Bladder perforations in children

Context: Bladder perforations in children occur due to several different reasons.Aim: In this clinical series study, we focused on bladder perforations due to the pelvic injury, and our aim also was to create awareness for a rare type of bladder injuries.Setting and Design: This was a retrospective study of the patients who were treated in our clinic for bladder perforation between 2006 and 2011.Subjects and Methods: We reviewed the documents of childhood bladder perforations, and demographic and clinical characteristics of the patients were obtained. No statistical analyses were used because of the limited number of cases.Results: There were ten patients who suffered from bladder perforation in 5‑year period; 5 were male, and 5 were female. The mean age of the patients was 4.35 years. Four patients (40%) experienced iatrogenic perforation and six patients (60%) experienced perforation due to the accident. Common symptoms were hematuria, abdominal tenderness, and inability to urinate. Three patients were diagnosed via emergency laparotomy, without any radiological examinations performed before surgery. Four patients suffered from the intraperitoneal perforation, three patients suffered from extraperitoneal injury and three of them both of intraperitoneal and extraperitoneal injuries. Mean recovery time for patients was 15 days. One patient developed a urinary tract infection and one newborn died due to accompanying morbidities. Nine patients were discharged from the hospital.Conclusion: If the patients had a pelvic injury, surgeons must pay attention for the bladder perforation. Isolated bladder perforations are rare, and they are generally associated with iatrogenic injuries. Clinicians should pay attention to findings such as anuria, inability to insert a urinary catheter, and free fluid in the abdomen in order to diagnose the bladder perforation in newborns. Novice surgeons should pay more attention to avoid causing iatrogenic bladder perforation during inguinal hernia repair.Keywords: Bladder, child, iatrogenic, perforation, traum

Laboratory Results and Clinical Findings of Children with Hydatid Cyst Disease

Objectives: The relationship hydatid cyst (HC) is a parasitic disease that is endemic worldwide. Aims: To study the clinical findings and laboratory results of patients with hydatid disease. Materials and Methods: Total number of patients (n = 78) who underwent surgery for HC disease from 2000 to 2017 were retrospectively  evaluated. The patients’ demographic characteristics, reasons for admission into hospital, lesion location and size, laboratory results, andcomplications were recorded. Results: Of the HCs, 59% and 26.9% were located in the liver and lungs, respectively. The rate of multiple organ involvement was 10.3%. A total of 16 (20.5%) cases had ruptured HCs (7 livers, 7 lungs, 1 spleen, and 1 omentum). There was no significant difference in the rate of eosinophilia between patients with and without cyst rupture (P = 0.9). Indirect hemagglutination (IHA) tests yielded negative results in 38.9% of the patients; among them, 32.1% had ruptured HCs. A negative IHA test result was significantly associated with rupture (P = 0.046). No significant difference between ruptureand cyst size or location was found. Conclusions: HC rupture was not correlated with cyst size. The sensitivity of serological tests and the blood eosinophil count was low, even in cases of ruptured HCs. The recurrence rate can be reduced by open surgery and medical treatments. Keywords: Child, echinococcosis, hemagglutination test, recurrence, ruptur

Is stent type used in snodgrass method a factor in fistula formation?

Context: Snodgrass method (tubularized incised plate urethroplasty [TIPU]) is a widely used technique for hypospadias repair.Aim: It was aimed to compare the outcome of hypospadias repair with stenting using feeding tube compare with those with Foley catheter.Subjects and Methods: The demographic characteristics of the 123 patients who underwent hypospadias repair with Snodgrass method, the success of the applied method, and the factors affecting fistula complication were evaluated retrospectively. Patients were divided into two groups: those operated before January 2010 (Group A) and those who were operated after (Group B). In Group A patients, urethroplasty was performed using silicone Foley catheters, in which balloon of these catheters was filled by saline at appropriate size. In Group B, urethroplasty was performed using feeding catheter.Results: Group A and Group B consisted of 32 and 91 patients, respectively. Fistula developed in 10 (31.3%) and 4 (4.39%) patients in Group A and Group B, respectively. There was a statistically significant difference between the two groups in terms of the development of fistula complication (P = 0.0002).Conclusion: The use of a feeding catheter in TIPU could be a more advantageous than using a Foley catheter.Keywords: Complication, fistula, hypospadias, stent, tubularized incised plate urethroplast

Bochdalek Hernia and Intrathoracic Ectopic Kidney: Presentation of Two Case Reports and Review of the Literature

Bochdalek hernia is a congenital abnormality with high morbidity and mortality characterized by passage of the abdominal organs into the thoracic cavity through a diaphragmatic defect. Intrathoracic location of abdominal organs such as kidneys is very rare, with a reported incidence of only 0.25% in the literature. Herein, we present two cases of Bochdalek hernia with a herniation of intra‑abdominal organ such as kidney that was treated in our clinic and compare this rare case with those in the literature. In both cases, the functionally normal kidneys were left in situ during diaphragmatic repair. No complications were observed during the postoperative period, and 10‑ and 1‑year follow‑ups. In cases with Bochdalek hernia associated with an intrathoracic ectopic kidney, the functionally normal ectopic kidneys were left in situ during repair of the diaphragmatic defect without complications.Keywords: Bochdalek hernia, intrathoracic ectopic kidney, review of literature, two case report

Irisin immunohistochemistry in gastrointestinal system cancers

Cancer is the leading cause of morbidity and mortality worldwide. Some studies have shown that high heat kills cancer cells. Irisin is a protein involved in heat production by converting white into brown adipose tissue, but there is no information about how its expression changes in cancerous tissues. We used irisin antibody immunohistochemistry to investigate changes in irisin expression in gastrointestinal cancers compared to normal tissues. Irisin was found in human brain neuroglial cells, esophageal epithelial cells, esophageal epidermoid carcinoma, esophageal adenocarcinoma and neuroendocrine esophageal carcinoma, gastric glands, gastric adenosquamous carcinoma, gastric neuroendocrine carcinoma, gastric signet ring cell carcinoma, neutrophils in vascular tissues, intestinal glands of colon, colon adenocarcinoma, mucinous colon adenocarcinoma, hepatocytes, hepatocellular carcinoma, islets of Langerhans, exocrine pancreas, acinar cells and interlobular and interlobular ducts of normal pancreas, pancreatic ductal adenocarcinoma, and intra- and interlobular ducts of cancerous pancreatic tissue. Histoscores (area x intensity) indicated that irisin was increased significantly in gastrointestinal cancer tissues, except liver cancers. Our findings suggest that the relation of irisin to cancer warrants further investigation