Factors Affecting the Prevalence of Gastro-oesophageal Reflux in Childhood Corrosive Oesophageal Strictures

Background: Gastro-oesophageal reflux may accompany the corrosive oesophageal damage caused by the ingestion of corrosive substances and affect its treatment. The factors that affect the development of reflux in these cases and their effects on treatment still remain unclear. Aims: Our aim is to investigate the prevalence of gastro-oesophageal reflux in children with corrosive oesophageal strictures, the risk factors affecting this prevalence and the effects of gastro-oesophageal reflux on treatment. Study Design: Case-control study. Methods: We enrolled 52 patients with oesophageal stricture due to corrosive substance ingestion who were referred to our clinic between 2003 and 2010. Groups, which were determined according to the presence of gastro-oesophageal reflux (GER), were compared with each other in terms of clinical findings, results of examination methods, characteristics of the stricture and success of the treatment. Results: The total number of patients in our study was 52; 30 of them were male and 22 of them were female. The mean age of our study population was 4.2±2.88 years. Thirty-three patients had gastro-oesophageal reflux (63.5%). Patients who had strictures caused by the ingestion of alkali substances were 1.6-times more likely to have reflux. There were no differences between patients with or without reflux in terms of number and localisation of strictures. Mean distance of stricture was longer in patients with reflux (3.7±1.8 cm) than in patients without (2.2±1.0 cm) (p0.05). Conclusion: Corrosive oesophageal stricture was usually accompanied by gastro-oesophageal reflux and the length of stricture is an important risk factor. Negative effects of reflux over dilatation treatment have not yet been demonstrated in the short-term. Nevertheless, this frequent rate of reflux may eventually increase the risk of oesophagitis and Barrett’s oesophagus; therefore, we suggest that these effects should be prospectively evaluated in a large number of patients and these patients should be followed-up routinely in terms of the long-term effects of reflux

Factors affecting the prevalence of gastro-oesophageal reflux childhood corrosive oesophageal strictures

Background: Gastro-oesophageal reflux may accompany the corrosive oesophageal damage caused by the ingestion of corrosive substances and affect its treatment. The factors that affect the development of reflux in these cases and their effects on treatment still remain unclear. Aims: Our aim is to investigate the prevalence of gastro-oesophageal reflux in children with corrosive oesophageal strictures, the risk factors affecting this prevalence and the effects of gastro-oesophageal reflux on treatment. Study Design: Case-control study. Methods: We enrolled 52 patients with oesophageal stricture due to corrosive substance ingestion who were referred to our clinic be- tween 2003 and 2010. Groups, which were determined according to the presence of gastro-oesophageal reflux (GER), were compared with each other in terms of clinical findings, results of examination methods, characteristics of the stricture and success of the treatment. Results: The total number of patients in our study was 52; 30 of them were male and 22 of them were female. The mean age of our study population was 4.2±2.88 years. Thirty-three patients had gastro- oesophageal reflux (63.5%). Patients who had strictures caused by the ingestion of alkali substances were 1.6-times more likely to have reflux. There were no differences between patients with or without reflux in terms of number and localisation of strictures. Mean dis- tance of stricture was longer in patients with reflux (3.7±1.8 cm) than in patients without (2.2±1.0 cm) (0.05). Conclusion: Corrosive oesophageal stricture was usually accompa- nied by gastro-oesophageal reflux and the length of stricture is an important risk factor. Negative effects of reflux over dilatation treat- ment have not yet been demonstrated in the short-term. Neverthe- less, this frequent rate of reflux may eventually increase the risk of oesophagitis and Barrett’s oesophagus; therefore, we suggest that these effects should be prospectively evaluated in a large number of patients and these patients should be followed-up routinely in terms of the long-term effects of reflux. (Balkan Med J 2014;31:137-42).Background: Gastro-oesophageal reflux may accompany the corrosive oesophageal damage caused by the ingestion of corrosive substances and affect its treatment. The factors that affect the development of reflux in these cases and their effects on treatment still remain unclear. Aims: Our aim is to investigate the prevalence of gastro-oesophageal reflux in children with corrosive oesophageal strictures, the risk factors affecting this prevalence and the effects of gastro-oesophageal reflux on treatment. Study Design: Case-control study. Methods: We enrolled 52 patients with oesophageal stricture due to corrosive substance ingestion who were referred to our clinic be- tween 2003 and 2010. Groups, which were determined according to the presence of gastro-oesophageal reflux (GER), were compared with each other in terms of clinical findings, results of examination methods, characteristics of the stricture and success of the treatment. Results: The total number of patients in our study was 52; 30 of them were male and 22 of them were female. The mean age of our study population was 4.2±2.88 years. Thirty-three patients had gastro- oesophageal reflux (63.5%). Patients who had strictures caused by the ingestion of alkali substances were 1.6-times more likely to have reflux. There were no differences between patients with or without reflux in terms of number and localisation of strictures. Mean dis- tance of stricture was longer in patients with reflux (3.7±1.8 cm) than in patients without (2.2±1.0 cm) (0.05). Conclusion: Corrosive oesophageal stricture was usually accompa- nied by gastro-oesophageal reflux and the length of stricture is an important risk factor. Negative effects of reflux over dilatation treat- ment have not yet been demonstrated in the short-term. Neverthe- less, this frequent rate of reflux may eventually increase the risk of oesophagitis and Barrett’s oesophagus; therefore, we suggest that these effects should be prospectively evaluated in a large number of patients and these patients should be followed-up routinely in terms of the long-term effects of reflux. (Balkan Med J 2014;31:137-42)

