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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.

Background: Malnutrition increases postoperative complications in pediatric surgical patients. Objective: The aim of the present study was to examine whether the preoperative nutritional status had any effect on postoperative outcomes in pediatric patients with acute appendicitis who were in need of emergency surgery. Methods: This retrospective clinical study was carried out at the Department of Pediatric Surgery, Adana City Training and Research Hospital, University of Health Sciences. The study included 74 patients, whose data were analyzed retrospectively. The patients' preoperative Gomez malnutrition classifications and body mass indexes (BMI) were calculated and compared to clinical outcomes. Results: The study included 74 children who had appendectomy procedures. The mean age was 11.5±3.7 years, 64.9% of the patients in the study were male, while 35.1% were female. The duration of admission to the hospital was 1.77±1.34 days. A BMI cut-off value of less than 16.74 was found to be statistically significant (p

Introduction: To evaluate the effect of the COVID-19 pandemic on patients admitted to the pediatric emergency department and operated with the diagnosis of acute appendicitis in the pediatric surgery clinic.Metods: Files of patients who underwent appendectomy in the pediatric surgery clinic of Health Sciences University Adana City Training and Research Hospital between 16 March-16May 2019 and 16 March-16 May 2020 were retrospectively analyzed and divided into two groups respectively.Results: In the study, 95 patients in Group-1 (5.1% 95/1851) and 83 patients in Group-2 (11.5% 83/724) was operated for acute appendicitis. There was a significant difference between the two groups in terms of the number of patients who underwent appendectomy (p=0.001). A statistically significant difference was not found between the two groups when age, gender, duration of admission to hospital, preoperative laboratory values and duration of hospitalizasyon were compared. Perforated appendicitis was detected in 9 (9.5%) of the patients who underwent appendectomy in Group-1 and in 13 (15.7%) of the patients in Group-2 and it was not statistically significant (p=0.007). The mean size of appendix of the surgical pathology specimens was found to be 8.98±3.12 mm in Group-1 and 10.3±3.43 mm in Group-2 (p=0.007).Conclusion: Although the number of applications to pediatric emergency services decreased during the pandemic period, there was no decrease in the number of patients operated on due to appendicitis. In addition, it was found that the rate of perforated appendicitis increased. For this reason, it should be considered that the situations requiring emergency surgery do not decrease with the epidemic., Amaç: COVİD-19 pandemisinin çocuk acil servise başvuran ve çocuk cerrahi kliniğinde akut apandisit tanısı ile ameliyat edilen hastalar üzerindeki etkisinin değerlendirilmesi.Metod: Sağlık Bilimleri Üniversitesi Adana Şehir Eğitim ve Araştırma Hastanesi çocuk acil servisine 16Mart–16Mayıs 2019 ile 16Mart–16Mayıs 2020 tarihleri arasında başvuran ve çocuk cerrahi kliniğinde apendektomi yapılan hastaların dosyaları retrospektif olarak incelenmiştir. Hastalar iki gruba ayrılmıştır, Grup1: 16Mart–16Mayıs 2019, Grup2: 16Mart–16 Mayıs 2020 tarihleri arasında ameliyat edilen hastalar olarak belirlenmiştir. Hastaların demografik verileri, hastaneye başvuru süresi, hastanede yatış süresi, patoloji raporlarında kayıtlı olan apendiks çapı, perforasyon olup olmaması ve laboratuvar bulguları değerlendirilmiştir. Bulgular: Çalışmada Grup1’de 95 hastaya (%5,1 95/1851) Grup2’de 83 hastaya (%11,5 83/724) akut apandisit nedeni ile apendektomi yapıldığı saptanmıştır. Her iki grup arasında apendektomi yapılan hasta sayısı açısından anlamlı fark saptanmıştır (p=0,001). İki grup arasında yaş, cinsiyet, hastaneye başvuru süresi, ameliyat öncesi laboratuar değerleri ve hastanede yatış süresi karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmamıştır. Grup1’de apendektomi yapılan hastaların 9’unda (%9,5), grup 2’deki hastaların 13’ünde (%15,7) perfore apandisit saptanmışve istatisktiksel olarak anlamlı fark bulunmamıştır (p=0,07). Patoloji raporlarında ölçülen apendiks çapı ortalama değerleri Grup1 ‘de 8,98±3,12mm, Grup2’de 10,31±3,43mm hesaplanmış ve istatistiksel olarak anlamlı bulunmuştur (p=0,007).Sonuç: Pandemi döneminde çocuk acil servislerine başvuru sayısı azalmış olmasına rağmen apandisit nedeni ile ameliyat edilen hasta sayılarında azalma görülmemiştir. Ayrıca perfore apandisit oranının artmış olduğu saptanmıştır. Bu nedenle acil cerrahi gerektiren durumların salgın ile azalmadığı konusunda uyanık olunması gerektiği hatırlanmalıdır.

