C for 10 minutes. This protocol was performed twice daily for 4 days. Iloprost was used (2 μgr/kg, intraperitoneally) in group III at the end of the each hypoxic and cold stress. Samples from the blood, hepatic and splenic tissue for microbiological study and terminal ileum biopsy for histopathological evaluation were obtained at the end of the 4th day. Results: No bacterial growth was detected in the blood, hepatic and splenic tissue cultures in the control group. Bacterial reproduction was detected in all rats in group II and in 5 rats in group III. Most of the isolated microorganisms were gram negative bacteria. Terminal ileum biopsies were normal in the control group. In group II, histopathologic findings were normal in three rats while grade-2 and grade-3 injury was detected in five and two rats respectively. In group III, seven rats had normal histopathological findings while grade-1 and grade-2 injury were detected in 2 and 1 rats respectively. There were statistically significant difference betweengroup I and group II and between group II and group III. Discussion: Iloprost reduced the severity of the intestinal damage which occurred secondary to hypoxia and hypothermia causing NEC. We suggest that iloprost and its analogues may be effective with their vasodilating, antitrombotic, tissue and cytoprotective effects against causes of NEC

Our approach to esophageal perforation secondary to dilatation of caustic esophageal stricture in children

Background: This study aims to review our 20-year experience in children with esophageal perforation and develop an algorithm