Knotted bladder catheter: A simple removal technique with a guide wire

Mesane kateterizasyonunun nadir bir komplikasyonu olan kateter düğümlenmesi gelişen 14 aylık bir kız olgu sunulmaktadır. İdrar çıkışını engellemeyen kateter düğümü, floroskopi altında kılavuz tel yardımı ile açılarak kateter kolayca çıkarılabilmiştir. Kullanılan kılavuz telin ucunun bükülebilir, gövdesinin ise sert olmasının işlemi kolaylaştırdığı düşünülmüştür.We present a 14 months old girl in whom knotted bladder catheter without urinary retention was observed. Catheter knot was successfuly untied with a guide wire under floroscopy control. We thought that a guide with stiff body and flexible tip make the procedure easier

Severe Abdominal Trauma Involving Bicycle Handlebars in Children

Objectives: To emphasize the severity of the underlying injury which may not be realized during the initial patient admission to the emergency department

The place of rectal submucosal punch biopsy in definitive diagnosis of Hirschsprung's Disease

Amaç: Hirschsprung Hastalığı (HH)'nın kesin tanısında ülkemizde altın standart, halen, tam kat rektal biyopsidir (TKRB). Bu çalışmanın amacı HH tanısında alternatif bir biyopsi yöntemi olan rektal submukozal biyopsi (RSB) ile tam kat biyopsinin karşılaştırılmasıdır. Yöntem: Kliniğimize başvurup HH ön tanısı konan 20 olgunun RSB ve TKRB örnekleri geriye dönük olarak değerlendirildi. RSB'ler ameliyathane dışında, kliniğimizce hazırlanan özel bir tüp ve laringeal "punch" biyopsi forsepsi yardımı ile rektum arka duvarından mukoza ve submukozayı içerecek şekilde alınırken, TKRB'ler ameliyathane koşullarında gerçekleştirildi. Biyopsi örnekleri formaldehitle tespit edilerek, parafin bloklama sonrası 30 - 75 seri kesit HE ile boyanıp ışık mikroskobunda değerlendirildi. RSB örneklerinde submukozal pleksus, TKRB örneklerinde ise submukozal ve myenterik pleksuslar ganglion hücreleri açısından incelendi. Bulgular: Yirmi olgunun beşinde RSB örneklerinde ganglion hücresi belirlenirken, geri kalan onbeş olguda seri kesitlerde ganglion hücresi saptanmadı. Tüm olgularda TKRB örneklerinin inceleme sonuçları RSB sonuçları ile benzer bulundu. Sonuç: Bu çalışmanın sonuçları RSB'nin HH tanısında güvenilir, anestezi ve ameliyathane koşulları gerektirmeyen, düzeltici cerrahi işlemi etkilemeyen ve ucuz bir tanı yöntemi olduğunu düşündürmektedir. RSB, biyopsi örneklemesinde ve incelemesinde titiz davranılması kaydı ile diğer klinik ve görüntüleme yöntemleri ile birlikte HH tanısında rutin olarak kullanılabilmektedir.Purpose: Full thickness rectal biopsy is still the popular definitive diagnostic method for Hirschsprung's disease (HD). The purpose of this study is to compare rectal punch biopsy (RPB) with full thickness rectal biopsy (FTRB) in the diagnosis of Hirschsprung's disease. Methods: RPB and FTRB materials of 20 children with a presumptive diagnosis of HD were evaluated retrospectively. RPB were taken in an out-patient basis using a special designed rectal tube and a laryngeal punch biopsy forceps. After routine preparations, all the biopsy specimens were examined under light microscope. Submucosal plexus in RPB, submucosal and myenteric plexus in FTRB materials were investigated for the presence of ganglion cells. Results: 15 RPB materials showed absence of ganglion cells. Ganglion cells were positive in remaining five RPB materials. There was no difference between the findings of RPB and FTRB materials of each patient. Conclusion: This pilot study suggests that, RPB is a safe and cheap method without anesthesia and operating room necessity