Search

Amaç: Bu çalışmanın amacı, çocuklarda primer malign böbrek tümörlerinin klinik özellikleri, tedavi yaklaşımları ve tedavi sonuçlarının değerlendirilmesidir. Gereç ve Yöntem: 2006 ile 2020 yılları arasında primer malign böbrek tümör tanısı alan ve izlenen çocuk hastaların onkoloji dosyaları geriye yönelik incelendi. Hastaların demografik ve klinik özellikleri ile tedavi yaklaşımları ve izlemleri not edildi. Bulgular: Bu yıllar arasında izlenen 950 malign hastalıklı çocuğun 49’unda(%5,2) primer malign böbrek tümörü vardı. Hastaların yaşı üç gün ile 13 yıl arasında değişiyordu (ortanca, 3 yıl). Erkek kız oranı 25/24'dü. En sık görülen semptom ve bulgu karında kitle idi. İki hasta da bilateral hastalık vardı (%4,1). Patolojik tanılar, Wilms tümörü (n = 44, % 89,8), mezoblastik nefroma (n=2, % 4,1), böbreğin clear hücreli sarkomu (n=2, % 4,1) ve böbreğin primer sinovyal sarkomuydu (n=1, %2). Wilms tümörlü hastalardan sadece ikinde diffüz anaplazi vardı. Hastalarımızın risk grupları düşük (n = 4, % 8.3), orta (n = 35, % 72.9) ve yüksek riskli (n = 9, % 18.8) idi. Hastaların takip süreleri iki ay ile 15 yıl (ortanca, 5 yıl) arasında değişiyordu. Primer böbrek tümörlerinde genel ve olaysız sağ kalım oranları sırasıyla % 72,7 ve% 59,7 idi. Wilms tümörlü hastaların genel ve olaysız sağ kalım oranları %79 ve %63'dü. Sonuç: Primer malign böbrek tümörlerinde özellikle de Wilms tümöründe multidisipliner yaklaşımlarla başarı oranları yükselmiştir. Bundan sonra hem tedavi başarısının daha da artırılması hem de tedavi ilişkili yan etkilerin azaltılması üzerinde durulmalıdır.

Aim: Breeders provide a set of reference values for the specific populations, however, rats produced in local experimental animal research centers may have undergone physiological and genetic changes. Our aim in this study was to contribute to further studies by investigating the biochemical and hematological profile of Wistar rats raised under standard local conditions at the Selcuk University Experimental Medicine Research and Application Center (SUDAM), Konya, Turkey. Materials and Methods: The study included 1 (male=15, female=15), 3 (male=15, female=15), 6 (male=15, female=15), and 12-month-old (male=15, female=15) Wistar rats living their normal lives in the Animal House of SUDAM. Selected biochemical and hematological parameters were measured with the Beckman AU 5800 and Beckman Coulter LH-780 analyzers, respectively. Results: Urea, creatinine, ALT, albumin, globulin, RBC, hemoglobin, hematocrit, and MCH levels differed significantly between rats according to months (p Conclusion: This study proved that biochemical and hematological parameters of Wistar rats may alter with factors such as age, gender, environment, and nutrition.

Amaç: Over disgerminomu tanısı ile izlenen hastala­rın demografik ve klinik özellikleri ile tedavi yaklaşımlarını geriye dönük olarak incelemektir. Gereç ve Yöntem: XXXXXX Üniversitesi Tıp Fakültesi Çocuk Onkoloji Bilim Dalı’nda, 2006-2020 yılları arasında over disgerminom tanısı alan çocuk hastaların dosyaları geriye dönük olarak incelendi. Sonuç: On disgerminom tanısı alan hasta çalışmaya dâhil edildi. Hastaların yaşları 8 ile 17 yıl arasında değişmekteydi (ortanca, 12,5 yıl). Dokuz hastada kitle tek taraflı iken (%90), bir hastada iki taraflıydı (%10). Tüm hastalarda, başvuru şikâyetleri karında şişlik ve karın ağrısı idi. Bir hastada over torsiyonu gelişmişti. Yedi hastada ameliyat öncesi alfa föto protein düzeyleri normal sınırlarda iken, hCG düzeyleri yedi hastanın tamamında yüksekti. Laktat dehidrojenaz enzim düzeyi beş hastada bakılmıştı ve hepsinde yüksekti. Beş hasta primer cerrahi uygulandı ve bu hastaların tamamı evre I’di ek tedavi verilmedi. Üç hastada, bilateral hastalık ya da yaygın hastalık nedeniyle neoadjuan tedavi olarak uygulandı. Hastaların izlem süreleri bir yıl ile 13 yıl arasında değişmekteydi (ortanca, 5,5 yıl). Hastaların genel yaşam oranı % 87,5 idi. Yorum: Özellikle ergenlik çağına yakın kız hastalarda hızlı büyüyen karın içi kitlelerde disgerminom akla gelmeli ve tedavi planlaması buna göre yapılmalıdır.