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.

Giriş: Covid 19 salgını dünyada ve ülkemizde hızla yayılım gösteren ciddi bir sağlık sorunu haline gelmiştir. Covid-19 enfeksiyonu geçirmiş hastalarda ileri ki dönemlere ait karşılaşılacak sorunlar hala bilinmemektedir. Bu çalışmada covid-19 enfeksiyonu sonrası devam eden semptomları değerlendirilmesi amaçlanmıştır. Materyal ve Method: Bu çalışmada covid-19 tanısı nedeni ile yoğun bakımda yatan hastaların taburculuk sonrası devam eden semptomları değerlendirilmiştir.Bulgular: Covid-19 enfeksiyonu sonrası devam eden en sık semptomun halsizlik olduğu görüldü. Hasta yaşının artışı ile covid-19 enfeksiyonu sonrası semptomların görülme sıklığı artmaktadır.Sonuç: Covid-19 enfeksiyonu sonrası devam eden semptomlar mevcuttur. Bunların tanınması erken tanı ve tedavi için önemlidir., Introduction: The Covid 19 pandemic has become a serious health problem that spreads rapidly in the world and in our country. The problems that may be encountered in the future in patients with Covid-19 infection are still unknown. This study aimed to evaluate long-term symptoms following Covid-19 infection. Materials and Methods:This study evaluated post-discharge continued symptoms of patients hospitalized in the intensive care unit with the diagnosis of Covid-19.Results: The most common symptom that persisted after Covid-19 infection was fatigue. It was determined that as the age of the patient increases, the incidence of symptoms after Covid-19 infection increases.Conclusion: There are persistent symptoms after Covid-19 infection. Their identification is crucial for early diagnosis and treatment.

Amaç: Akut apandisit, çocuk cerrahisi pratiğinde en önemli ve yaygın olarak uygulanan acil cerrahilerden biridir. Çocuklarda apandisit tanısı yetişkinlere göre daha zordur. Olgunlaşmamış granülosit yüzdesi (%IG) son zamanlarda erişkin popülasyonda inflamasyon şiddetinin saptanması için laboratuvar parametresi olarak araştırılmaktadır. Çalışmanın amacı, pediatrik akut apandisit erken tanısında IG sayısı ve yüzde rolünün belirlenmesidir. Gereç ve Yöntemler: Ocak 2021-Aralık 2022 tarihleri ​​arasında karın ağrısı şikayeti ile Acil Servise başvuran ve preoperatif akut apandisit tanısı ile opere edilen hastaların verileri hastane kayıtlarından geriye dönük olarak incelendi. 18 yaş altı, akut apandisit ön tanısı ile ameliyat edilen ve hemogramı olan hastalar çalışmaya dahil edildi. Bulgular: Çalışmaya 108 hasta dahil edildi. Akut apandisit grubunda 48 hasta, perfore apandisit grubunda 9 hasta ve kontrol grubunda 53 hasta vardı. Apandisit ve kontrol grubundaki hastalarda ortalama IG %'si sırasıyla 0,31±0,37 ve 0,96±5,1 idi. Apandisit hastaları ile kontrol grubu arasında IG sayısı ve yüzdesi açısından anlamlı fark bulunmadı. Akut ve perfore apandisit arasında IG sayısı ve IG % açısından istatistiksel olarak anlamlı fark bulunmadı. Sonuç: IG sayısı ve IG%, herhangi bir ek fayda sağlamadı ve klinisyen için akut apandisit belirlemede kesin bir biyobelirteç değil. Akut apandisit tanısı için anamnez, fizik muayene ve laboratuvar testinin bir kombinasyonu altın standart olmaya devam etmektedir.

