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Since the beginning of the Covid19 pandemic, it has greatly affected healthcare professionals who are in direct contact with patients in our country and in our hospital, as well as all over the world. Many guidelines have been published for the precautions to be taken during the preoperative, perop and postoperative periods, especially in surgical branches that need to intervene in organs with high viral load. In our study, we aimed to share up-to-date information about what needs to be done, and what has been done in the pediatric surgery and organ transplant clinic in this process. [ABSTRACT FROM AUTHOR]

Purpose: Adrenal gland injury (AGI) caused by trauma may cause bleeding and life-threatening problems in children. The objective of this study was to analyze the prevalence of AGI in final diagnoses of trauma. Materials and Methods: The records of 458 patients with abdominal trauma (out of a total 8,200 pediatric patients with trauma of any sort), who were referred to our clinic between January 2009 and July 2014, were reviewed retrospectively. The numbers of patients with AGI and their ages, gender, trauma patterns, affected organs, pediatric trauma scores (PTSs), and injury severity scores (ISSs) were recorded, as well as the associated ultrasound (US) and tomographic scan data, treatments, and complications. Computed tomography (CT) scans obtained after trauma were subjected to both primary and secondary evaluation. Results: In total, 28 patients with AGI were detected; their average age was 8.54 ± 4.09 (3-17) years. Twenty (71%) patients were male and 8 (29%) were female. Nineteen (68%) patients had fallen from heights; the most commonly injured organs were the kidneys, spleen, and lungs. Injuries were right-sided in 26 (92.9%) patients. The mean ISS was 13.2 (range 5-50) and the mean PTS 8.6 (range 0-11). Seven patients had ISS > 16 and nine had PTS < 8. AGI was diagnosed by CT in 14 (50%) patients and in 3 (9%) by US at primary evaluation. Upon secondary scan inspection focusing on the possibility of adrenal gland injury, such injury was ultimately detected in 28 patients. All patients underwent conservative follow-up, and one died. Conclusion: We recommend calculation of the PTS, as well as other trauma scores, when pediatric patients suffering multiple or blunt abdominal trauma(s) present to the emergency . In addition, we believe that in children with trauma involving the liver, spleen or kidneys, careful evaluation using a CT scan would increase the diagnosis of AGI and reveal a realistic rate of AGI in trauma cases. [ABSTRACT FROM AUTHOR]

Objectives: In our study, the assessment of age, gender, incidence and seasonal differences in the regions related to appendicitis were investigated. Methods: 676 patients that received an operation following a diagnosis of appendicitis in 3 hospitals from 3 different regions of Turkey occurring at different dates were examined retrospectively after being categorized by region. The differences among groups were compared to each. Results: The mean age of male (63%) (n = 426) and female (37%) (n = 250) patients (total = 676) was 10.8 years (range, 1-18 years). The percentage of female patients in the The Black Sea Region (BR) group was significantly higher (48%) than that in the other two groups (%33 for SR, 30% for MR) (P = 0.001). The frequency of appendicitis was higher (36%) in the spring and winter (25%) than that during summer or fall. The number of cases increased the most in the BR group in spring (47%) (P < 0.001). When the types of appendicitis in the different age groups were compared with season, acute appendicitis (P < 0.02) was more frequently (93%) seen in the child-adolesan (CA) group in the spring; however, perfore apandicitis (45%) was greater in the Infant-Preschool (IPS) group (P < 0.02). Acute appendicitis comprised 55% and perforated appendicitis comprised 45% of cases in the IPS group, whereas acute appendicitis comprised 78% and perforated appendicitis comprised 22% in the CA group. Conclusion: According to the results of our study, appendicitis was most frequently seen in the spring and winter seasons and more frequent in boys between the ages of 10-13 years. As age decreases, the frequency of perforated appendicitis increases. Appendicitis is affected by environmental factors. Reducing the incidence of appendicitis may be possible by establishing regional and specific studies related to this subject and the etiologies of the disease. [ABSTRACT FROM AUTHOR]