Aims: This study aims to evaluate the role of standardized dynamic renal scintigraphy (DRS) in recognizing vesicoureteral reflux (VUR) in patients detected with VUR by voiding cystourethrography (VCUG). Methods: The data of all pediatric patients who underwent both VCUG and DRS [technetium-99m diethylenetriamine pentaacetic acid (Tc-99m DTPA) or technetium-99m mercaptoacetyltriglycine dynamic renal scintigraphy (Tc-99m MAG-3)] in our hospital between 2013 and 2022 were retrospectively reviewed. Tc-99m MAG-3 was used in infants and Tc-99m DTPA radiopharmaceutical in children over one year old. According to VCUG findings, VUR grades were grouped as grade I-II-III low-grade VUR and IV-V high-grade VUR. The role of DRS in detecting VUR in both low and high-VUR-grade groups was evaluated. Results: A total of 56 patients (and 69 renal units), 23 girls (%41.1), and 33 boys (%68.9) were included in this study. The median value of the time elapsed between the DRS and VCUG examinations was nine days. According to VCUG, VUR was grade I in five renal units, grade II in 19 renal units, grade III in six renal units, grade IV in six renal units, and grade V in 33 renal units. DRS detected VUR in two of 30 renal units (%6.7) in the low VUR grade group. On the other hand, VUR was observed with DRS in 27 of 39 renal units (%69.2) in the high VUR grade group. Conclusions: Standardized DRS shows very low sensitivity in recognizing low-grade VUR, and its performance in detecting high-grade VUR is comparatively better. Raising awareness among clinicians that VUR can be observed with standardized DRS will benefit the patient in terms of early detection of accompanying VUR pathologies.

BACKGROUND: Abdominal pain is a common and non-specific symptom in children. It is important to be able to distinguish the source of abdominal pain before surgery. OBJECTIVES: Assess importance of the systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and other systemic inflammatory response blood cell indices in predicting the diagnosis and prognosis of acute appendicitis in children. DESIGN: Retrospective cohort SETTING: Single center in Turkey PATIENTS AND METHODS: The files of patients with abdominal pain aged 0–18 years who underwent surgery for appendicitis in our clinic between January 2011 and January 2022 were reviewed. According to the pathology results, patients were divided into two groups, those with pathologic findings of appendicitis (positive for appendicitis) and those without appendicitis. Systemic inflammation markers were statistically compared between the groups. MAIN OUTCOME MEASURES: Systemic inflammation markers. SAMPLE SIZE: 1265 patients RESULTS: Of the 1265 patients, 784 (62%) were male and 481 were female (38%). According to the pathologic examinations, 256 (20.2%) patients did not have appendicitis, and 1009 (79.8%) patients had acute appendicitis. The SIRI level was significantly higher in patients with acute appendicitis compared with patients without acute appendicitis (P

ABSTRACT: Trichobezoar in two different localizations at the same time: a case report Trichobezoar occurs when the hair cannot be digested and accumulated in the gastrointestinal tract after ingestion in patients with trichobezoar, trichotillomania, and trichophagia. It is frequently seen in girls aged 13-20 years and is accompanied by psychiatric disorders. A case with trichobezoar in two different localizations is presented at the same time. A 16-year-old girl weighing 56 kg presented to another hospital with complaints of nausea, vomiting, and loss of appetite after almost every meal in the last 2 months. The patient was referred to our clinic upon the detection of gastric trichobezoar on computerized tomography (CT). Laparotomy was performed on the patient.. A giant mass filling the entire stomach and a separate mass almost completely blocking the intestinal lumen were detected in the proximal jejunum. Both masses were removed by gastrotomy and jejunotomy. The patient was discharged on the 6th postoperative day with recovery. Anxiety disorder was detected in the patient who was consulted with pediatric psychiatry in the postoperative period. Our case had a psychiatric disorder similar to the cases in the literature. Our case was a successful science high school student contrary to the common situations in the literature. Cases with two different masses in two different localizations at the same time are very rare, as in our case. The patient's images should be carefully examined before the operation and exploration should be performed well during the operation.