Amac: Acik kalp cerrahisi gecirecek yetiskin hastalarda, kardiyak cerrahi iliskili bobrek hasari gelismesi en yaygin komplikasyonlardan biridir ve bu durum yuksek mortalite ve morbidite ile iliskilendirilmektedir. Kardiyak cerrahi sonrasi akut bobrek yetmezligi sikligi, akut bobrek yetmezligine, kronik bobrek hasari uzerine gelisen akut bobrek yetmezligine yol acan faktorler ve hemodiyaliz gereksinim sikliginin saptanmasi amaclanmistir. Yontemler: Universite hastanesi Gogus Kalp Damar Cerrahisi Anabilim Dali’nda Ocak 2009 ile Aralik 2009 tarihleri arasinda elektif koroner arter bypass, kapak cerrahisi veya her iki cerrahiyi geciren hastalar, bu retrospektif kohort calismada incelendi. Hastalarin preoperative yas, cinsiyet, body mass index, eski kardiyak cerrahi, unstabil anjina, myojard enfarktus, kardiyojenik sok oykusu olmasi, preoperatif ilac kullanimi, ek hastalik oykusu, sol ventrikul ejeksiyon fraksiyonu, intraoperatif gecirdigi cerrahi tipi, cerrahi suresi, kros-klemp suresi, postoperatif hastane ve yogun bakim kalis suresi, revizyon cerrahisi, hemodiyaliz gereksinimi, mortalite verileri retrospektif olarak kaydedildi. Bulgular: Ileri yas, cerrahi suresinin ve aort kros klemp suresinin uzun olmasi, acik kalp cerrahisi geciren hastalarda renal hasar gelismesi acisindan risk faktorleri olarak bulunmustur (P=0,002, P=0,03, P=0,02). Gecirilmis kardiyak cerrahi, cinsiyet, sol ventrikuler ejeksiyon fraksiyonu, preoperatif ilac kullanimi, cerrahi tipi ile ilgili gruplar arasi farkliliga rastlanmamistir (P=0,69, P=0,10, P=0,19, P=0,66, P=0,86). Akut bobrek yetmezligi gelisen hastalarin hastanede ve yogun bakimda kalis suresi daha uzun bulunmustur (P=0,001, P=0,001). Cerrahi sonrasi hemodiyaliz ihtiyaci %1,3, mortalite %2 oraninda gozlenmistir. Sonuc: Sonuc olarak preoperatif donemde hastalarin ayrintili incelenmesi ve mumkun olan optimal sagaltimin yapilmasinin, operasyon planinin iyi yapilarak renal hasar gelisebilecek hastalarin onceden tahmin edilerek yaklasimin buna gore degistirilmesinin postoperatif mortalite ve morbiditeyi azaltma konusunda onemli bir yer tutacagi kanisindayiz.

Hydatid cyst is a common zoonosis caused by larval forms of tapeworms called Echinococcus. The problem often occurs in the liver or lung. Cyst rupture and secondary bacterial infection are the most important complications of pulmonary hydatid cyst (PHC). PHC may mimic serious lung diseases such as treatment-resistant pneumonia, tuberculosis, and tumours. This report discusses the case of a paediatric patient with PHC who presented with chronic cough, hilar lymphadenopathies up to 3 cm, and worsening symptoms despite non-specific pneumonia treatment. Hence, PHC should be considered in patients with treatment-resistant pneumonia and mediastinal lymphadenopathy.

Foreign body ingestion is an important condition with a potentially high mortality rate that is encountered in pediatric emergency departments and outpatient polyclinics. Foreign body ingestion occurs in 80% of children, especially those between 6 months and 3 years of age. However, in patients with mental disorders, in this case, autism, foreign body ingestion may occur at any age. A 16-year-old autistic patient presented with complaints of discomfort and restlessness, with no history of ingestion, however, we discovered through further investigations that the patient had in fact swallowed a foreign object. In this case, we would like to emphasize that autistic patients of any age can ingest foreign bodies, even without any suspicious history., Yabancı cisim yutulması, pediatrik acil servislerinde ve genel polikliniklerde karşılaştığımız, potansiyel olarak yüksek ölüm oranına sahip olabilecek önemli bir durumdur. Yabancı cisim yutulması çocukların % 80’înde ve özellikle 6 ay ile 3 yaş arasındaki çocuklarda görülür. Ancak ruhsal bozukluğu olan hastalarda, özellikle bu olguda olduğu gibi otizimli çocuklarda, yabancı cisim yutulması her yaşta ortaya çıkabilir. 16 yanındaki otistik bir hastada, rahatsızlık ve huzursuzluk şikayeti ile getirildi, öyküsünü sorguladığımızda bize yararlı bir bilgi yoktu, daha ileri incelemelerde hastanın aslında yabancı bir nesneyi yuttuğunu fark ettik. Bu durum nedeni ile her yaştaki otistik hastaların öykü alma sırasında herhangi bir şüphe duymadan yabancı cisim yutabileceğini vurgulamak istiyoruz.

