Evaluation of Cases with Hydatid Cyst Who Presented with Pulmonary Symptoms

Aim: Hydatid disease is a parasitic infection caused by Echinococcus granulosus. The lungs are the most common affected organs in children. Hydatid disease can appear with nonspecific symptoms such as cough, chest pain and hemoptysis. Radiological findings are important in the diagnosis of the disease. In this article, we report ten patients who presented with nonspecific pulmonary symptoms. Methods: We included 10 patients (age range: 4-15 years) who attended our pediatrics outpatient clinic with the diagnosis of hydatid disease between May 2011 and May 2012. We analyzed the data on age, gender, primary complaint, clinical features, diameter and location of the cysts, and history of contact with animals. Hydatid cysts were diagnosed by imaging techniques and serologic tests. Results: The most common symptoms were coughing, chest pain, weakness, dyspnea, fever, and hemoptysis. In five patients, the cysts were located in the right lung; in four patients, the cysts were located in the left lung, and in the remaining patient, the cysts were bilateral. The diameters of the lung cysts were between 5 and 13 cm. Five of ten patients had both lung and liver cysts. Complications were observed in five patients. In eight patients, serologic tests results were positive. Five patients had a history of previous contact with animals. The patients were operated in the pediatric surgery unit. Conclusion: Hydatid disease is endemic in Turkey. Disease awareness and knowledge in children and their families is of great importance for the prevention of hydatid disease. (The Medical Bulletin of Haseki 2015; 53: 147-52

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