The aim of the present study is to evaluate the epidemiology and outcome of paint thinner induced burn injuries at a local burn center. A retrospective analysis of 55 patient paint thinner thermal burn cases was conducted. Relevant patients data such as age, sex, etiologic factors, burn extent and localization, employed methods of treatment, hospitalization period, and results were evaluated in retrospect from patients records. 50 male and five female patients with a mean age of 26,78 (14-47) years participated in the presented study. Kindling fire with paint thinner was the most frequent etiologic factor. Total body surface burn area was 22,5 % (5-90). The mean hospitalization period of the survivors was 24 (5-64) days. Early excision and split-thickness sking grafting was applied in 22 patients. The remaining 26 patients were treated with topical agents. Total mortality was only 7 (12.7%). These patients had paint thinner induced burned body surfaces of 60 % with accompanying inhalation injuries. Paint thinner may cause catastrophic thermal injuries even with terminal outcomes and should therefore never used to kindle a fire. [Med-Science 2017; 6(4.000): 733-736]

Undescended ovary is a rare entity and usually presentedas a case report. It is associated with urinary and uterine anomalies. Symptomatic patients are diagnosed during surgery. Most of the patients are asymptomatic and treatment is unnecessary. They are incidentally diagnosed during infertility evaluation and treatment such as ovarian hyperstimulation studies. A 15-year-old female patient presented with the diagnosis of renal cystic massas identifiedduring ultrasonography in another hospital. Abdominal computedtomography image was requested. A cystic lesion of about 48×34 mm with well-defined borders associated with the appendix and probably with mucocele of the appendix was reported in the lower right abdominal quadrant close to the cecum. During exploration, the right ovary was seen to be attached to the cecum and was higher in position as well as a right ovary originated cystic structure of 5×5 cm.Using needle aspiration,intraovarian hemorrhage was confirmed and partial cystectomy was performed. The present study reports on an undescended ovary that hadacute abdomen symptoms imitating mucocele. In girls referring to the hospital with abdominal pain, although quite rare, undescended ovaries are to be also considered. As the incidence of renal and uterine anomalies is higher in suchpatients, in symptomatic cases relevant organs are to be investigated carefully during surgical intervention.

Dermatofibroma (DF) are common benign lesions located in the dermis or subcutaneous tissue with well defined borders, less than one centimeter, and generally seen in adults. It is extremely rare in children. In the current literature, to our best knowledge, there is not any dermatofibroma case in the scrotum of children. Hence, this case study is the first of its kind. The aim of the manuscript is present a pediatric case with a mass on scrotal in the light of the relevant literature. [Med-Science 2016; 5(3.000): 873-7]

Ovarian cysts are an extremely common gynecological problem in adolescent. Ovarian Mucinous cystadenoma are rare in children. A 14-year-old presented with a history of increasing abdominal distension and pain for approximately six months. An adnexal mass measuring 24x18x13 cm was detected by abdominal ultrasonography and computed tomography. She underwent laparotomy and after surgical removal. Histopathology findings showed that the tumor was diagnosed as a mucinous cystadenoma(MCA) of the ovary. Epithelial tumors should not be forgotten in the differential diagnosis. We present a case of giant MCA of the right ovary in a 14-year-old pubertal girl and a review of the supporting literature. [Med-Science 2016; 5(2.000): 630-6]

Aim To investigate optimal surgical management of pilonidal sinus (PS) in pre-adolescent and adolescent periods in which it is less common. Methods A retrospective study based on 25 adolescent patients with PS disease that were treated at the Department of Pediatric Surgery, Selcuk University, Konya, Turkey, between 2010 and 2013 was conducted. Results Among 25 patients with PS disease 17 (68%) were males and eight (32%) females, with a mean age of 16.08 ± 1.2 years. According to the body mass index (BMI), 17 (68%) of the cases were in the normal range, 4 four (16%) of each were overweight, and obese, respectively. Twenty cases (80%) were managed with total excision and primary closure, while five (20%) cases underwent Limberg flap repair. Four patients were managed with the Limberg procedure due to very large sinuses, while a single patient underwent the procedure due to a recurrence following primary repair. Conclusion Factors that predispose patients to developing PS include an above average BMI, significant body hair, and prolonged time in a seated position. Elevated BMI as a risk factor for PS is a growing concern given the rise in obesity. Although there are various treatment modalities, total excision and primary closure has demonstrated successful outcomes.

