Caustic Ingestion

Caustic ingestion with resultant esophagitis and gastritis is still an important social and medical problem due to early and long-term complications. This injury is seen frequently as an accidental event and may also lead to psychosocial impacts, including antisocial behavior, suicide attempts, criminal incarceration, and educational delinquency. It often occurs as a result of uncontrolled and unsafe storage of materials used in household cleaning. Despite the various treatment proposals, optimal management of the patients remains controversial. The presentation of the depth and extent of injury with endoscopy plays a key role in treatment planning. In the absence of life-threatening complications, the general approach is conservative management in the acute period. The most common complications are esophageal stricture and gastric outlet obstruction. Different treatment methods such as bougienage, stent application, balloon dilation, or esophageal replacement are used in the treatment of the caustic esophageal strictures. The decision of the least invasive method for the treatment of complications will reduce the potential hazardous results

Çocuklarda kronik rektal kanamanın nadir bir sebebi; soliter rektal ülser: Olgu sunumu

Solitary rectal ulcer causing lower gastrointestinal bleeding is extremely rare in children. Rare presentation, non-specific symptoms, insufficient experience, and characteristics mimicking other rectal diseases may cause misdiagnosis or delay of diagnosis in some pediatric patients. Here, we report a 10-year-old boy with solitary rectal ulcer diagnosed two years after onset of the symptoms who responded well to the conservative therapy, including high-fiber diet, laxatives, defecation training, and sucralfate enema.Alt gastrointestinal kanamaya neden olan soliter rektal ülser, çocuklarda oldukça nadir görülür. Nadir görülmesi, özgün olmayan bulgularla ortaya çıkması, bu konuda yeterli deneyimin olmaması ve çeşitli rektal hastalıkları taklit etmesi, bazı çocuk hastalarda yanlış veya gecikmiş tanıya neden olabilmektedir. Burada, belirtilerin başlangıcından 2 yıl sonra tanısı konan, yüksek lifli diyet, laksatif, tuvalet eğitimi ve sükralfat lavman tedavisine iyi yanıt veren soliter rektal ülserli 10 yaşındaki bir olgu sunuldu

Tekrarlayan peritonitle bulgu veren atipik mesane divertikülü : Olgu sunumu

Mesane divertikülleri detrusor kasının doğuştan zayıflığından kaynaklanır. Sıklıkla divertikül içindeki üriner staz sunucu gelişen idrar yolları enfeksiyonu ile kendini gösterir. Mesane çıkım tıkanıklığı, alt ekstremitede siyanoz, intestinal tıkanıklık, üreteral tıkanıklık gibi divertikülün doğrudan basısı sonucu ve divertikülün kendiliğinden rüptüre sonucu gelişen peritonit gibi farklı klinik tablolara neden olabilmektedir. Bu yazıda, perfore apandisiti taklit eden ve perforasyon olmadan tekrarlayan jeneralize peritonite neden olan mesane divertikülü olan bir olgu sunuldu.Bladder diverticula develop from congenital detrusor muscle defect and frequently present with urinary tract infection, which occurs as a result of urinary stasis in the diverticula. Different clinical presentations, such as bladder outlet obstruction, cyanosis of the lower extremities, intestinal obstruction, ureteral obstruction (which may occur due to direct diverticular compression), and peritonitis due to spontaneous rupture of the diverticula, were reported previously. Here, we report a case with the diagnosis of bladder diverticulum that caused recurrent generalized peritonitis without perforation and mimicked perforated appendicitis

A giant pulmonary hydatid cyst causing respiratory failure : Case report

Hidatidozisin klinik bulguları kistin lokalizasyonu ve büyüklüğü ile ilişkilidir. Küçük kistler perforasyon veya enfeksiyon gibi komplikasyonlar gelişmediği sürece genellikle belirti vermezler. Ancak, büyük boyutlara ulaşmış kistler komşu organlara yaptığı bası ile semptomatik hale gelebilirler. Burada sol hemitoraksı dolduran dev hidatik kiste sahip ve solunum sıkıntısı nedeniyle acil cerrahi müdehale gerektiren 6 yaşındaki kız hasta sunulmuştur.The clinical signs of hydatidosis depend on the size and location of the cyst. Small pulmonary cysts are usually asymptomatic unless it they show complications such as perforation and enfection. However, large cysts may be symptomatic by compression of the adjacent vital organs. We report a 6-year-old girl with huge hidatid cyst in the left hemithorax, who required emergency surgical intervention because of respiratory distress

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

Complications of total implantable access ports and efficacy of Taurolidine-citrate lock solution against catheter-related infections

Background: Totally, implantable access ports (TIAPs) are used for long standing venous catheterization. This study was designed to present our experiences of the TIAPs applications and efficacy of Taurolidine-citrate lock solution (TCLS) against catheter-related infections. Materials and Methods: We evaluated records of the 108 patients implanted with 112 TIAPs, which had been performed using heparin solution or TCLS between 2005 and 2013. Results: Duration of exposure to TIAPs was 17-2051 days (median: 411 days). The primary diagnoses were solid tumours (n = 57), lymphoma (n = 23), haematologic diseases (n = 23), nephrotic syndrome (n = 4), Hirschsprung disease (n = 1). The right external jugular vein was most frequently used vascular access route (72.3%). Mechanical complications were observed in four cases. TIAPs were removed due to remission in 19 cases and infection in 19 cases. Median time from implantation and to the development of infection was 60 days. Heparin solution had been used for care in 33 ports, whereas heparin and TCLS had been used in 79 ports. Based on statistical comparison, use of TCLS was considered to be an important factor for preventing infection (P = 0.03). Conclusion: We consider that TCLS reduces infection prevalence so TIAPs would be used more extensively and effectively to prevent infections

Approaches to Female Congenital Genital Tract Anomalies and Complications

Objective: Female congenital genital tract anomalies may appear with quite confusing and deceptive complications. This study aims to evaluate the difficulties in diagnosis and treatment of female congenital genital tract anomalies that frequently present with complications. Summary: During a 10-year period, we evaluated 20 female patients with congenital genital tract anomalies aged between 3 days and 16 years. All patients were retrospectively analyzed in terms of the results of diagnostic studies, surgical intervention, and treatment. Methods: Ultrasonography and magnetic resonance imaging revealed hydromucocolpos or hematocolpometra, imperforate hymen, distal vaginal atresia, didelphys uterus, an obstructed right hemivagina, uterovaginal atresia, a unicornuate uterus with a noncommunicating rudimentary horn, a vesicovaginal fistula, a utero-rectal fistula, intraabdominal collection, and a vaginal calculus. Results: Two patients had Mayer-Rokitansky-Kuster-Hauser syndrome and 6 patients had obstructed hemivagina and ipsilateral renal anomaly syndrome. Definitive surgical interventions were hymenotomy, vaginal pull-through, vaginovaginostomy, and vesico-vaginal fistula repair using a transvesical approach. In conclusion, female congenital genital tract anomalies may appear with a wide range of complications. Conclusions: There is a potential to do significant harm, if the patient's anatomic problems are not understood using detailed imaging. Revealing the anatomy completely and defining the complications that have already developed are critical to tailor the optimal treatment strategies and surgical approaches