Özet: Konjenital lober amfizem, alt solunum yollarında hiperinflasyon ile karakterize nadir rastlanan akciğerin doğumsal bir anomalisidir. Konjenital lober amfizemli hastalarda klinik seyir, hastalığın ortaya çıktığı yaşa, etkilenen loba veya normal lobların baskılanmasına bağlı olarak değişebilir. Tanısı klinik ve görüntüleme yöntemleri ile birlikte konulur. Semptomları hafif olan olgular konservatif tedavi ile izlenirken, ağır solunum semptomu olan olguların lobektomi ile tedavisi iyi sonuçlar vermektedir. Konjenital lober amfizem, nadir görülen bir akciğer anomalisi olmasına rağmen, nedeni bilinmeyen solunum sıkıntısı olan hastalarda ayırıcı tanıda göz önünde bulundurulması gereken bir hastalıktır. Bu yazıda erken dönemde konjenial lober amfizem tanısı konulan, hafif semptomları olması nedeniyle de konservatif tedavi yöntemleri ile izlenilen 4 aylık kız hasta sunulmaktadır., Congenital lobar emphysema is a rare congenital anomaly of the lung characterized by hyperinflation of the lower respiratory tract. In patients with congenital lobar emphysema, the clinical course may vary depending on the age at which the disease occurs, suppression of the affected lobe or normal lobes. Diagnosis is made together with clinical and imaging methods. While the patients with mild symptoms are followed with conservative treatment, the treatment of patients with severe respiratory symptoms with lobectomy gives good results. Although congenital lobar emphysema is a rare lung anomaly, it should be considered in the differential diagnosis in patients with unresolved respiratory distress. In this article, we present a 4-month-old girl who was diagnosed with congenial lobar emphysema in the early period and who was followed with conservative treatment because of mild symptoms.

Foreign body ingestion (FBI) is one of the critical conditions encountered in pediatric emergency services. FBI can lead to high mortality in children. Neodymium magnets are increasingly popular due to children’s great interest in them. In cases of multiple magnet ingestion, the risk of mucosal perforation is higher when compared with other types of FBI. With this case, an attempt to raise awareness of this medical problem was made by sharing the case of a neodymium magnet body in a 24-month-old patient. The magnet was detected incidentally during our fever etiology examination although possible ingestion of a foreign body had previously been reported in her medical history. Our patient presented with abdominal tenderness, agitation, and other symptoms. An abdominal X-ray was taken. A foreign body that resembled a neodymium magnet sphere was observed. During surgery, a gastrocolic fistula in the antrum was observed. Multiple magnets are foreign bodies that present a higher risk of causing intestinal perforation compared to other foreign bodies. It is known that multiple magnet ingestions may cause mucosal ulceration, and it should be emphasized that such ingestion may cause gastrointestinal fistulas. Since pediatric patients in a certain age group tend to put objects in their mouths, each patient with an unclear cause of fever and abdominal sensitivity should be questioned with respect to FBI and then tested radiologically.

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p

Intussusception is common abdominal emergency in early childhood. Idiopathic ileoileal intussusceptions are rare in children without an apparent predisposing cause. Patients present with vomiting and colicky abdominal pain, which can mimic many conditions. We report a case with primary ileoileal intussusception, which was successfully reduced manually during exploratory laparotomy. There was no evidence enlarged mesenteric lymph nodes.