Fibroadenomas are common, benign breast tumors that usually affect women in the second and third decade of life. Giant fibroadenomas often cause significant concern for the patient or family regarding malignant potential and altered breast development. Most fibroadenomas are benign. Local excision of small lesions through a circumareolar or inframammary incision rather than radical surgery is appropriate. Breast ultrasound represents the most commonly used imaging modality for the study of pediatric female breast masses and fibroadenomas. Detailed descriptions of the sonographic appearances of fibroadenomas in young girls are sparse. We believe that surgical treatment for the patient should include tumor extirpation and immediate restoration of breast appearance, minimizing visible scars, protection of the developing breast bud, nipple, and areola. This modality reduces psychosocial comorbidity.

Amaç: Selçuk Üniversitesi Tıp Fakültesi Çocuk Cerrahisi ve Göğüs Cerrahisi Kliniklerince Ocak 2013 ile Ocak 2014 tarihleri arasında çocuk hastalarda özofagus’a yabancı cisim tanısıyla yatmış ve tedavi olmuş olguların retrospektif değerlendirilmesi amaçlandı. Gereç ve yöntem: Selçuk Üniversitesi Tıp Fakültesi Çocuk Cerrahisi ve Göğüs Cerrahisi Kliniklerince Ocak 2013 ile Ocak 2014 tarihleri arasında çocuk hastalarda özofagusda yabancı cisim tanısıyla yatmış ve tedavi olmuş olgular retrospektif değerlendirildi. Bulgular: Hastanemizde son 1 yıl içinde toplam 13 hasta, endoskopik olarak özofagusda yabancı cisim nedeniyle tedavi edildi. Ortalama yaş 4.8 yaş 6ay-12yaş idi. Birinci darlıkda yabancı cisim 10 hastada olup 6’sında %60 bulunan cisim paraydı. 2. darlık’da 2 olguda bu gıda artığı olup, bu iki olgunun birinde opere özofagus atrezi darlığı nedeniyle gıda artığı vardı, diğerinde ise koraziv madde içimi sonrası oluşan darlığa sekonder gıda artığı vardı. Sonuç: Özofagus yabancı cisimlerinin erken tanısı, tedavisi ciddi ve hayatı tehdit edebilecek komplikasyonlardan dolayı çok önemlidir. Yabancı cisimlerden para en sık görülümekte olup, özofagustaki yabancı cisim disk pil ise, erken dönemde çıkarılmalıdır. Çünkü ciddi yanık ve perforasyon yapabilir

Objective: In this study, we aimed to evaluate preschool children with major burns under inpatient treatment and to examine the reasons for those burns. Method: We retrospectively studied 255 patients between 0 and 5 years of age who suffered from major burns and who received inpatient treatment in the Burn Unit based on the guidelines of the American Burn Association between 2009 and 2011. The patients' age, gender, burn location, cause of burn, time to reach a health center after burn, and depth and width of the burn were evaluated. The possibility of a seasonal correlation was investigated as well. Results: Of the patients, 38.4% were female and 61.6% were male. The mean age of the patients was 2.1+/-1.2 years. The mean burned surface area amounted to 10.8% +/-7.4%. The nature of the burns was as follows: scalding in 73.7% (tea in 46.7%, hot water in 25.9%, and vapor in 1.2%), chemical burns in 16.1%, contact burns from hot contact in 5.5%, and flame burns in 4.7%. Conclusion: Most of the burns observed among preschool children occur indoors, with the majority of these burns represented by scalding burns. Most scalding burns arise from splashes of hot tea. In fact, burns associated with hot tea comprise nearly 50% of all burns. [Arch Clin Exp Surg 2013; 2(1.000): 32-37]

Vaginal agenesis is known as one of the Mόllerian anomalies. Mόllerian anomalies occur during gonadal development and differentiation, and may lead to complex outcomes. McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by Mόllerian anomalies with hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female newborn that developed hydronephrosis and respiratory distress due to compression of the cystic mass and underwent surgery on postpartum day 3. Pull-through vaginoplasty was performed with an abdomino-perineal approach. We report the unique treatment approach in this case.