Objectives: In our study, the assessment of age, gender, incidence and seasonal differences in the regions related to appendicitis were investigated. Methods: 676 patients that received an operation following a diagnosis of appendicitis in 3 hospitals from 3 different regions of Turkey occurring at different dates were examined retrospectively after being categorized by region. The differences among groups were compared to each. Results: The mean age of male (63%) (n = 426) and female (37%) (n = 250) patients (total = 676) was 10.8 years (range, 1-18 years). The percentage of female patients in the The Black Sea Region (BR) group was significantly higher (48%) than that in the other two groups (%33 for SR, 30% for MR) (P = 0.001). The frequency of appendicitis was higher (36%) in the spring and winter (25%) than that during summer or fall. The number of cases increased the most in the BR group in spring (47%) (P < 0.001). When the types of appendicitis in the different age groups were compared with season, acute appendicitis (P < 0.02) was more frequently (93%) seen in the child-adolesan (CA) group in the spring; however, perfore apandicitis (45%) was greater in the Infant-Preschool (IPS) group (P < 0.02). Acute appendicitis comprised 55% and perforated appendicitis comprised 45% of cases in the IPS group, whereas acute appendicitis comprised 78% and perforated appendicitis comprised 22% in the CA group. Conclusion: According to the results of our study, appendicitis was most frequently seen in the spring and winter seasons and more frequent in boys between the ages of 10-13 years. As age decreases, the frequency of perforated appendicitis increases. Appendicitis is affected by environmental factors. Reducing the incidence of appendicitis may be possible by establishing regional and specific studies related to this subject and the etiologies of the disease.r. [ABSTRACT FROM AUTHOR]

Background: There are insufficient data on pre-screening for pancreatic pseudocysts (PC) following pancreatic trauma. This study investigated the use of radiological and laboratory testing for predicting the development of pancreatic pseudocysts after trauma.Materials and Methods: The clinical records of all pediatric patients presenting with pancreatic trauma between January 2003 and December 2014 were reviewed retrospectively. Patients with American Association for the Surgery of Trauma (AAST) scores of Grade 3-5 were enrolled. The patients were divided into groups that developed [Group 1 (n = 20)] and did not develop [Group 2 (n = 18)] PC. The patients were evaluated in terms of their baseline characteristics, additional injuries, Injury Severity Score (ISS), pancreatic injury site, blood amylase levels 2 h and 10-15 days after the trauma, clinical presentation, and duration of intensive care unit (ICU) stay.Findings: We followed 38 patients. Of the patients in Group 1, 70 % had an injury to the tail of the pancreas. The ISS trauma scores and durations of hospitalization and ICU stay were significantly greater in Group 2 (p < 0.05). The mean blood amylase level on Day 1 was 607 U/L (range 183-801 U/L) in Group 1 and 314 U/L (range 25-631 U/L) in Group 2; the respective levels on Day 10 were 838 U/L (range 123-2951 U/L) and 83.2 U/L (range 35-164 U/L). The serum amylase levels were significantly higher (p < 0.001) in Group 1 than in Group 2 on Days 1 and 10. Four patients developed complications and two patients died.Conclusion: Pancreatic pseudocyst formation is more likely in patients with AAST Grade 3 pancreatic injury, also serum amylase levels ten times greater than normal 2 h after the trauma, and persistently elevated serum amylase levels 10-15 days following the trauma. [ABSTRACT FROM AUTHOR]