Introduction: Appendicitis is the inflammation of the appendix vermiformis. Clinical diagnosis of acute appendicitis in children is still a problem. Platelet indices, platelet distribution width and mean platelet volume have been evaluated for some infectious and inflammatory diseases. In this study, we aimed to investigate whether platelet distribution width values and mean platelet volume were decisive for the diagnosis of appendicitis in children. Methods: In our hospital, 504 pediatric patients who presented with acute abdomen and received the diagnosis of acute appendicitis between 2011 and 2016, and 106 children living in the same region, who attended the pediatric outpatient clinics for general follow-up, were included in the study. The patient and control groups were analyzed for gender, age, platelet count, platelet distribution width and mean platelet volume. A receiver operating characteristic (ROC) curve was drawn to describe the parameters that may be statistically significant. Results: There was a significant difference in platelet distribution width and mean platelet volume values between the two groups (p14.3 fL for platelet distribution width for the diagnosis of appendicitis with a sensitivity, specificity, positive predictive value, and negative predictive value of 77.6%, 85.8%, 96.3%, and 44.6%, respectively. A cut-off value of

Ovarian sex cord-stromal tumors, including granulosa cell tumors are rare, especially in children. They are classified into juvenile and adult types. Juvenile granulosa cell tumors (JGCT) comprise 5% of all granulosa cell tumors. Precocious pseudo-puberty is a common presentation of these tumors, associated with hormonal changes. We report a rare case of JGCT of the ovary in a 4-year-old girl who presented with breast enlargement and alveolar pigmentation for two months. At her examination she had also an abdominal mass. Based on imagining features and laboratory findings, the diagnosis of the mass was unclear. After surgery, histopathological examination revealed JGCT of the left ovary. Although in most of girls with precocious puberty, the etiology is idiopathic, important causes, such as ovarian tumors like JGCTs must be considered., Granüloza hücreli tümörleri içeren over seks kord stromal tümörleri, özellikle çocuklarda nadir görülen tümörlerdir. Juvenil ve yetişkin tip olarak iki gruba ayrılırlar. Juvenil granüloza hücreli tümörler (JGHT) tüm granüloza hücreli tümörlerin % 5’ini içerir. Yalancı puberte prekoks, hormonal değişiklikler ile ilişkili bu tümörlerin en sık görülen bulgusudur. Biz burada 2 aydır meme büyümesi ve alveoler pigmentasyon şikayeti ile başvuran, 4 yaşındaki bir kız çocuğunda görülen nadir bir JGHT olgusunu bildirdik. Muayenesinde abdominal kitlesi de mevcuttu. Görüntüleme ve laboratuvar bulguları ile kitlenin tanısı belirsizdi. Operasyon sonrası histopatolojik tanı sol overin JGHT’ ü olarak konuldu. Puberte prekoksu olan kızların çoğunda etyoloji idiyopatik olsa da JGHT de içeren bazı over tümörleri gibi önemli nedenler göz önünde bulundurulmalıdır.

Amaç: Bu çalışmanın amacı Çocuk Cerrahisi yenidoğan yoğun bakım ünitesinde tedavi edilmiş hastalarda sağlık bakımı ilişkili enfeksiyon (SBİE) sıklığını, enfeksiyon etkenlerini ve risk faktörlerini araştırmaktır.Gereç ve Yöntem: Hastalar cinsiyet, doğum şekli, doğum kilosu, gestasyonel yaş, başvuru anındaki yaş, hastanede kalış süresi, ameliyat yapılıp yapılmaması, sepsis gelişimi, TPN (Total parenteral nutrisyon) alımı, toraks tüpü uygulaması, endotrakeal entübasyon, idrar sondası kullanımı, nazal veya oral sonda kullanımı, karın dreni uygulaması, santral kateter uygulaması, oral beslenmeme süresi, laboratuar parametreleri, cerrahi stres dereceleri, yara niteliği yönünden incelendi. Bulgular: Düşük doğum ağırlığı, yüksek cerrahi stres derecesi, TPN kullanımı ve süresi, toraks tüpü takılması ve süresi, endotrakeal entübasyon ve süresi, idrar sondası ve süresi, santral kateter, ameliyatlarda karın dreni konulması, nazal-oral sonda süresi ve enteral beslenmesiz geçen sürenin uzaması SBİE için risk faktörü olarak bulundu. SBİE olan hastaların 57’sinde sepsis saptandı, bunların 35’i öldü. Sonuç: İnvaziv işlemler ve süresinin azaltılması, hastanede kalış süresinin kısaltılması, salgın şeklindeki mikroorganizmalara özel önlemler alınması SBİE ve buna bağlı ölüm oranlarını düşürebilir., Purpose: The purpose of this study is to investigate the infectious agents, risk factors and prevalance of the healthcare-associated infections (HAIs) in patients treated at surgical neonatal intensive care unit. Materials and Methods: Patients were examined for application date, sex, mode of delivery, birth weight, gestation age, age at admission, hospital stay, hospitalization at another center, the provinces they come, surgery, developement of sepsis, use of TPN (Total parenteral nutrition), application of chest tube, endotracheal intubation, urinary catheter use, nasal or oral catheter use, application of abdominal drains, central catheter application, oral feeding time, laboratory parameters, degree of surgical stress and the nature of wounds. Results: Low birth weight, prior hospitalisation at another center, high degree of surgical stres, TPN use and duration, chest tube application and duration, endotracheal intubation and duration, urinary catheterisation and duration, central cathetery, application of abdominal drains at surgery, duration of nasal-oral catheterisation and the duration of nonenteral feding were found as risk factors of HAIs. Sepsis was detected at 57 of HAIs patients and 35 of them died.Conclusion: Decreasing the number and duration of invasive procedures, shorten the duration of hospital stay, special measures for the epidemic microorganisms can reduce the HAIs and the related deaths.