A circumcaval ureter is a rare congenital anomaly in which the ureter passes behind, and is compressed by, the inferior vena cava. Its etiology is assumed to be abnormal embryologic development of the inferior vena cava as a result of atrophy failure of the right subcardinal vein in the lumbar portion. A circumcaval ureter is also termed a retrocaval ureter. The right supracardinal system fails to develop, whereas the right posterior cardinal vein persists. With one reported exception, the anomaly always occurs on the right side. Patients with this anomaly may develop partial right ureteral obstruction or recurrent urinary tract infections. Therapeutic options include surgical relocation of the ureter anterior to the cava. A 14-year-old female patient came with complaints of fever, intermittent colic and dysuria 4 years ago. A right ureteric fourth-grade VUR and circumcaval ureter were established. An anomaly in which both of these are together could not be found in literature. If after the VUR treatment he has progressive abdomen pain and advancing hydronephrosis, a circumcaval ureter as an additive anomaly must not be forgotten. For that reason, in a patient having a urinary system anomaly, a likely extra anomaly should be searched. [Arch Clin Exp Surg 2012; 1(3.000): 191-194]

Giriş: Testis ve over tümörleri nadir görülen tümörlerdir ancak çocuklarda sıklığı yetişkinlere oranla daha yüksektir. İki taraflı da görülebilirler ancak sağ tarafı tercih ederler. Dördüncü dekatta pik yapmalarına rağmen her yaşta görülebilirler. Ergen ve çocuklarda en sık rastlanan genital neoplazma ise germ hücreli tümörlerdir. Akciğer, meme, kolon ve pankreas kanserlerinden sonra ölümlerin en sık nedenidir. Metod: Bu çalışmamızda retrospektif olarak Çocuk Onkoloji ve Çocuk Cerrahisi Kliniklerine son yedi yılda gonadal kitle nedeni ile başvuran hastaların epidemiyolojik ve klinik özellikleri gözden geçirilmiştir. Sonuç: Gonadal tümör teşhisi erkeklerde oldukça kolaydır. Dikkatli fizik muayene ile testiste kitle tespit edilebilir, hidrosel gibi, testiste kitle yapan hastalıklardan ayırt edil- melidir. Kızlarda şikâyetler belirsiz olduğu için teşhis genellikle kitle etkisi nedeni ile konulmaktadır. Bu nedenle yaş olarak daha geç tanı almaktadırlar. Kliniğe üriner sistem semptomları yada kabızlık ile gelen hastalarda mutlaka sorgulama ve fizik muayene dikkatle yapılmalı, gonadal tümörler unutulmamalıdır

Bladder probing is an invasive procedure that is often used by paediatric and other surgeons. We present a case who was ureter catheterized accidentally while placing a probe into the right ureter in an 18 months old female. If different catheter localization is determined during the examination, the process must be terminated immediately and the relevant specialist should be informed right away.

Penile torsion can be congenital and associated with hypospadias and chordee, or can be acquired after circumcision. The incidence of isolated neonatal penile torsion was 1.7 to 27% in the literature. The majority were between 10 and deg; and 20 and deg;. Generally, torsion was to the left in cases. The techniques for correction of penile torsion described in the literature are penile de-gloving and reattaching of skin, resection of Buck's fascia incising the base of the penis and removing angular ellipses of corporeal tissue with subsequent plication of tunica, and dorsal dartos flap rotation in severe cases. In conclusion, penile torsion may be familial. Therefore, brothers should be examined carefully. The degloving and realignment technique is successful in isolated penile torsion. [Arch Clin Exp Surg 2012; 1(2.000): 122-124]

Morgagni Hernisi; anteriyor, anteromediyal, parasternal veya retrosternal herni olarak bilinir. Konjenital diyafram hernisinin sık rastlanan tipidir. Tüm opere edilen olguların %4-6 sını oluşturur. Standart tedavisi açık cerrahi uygulamadır. Biz laparoskopik olarak 5 yaşındaki çocuk olguya başarılı tedavi uyguladık. Laparoskopik onarımı güvenli alternative metod olarak tavsiye ederiz. Bu yaklaşımın minimal invasive metod olması ve kozmetik açıdan mükemmel görünüm oluşturması gösterilmiştir.

Male circumcision is among the most frequent surgical interventions throughout history. Although considered as a minor intervention, it may have complications ranging from insignificant to catastrophic. These complications can be attributed to the surgical procedure and anesthesia. In this report we present two cases of scrotal skin necrosis after lidocaine with epinephrine injection using subcutaneous ring block technique prior to circumcision.

Ovarian cysts are an extremely common gynecological problem in adolescent. Majority of ovarian cysts are benign with few cases being malignant. Ovarian serous cystadenoma are rare in children. A 14-year-old presented with abdominal pain and severe abdominal distention. She underwent laparotomy and after surgical removal, the mass was found to be ovarian serous cystadenoma on histology. In conclusions, germ cell tumors the most important causes for the giant ovarian masses in children. Epithelial tumors should not be forgotten in the differential diagnosis.