Objective: This study summarises the outcomes of 149 patients who underwent surgery for antenatally diagnosed unilateral hydronephrosis. Methods: The medical records of such patients over a 23-year period were reviewed retrospectively. Age at the time of operation, preoperative and postoperative mean pelvic diameter on ultrasound, split renal function, washout patterns on scintigraphy, and early and late complications were recorded. Results: The mean preoperative follow-up period was five months (range: 1-66 months). One patient was operated on after 12 months and two patients after five years of follow-up. Mean preoperative pelvic diameter and renal function were 30.8 mm and 38.6%, respectively; all patients had an obstructive washout pattern. In the postoperative period, the corresponding measurements were 11.7 mm and 39.2%, with 111 non-obstructive, 24 partially obstructive, and 14 obstructive wash-out patterns. Three patients with severe caliectasis and low renal function underwent surgery despite mild hydronephrosis. The mean postoperative follow-up period was six (range 4-11) years. Complications developed in 14 (9.3%) patients. Conclusion: Patients with antenatal hydronephrosis may need surgery even after a follow-up period of six years. Because of the potential late development of complications, postoperative follow-up should be continued for 10 years. [ABSTRACT FROM AUTHOR]

A free-floating intraperitoneal mass is extremely rare, and almost all originate from an ovary. Here, we present the first case with an intraperitoneal free-floating autoamputated ovary that caused an acute abdomen in a child and also review the literature. A 4-year-old girl was admitted with signs and symptoms of acute abdomen. At surgery, the patient had no right ovary and the right tube ended in a thin band that pressed on the terminal ileum causing partial small intestine obstruction and acute abdomen. A calcified mass was found floating in the abdomen and was removed. The pathological examination showed necrotic tissue debris with calcifications. An autoamputated ovary is thought to result from ovarian torsion and is usually detected incidentally. However, it can cause an acute abdomen. [ABSTRACT FROM AUTHOR]

Objective:To investigate the role of cordycepin in testicular ischemia/reperfusion injury in rats.Materials and methods:Forty Wistar albino rats were randomly divided into four groups, as follows: group one, control (C); group two, torsion and ischemia (I); group three: detorsion with ischemia–reperfusion (IR); and group four, detorsion/cordycepin. The rats were then analyzed macromorphologically and histopathologically, and blood tests were performed. Specifically, the total oxidant status (TOS) and total antioxidant status (TAS) were determined, and malondialdehyde (MDA), tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β levels were analyzed. In addition, pyknotic nuclei, spermatozoa, edema, and hemorrhage were assessed.Results:When the IR and cordycepin groups were compared with the other groups, there was a statistically significant decrease in TNF-α and MDA levels (p< 0.05). Increased TAS levels were observed in the cordycepin group compared with the control group. TOS levels were significantly increased in the I and IR groups, but decreased in the cordycepin group (p< 0.05). Similar effects were observed in tissue biochemistry analysis. Histopathological evaluations revealed that the spermatozoa count was decreased in the I and IR groups. However, there was an increase in the cordycepin group, as well as a statistically significant difference between the IR and cordycepin groups (p< 0.01). Finally, edema and inflammation were increased in the I and IR groups, but decreased in the cordycepin group.Conclusions:Histological and biochemical findings revealed that cordycepin protected against IR-induced testicular injury. [ABSTRACT FROM AUTHOR]

Total avulsion and transection of the esophagus at the esophagogastric junction are very rare after blunt trauma, and their management is challenging. Here, we present the case of a boy with this injury. To date, only two cases have been reported in children. One was treated successfully and the other died. The initial emergency operation should aim to save the life and native esophagus. Therefore, a primary or early thoracal end esophagostomy with gastrostomy should be performed, while primary repair should not be. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to present our experience in the use of crystallized phenol (CP) to treat pediatric patients with 'simple' and complex' Pilonidal sinus disease (PSD).Materials and Methods: Patients who underwent CP treatment in between January 2015 and January 2020 were evaluated retrospectively, using prospectively collected data. The patients were divided into simple and complicated groups. The groups were assigned depending on the number of sinuses and clinical presentation. The groups were compared in terms of age, sex, number of sessions, cost analysis, body mass index (BMI), recurrence, time resolution, cosmetic results, results /improvement, and complications.Results: This study included 54 patients: 28 (52%) girls and 26 (48%) boys. The mean number of sinuses was 2.4. Symptoms included discharge in 50 (92%) patients, and pain in 42 (78%) patients. Fifty (93%) patients experienced mild pain during the procedure, whereas four (7%) patients had moderate pain. The mean number of CP sessions was 2.9; mean numbers of CP sessions were 2.2 and 4.2 in the Simple and Complicated groups. In total, 5 of 54 patients (9%) had recurrence.At the end of treatment, therapeutic success was achieved in 49 of 54 (91%) patients: 31 of 33 (94%) patients in the Simple group and 18 of 21 patients (86%) in the complicated group. The mean treatment cost for the whole cohort was $17.40. One patient (2%) presented with moderate skin burns. Cosmesis was deemed acceptable by patients, although there was evidence of minor skin burns following the procedure.Conclusions: The findings showed that the CP procedure was advantageous for treatment of PSD, because it was minimally invasive, cost-effective, provided good cosmesis, and had a high success rate and low complication rate. Furthermore, it did not require prior examination, and could be performed under local anesthesia. Therefore, the CP procedure may be useful as a first-line treatment option in children with PSD. [ABSTRACT FROM AUTHOR]

