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Purpose: Percutaneous endoscopic gastrostomy is the most preferred method for feeding in children with intact gastrointestinal system functions when oral nutrition is insufficient due to neurological, neuromuscular, or oncological diseases. This study aimed to evaluate the indications for percutaneous endoscopic gastrostomy and associated complications in the patients we followed up. Materials and Methods: In this descriptive study, the records of 130 patients who underwent percutaneous endoscopic gastrostomy for nutritional support between January 1st 2013- December 30th 2020 were retrospectively reviewed. Demographic data, indications, complications, and follow-up periods of the patients were examined. Results: Of the patients, 75 were male and 55 were female. The mean age of the patients was 48 months (min 1 month-max 211 months). The evaluation of the patients with percutaneous endoscopic gastrostomy in terms of diagnosis revealed that 95 patients required nutritional support due to neuromotor retardation associated with neurological disease, 19 patients due to central nervous system tumor, and 13 patients due to metabolic disease. Considering complications, the most frequent minor complication was leakage in 11of the 33 patients, while the most frequent major complication was colonic fistulation in 6 of the 9 patients. Two patients required open surgery in the early period due to intra abdominal leak. Conclusion: Although enteral nutrition with a percutaneous endoscopic gastrostomy tube seems to be an appropriate and reliable method to meet the nutritional needs of pediatric patients who have normal digestive system functions but cannot be fed orally due to swallowing disorders, it is necessary to pay attention to its complications like any surgical procedure.

Purpose: The goal of this study was to evaluate the pancreatic parenchyma in celiac patients with transabdominal ultrasonography (US) and ultrasound elastography (UE). The aim of this study is to identify the difference of pancreatic elastography values and pancreatic dimension between the different four pediatric coeliac patient groups with respect to their development curve standart deviation (SD) scores. Materials and Methods: This study is single-center, prospective study. We included 5–18 years old patients diagnosed with Celiac Disease (CD). Pancreatic dimension and parenchymal elastography measurements of 106 patients eligible for the study were performed by a single radiologist. Height, weight, body mass index (BMI), fecal elastase values, age at diagnosis, duration of illness and medical history of the patients were evaluated. The patients were divided into four groups with respect to their development curve SD scores. Results: Our study group included 106 CD patients, 72 female and 34 male children were included in our study. The age at diagnosis of the patients was 100.4±97.5 months, and the disease duration was 4.1±2.5 years. The patients were examined in 4 groups. There was no difference in pancreatic elastography values between four groups. There was no difference in the dimensions of the pancreatic head between these groups. It was observed that the anteroposterior diameters of the body and tail increased as SD values increased. There was no difference between fecal elastase values. Conclusion: Pancreas dimensions were higher in celiac patients with a higher kilogram SD score. However, no significant difference in pancreatic elastography values was observed when the kilogram SD score was used.

At the present study, study we aimed to analyze the risk factors for cardiac arrhythmias related disease factors by evaluating some ventricular repolarization parameters in the electrocardiographic (ECG) evaluation of CD. The study was conducted retrospectively from the files of the patients. The ECG evaluation of 63 patients aged 5-18 years diagnosis with CD and 63 healthy control group in Adana City Training and Research Hospital, between 01.2018-11.2022. Patients who were taking any drugs, who had a chronic disease and/or abnormal tests (vitamin B12, folate, tissue transglutaminase, anti-endomysium antibody titers) were excluded from the study. The ventricular repolarization parameters (QT interval, QTc interval, QT dispersion, QTc dispersion, Tp-e interval, Tp-e/QT, Tp-e/QTc) analyzed on ECG and compared both groups. The measured ventricular repolarization parameters of the patients and control groups were not statistically different. From the ECG data, it was found that the QTc min value was higher in patients diagnosed before 5 years old than the patients diagnosed after 8 years old. While the QTc dispersion was higher in patients diagnosed after 8 years old than the patients with an age at diagnosed before 5 years old. It was found that the values of QT min, QT max, and QT in the ECG were influenced by the duration of the disease and significantly high related with the disease duration (more than 5 years). We found that QTc dispersion was higher in patients with a later diagnosis. This suggests that cardiac involvement is also increased in patients with a late diagnosis.