Single-port laparoscopic surgery (SPLS) is a surgical technique with many advantages over conventional laparoscopy. Its range of indications has expanded alongside the development of its unique tools and equipment. We are able to safely perform SPLS with the low-cost glove-port method without need of any specially developed SPLS port or the TriPort Access System. For this study, the files of patients who underwent laparoscopic surgeries performed between the dates of January 2013 and December 2014 at our clinic were reviewed. Umbilical access single-port abdominal surgeries which were performed using glove-port technique were included in the study. Two hundred nineteen patients who underwent SPLS surgery were included in the study. Of these patients, 158 (72.1%) were male and 61 (27.8%) were females. 58.4% of the cases were appendectomies (n = 128), 20% were orchidopexies (n = 44), 8.6% were orchiectomies (n = 19), 5.4% were ovarian cyst excisions (n = 12), 3.6% were varicocelectomies (n = 8), 2.2% were peritoneal dialysis catheter placements (n = 5), and 1.3% were nephroureterectomies (n = 3). In 67 cases (30.4%), Kirschner wire was used to eliminate the need for a second port. The study concludes that glove-port SPLS, which can readily be performed using conventional tools and Kirschner wire rather than expensive specially developed instruments, is a preferable technique because it is reliable, more cost-effective, and results in a scarless recovery. [ABSTRACT FROM AUTHOR]

Objective: Ecballium elaterium(EE) is a plant from Cucurbitaceae family. Its anti-inflammatory role in sepsis is not well understood. We investigated the effects of EE on serum levels of proinflammatory cytokines and further explored the mechanisms underlying histological changes in liver and ileum following EE administration in a polymicrobial sepsis model.Methods:Thirty rats were divided into three groups of 10 rats each. Rats were subjected to sham laparotomy plus normal saline administration (control group, CG), laparotomy withcecal ligation and puncture(CLP) (sepsis group, SG), and laparotomy with CLP plus 2.5 mg/kg EE administration (experimental group, EG). Twenty-four hours after laparotomy, animals underwent cardiac puncture, and blood was collected for interleukin 1 (IL-1), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) assessment. Whole sections of liver and ileum tissues were collected for histologic examination.Results:The serum level of IL-6 was significantly lower in EG as compared to SG. Although IL-6 levels were shown a statistically significant (p< 0.0001) decline to near control values, no significant changes were observed in serum levels of IL-1 and TNF-α after EE treatment. Histologic examination revealed statistically significant reduction in collagen formation (p= 0.001) on serosal surface of ileum and hepatic venous congestion (p= 0.040) in EG as compared to SG.Conclusion:EE might play a protective role in sepsis prevention and treatment by decreasing IL-6 production and reducing liver damage and may influence bacterial translocation by reinforcing intestinal barrier function. [ABSTRACT FROM PUBLISHER]

Aim: The objective of the present study was to evaluate the diagnostic methods, concomitant organ injuries, factors affecting mortality and morbidity, treatment methods, and outcomes of patients treated for traumatic gastrointestinal (GI) perforation.Materials and Methods: We conducted a retrospective review of the medical records of 96 patients who had been treated for GI perforation between January 2000 and October 2015. Data were collected and organised according to the following categories: general patient information, age, gender, hospitalisation period, trauma mechanisms, concomitant injuries, radiological assessment, diagnosis and treatment methods, treatment forms, and complications. The cases were divided into two groups, blunt and penetrating traumas, and the patients within each group were compared. Colorectal trauma cases were not included in this study. Patients suspected of a GI perforation were assessed by standing plain abdominal radiograph (SPAR) and ultrasound scan (US). Patients who had a normal SPAR, and showed free or viscous fluid in the abdomen on US underwent computed tomography (CT) scanning. Surgery was performed if patients displayed free air in the abdomen on a SPAR or CT scan, showed viscous fluid without any additional injury, provided normal radiological images but displayed signs of peritonitis, or were clinically unstable. The patients were scored according to the Injury Severity Score (ISS) system.Results: In total, 96 patients, with an average age of 10.3 ± 4 years (1-17 years) and diagnosed with a GI perforation, were reviewed retrospectively. The patients included 88 (91 %) males and 8 (9 %) females. The presence of free air on SPAR was detected in 42 (52 %) patients, whereas no free air was detected in 39 (48 %) patients. Non-specific significant findings were detected in 45 (76 %) out of 59 patients by USS, and in 78 % of patients by CT (viscous fluid, fluid, free air). The most affected organ was the ileum, which was detected in 37 (39 %) patients. Primary repair was performed on 71 (74 %) patients, while resection was performed on 22 (23 %); 3 (3 %) patients underwent an ostomy. Ten (10 %) patients experienced complications and five (5 %) patients died. The ISS scores for blunt and penetrating traumas were 14, 15 and no significant difference was detected between the scores (p > 0.05).Conclusions: Although the complication rate for patients with penetrating trauma was higher than for those with blunt trauma, the rate of mortality increased in patients with blunt trauma. Free air may not be detected by SPAR even if a GI perforation exists. Since diagnostic challenges may increase the rate of mortality and morbidity in GI perforations, we believe that a combination of radiological imaging and rapid abdominal examination is important in cases where SPAR cannot detect free air. [ABSTRACT FROM AUTHOR]

Purpose: Using percutaneous nephrolithotomy (PNL), it is easy to reach stones in various parts of the kidney via a single access tract. In the current study, we set out to demonstrate that the intravenous catheter is a safe way to gain renal access, and that PNL is safe in children.Materials and Methods: We retrospectively reviewed the medical records of patients who underwent PNL as a treatment for renal stone disease at our center between September 2013 and December 2014. There were no specific exclusion criteria. We used 14 gauge intravenous catheter for renal access in all cases.Results: Eleven of the 32 patients (34.4%) were female and 21 (65.6%) were male. The mean ± SD patient age was 4.7 ± 3.71 years (9 months-16 years). Six patients (18.7%) were infants less than 1 year of age. Fifteen of the stones (46.8%) were located in the right kidney, and 17 of the stones (53.1%) were located in the left kidney. The average stone size was 13.9 ± 4.8 mm (range, 12-28). The average duration of operation was 69.7 ± 10.4 minutes (range, 50-110), and the average duration of fluoroscopy was 2.21 ± 1.06 minutes (range, 1-6). There were complications in 5 of the cases (15.6%).Conclusion: The access and dilatation stages are quite important. We propose that the intravenous catheter is a safe and inexpensive tool for renal access in PNL in pediatric age group patients. [ABSTRACT FROM AUTHOR]

Infantile fibrosarcoma is a very rare soft tissue tumor that originates most commonly in the body and extremities. We present a neonate with an infantile fibrosarcoma that originated in the ileocecal region and was detected incidentally without symptoms. This is the first case of fibrosarcoma reported in the ileocecal region. [ABSTRACT FROM AUTHOR]