Amaç: Çölyak Hastalığın (ÇH)’da puberte bozuklukları gözlenmektedir. Çalışmamızda ÇH tanılı çocuk ve adolesanlarda pubertal gelişim evrelerini, pubertal evrelemeye göre laboratuvar parametrelerini ve antropometrik ölçümleri değerlendirmeyi amaçladık. Materyal-Metot: Çalışma kesitsel özellikte düzenlenmiş olup, 01.10.2022-31.12.2022 tarihleri arasında Adana Şehir Eğitim ve Araştırma Hastanesi Çocuk Gastroenteroloji 1 Polikliniğin’e başvuran, 7-16 yaş arası, ÇH tanılı hastalar dahil edilmiştir. Olguların Tanner evreleri ve hormonal parametreleri kaydedilmiştir. Bulgular: Çalışmaya alınan 108 hastadan 39’u erkek (%36,1), 69’u kız cinsiyetindeydi (%63,9). Olguların 52’si (%48,1) Tanner evre 1 iken, 15’i (%13,9) Tanner evre 2, 11’i (%10,2) Tanner evre 3, 7’si (%6,5) Tanner evre 4 ve 23’ü (%21,3) Tanner evre 5’teydi. Olguların ortalama yaşı 10,7±3,5 yıl, ortalama izlem süresi 3,7±2,5 yıl idi. Cinsiyetler göre ayrıldığında erkek çocuklarda boy ortanca 10,5 persentil (p) (0.01-94.1) iken, ağırlık 8,5 p (0,01-98,8), kız çocuklarda boy ortanca 21,7 p iken (0,01-96,2) ağırlık 13,6 p (0,01-99,9) saptandı. Hasta grupları pubertal evrelere göre prepubertal ve pubertal olarak sınıflandırıldığında hastaların %51,9 (n= 56)’u pubertal evrede, %48,1 (n:52)’i ise prepubertal evrede idi. Pubertal olan olguların prepubertal grupta olan olgulara göre vitamin B12, folat, ferritin değerlerinin daha düşük olduğu saptandı (sırasıyla p=0.034, p Sonuç: ÇH’ler puberte gecikmesi açısından risk altında olsa da çalışmamızda pubertal bulgularda gecikme veya gonadal yetmezlik saptanmamıştır. Malnutrisyon taraması açısından önemi olan OKÇ’nin, pubertenin başlangıcını tahmin etme açısından da önemli olacağı gösterilmiştir. Ayrıca özellikle pubertal dönemde vitamin ihtiyaçlarının artması nedeniyle bu hastalarda kan düzeylerinin yakın monitörizasyonu gerektiğini düşünmekteyiz.&nbsp

Aim: Foreign body ingestion is one of the most common reasons for admission to pediatric emergency departments. It is one of the important admission complaints that should be questioned in the history and kept in mind regarding the need for urgent intervention in pediatric emergency service admissions and, in some cases, the difficulties in diagnosis. We wanted to examine the presentation patterns and complications of our patients who presented with foreign body ingestion, to examine an issue that is important for the emergency services, and to emphasize the necessity of questioning foreign body ingestion if the cause of the complaint cannot be found in some disease groups. Material and Method: Our study was carried out by retrospective examination of the files of the patients evaluated in a Pediatric Gastroenterology and Pediatric Surgery Outpatient Clinic, and recording the complaints, presence of complications, foreign body localization and what the removed bodies were. Results: Twenty-five patients with suspected foreign body ingestion and detected foreign body were included in the study. 40% of the patients were girls, 60% were boys, and the mean age was 4.5 years. The most common presentation was 44% asymptomatic. At the time of admission, 16% of the patients were complicated by perforation. Foreign bodies were removed endoscopically in 44% and surgically in 20%. The most extracted object was coin (20%). The most common location was the gastric antrum in 52%. Conclusion: Foreign bodies requiring intervention are most frequently removed endoscopically, and the rate of patients requiring surgical intervention is low. It should not be forgotten that a significant part of the patients are asymptomatic, and in some patient groups, especially in patients with autism and in very young age groups, foreign body ingestion should be asked, even if there are no symptoms.

82 gunluk kiz hasta ani gelisen sarilik, akolik diskilama olmasi nedeniyle yapilan Abdominal Ultrasonografisinde safra kesesinin gorulmemesi uzerine klinigimize yonlendirildi. Akciger grafisinde sag diyafram elevasyonu mevcut idi. Hastanin muayenesinde ayni tarafta solunum sesleri azalmis olarak aliniyor idi. Cekilen Tomografisinde sag diyafragmatik herni mevcut ve karaciger ile safra kesesi toraks bosluguna herniye idi. Olgumuzda sag Bochdalek hernisi mevcut idi ve safrayollarinin torasik kavitede sikismasina bagli obstruktif sarilik gelismis idi. Operasyon sirasinda alinan karaciger biyopsisinde fibroz bulgulari olusmaya baslamis idi. Operasyona alinan hastanin abdominal organlari yerine alinarak, kolesistektomi ve hepatikojejunostomi operasyonu yapildi. Erken tani ve tedavi ile hastanin takibinde yapilan karaciger biyopsisinde karacigerde gelisen bulgularin duzelmeye basladigi goruldu. Kolestaz, cok cesitli etyolojik nedenlere bagli olabilmekle birlikte cerrahi nedenlerin ivedilikle tani ve tedavisinin yapilmasi prognoz acisidan onem arz etmektedir. Bu olgu ile Bochdalek hernisinin cok farkli bir prezantasyon seklini sunmak istedik. Kolestaz ile gelen akolik diskisi mevcut olan hastalarin ayirici tanisinda diafragma hernisi de akilda tutulmalidir.