Sigmoid volvulus (SV) çocukluk çağında nadir görülen erken tanı konulmazsa hayatı tehdit edici bir hastalıktır. SV sigmoid kolonun kendi mezenter kökü etrafında dönmesi ile oluşup kolonik segmentteki obstrüksiyon ve iskemi ilerleyince nekroz, perforasyon, peritonit, sepsis gelişmesine neden olmaktadır. SV’de önemli olan karın ağrısı, konstipasyon, distansiyon gibi şikâyetlerle başvuran hastalarda ayrıntılı hikaye, fizik muayene ve laboratuvar bulgularının incelenmesinde hekimin bu tanıyı da akılda tutmasıdır. Böylece tanıyı doğrulayacak ileri radyolojik incelemelerin zaman kaybedilmeden planlanması ve uygun tedavi protokolü mümkün olacaktır., Sigmoid volvulus (SV) is a rare, but also life-threatening disease if not diagnosed earlier. SV appears as torsion of the sigmoid colon around its mesentery and causes necrosis, perforation, peritonitis and sepsis when obstruction and ischemia progresses in the colon segment. The important issue in SV to keep in mind is consideration of this rare condition during detailed examination of the history, physical examination and laboratory findings in the patient who refers because of some complaints such as abdominal pain, constipation and distention. This would allow planning the advanced radiological examinations and adequate treatment protocols to confirm the diagnosis.

Objective Physical and psychological stressors adversely affect the treatment and length of stay of patients in intensive care units. In this study, we aimed to describe environmental and psychological stressors affecting intensive care unit patients and to determine their priorities. Material and methods In this study, the 40-item Intensive Care Unit Environmental Stressor Scale was administered to patients in the General Surgery Intensive Care Unit and the Anesthesiology and Reanimation Intensive Care Unit. The patients' age, gender, marital status, educational status, cause of hospitalization, and intensive care unit length of stay were questioned and recorded. Acute Physiology And Chronic Health Evaluation II scores were determined for intensive care unit patients. Results A total of 98 patients, 80 in the General Surgery Intensive Care Unit and 18 in the Anesthesiology and Reanimation Intensive Care Unit, were included in the study between May 1, 2015 and October 31, 2015. Fifty-six of the patients were male (57.1%) and 42 were female (42.9%). The mean age of the patients was 55.1±15.1 years. The mean intensive care unit length of stay was 3.4±1.6 days. The median Acute Physiology And Chronic Health Evaluation II score of the patients was 6 (0 to 17). The patients were most affected by thirst (mean 2.44). The second most stressful stress factor was the presence of tubes in the mouth and nose (mean 2.25). The least stressful factor for the patients was the presence of nurses constantly performing activities around the bed. Although 51% of the patients were postoperative, pain was ranked 5th among stress factors. Conclusion The environmental and psychological factors affecting intensive care unit patients varied according to age, sex, and educational and surgical status. These factors had adverse effects on the patients. The elimination or modification of these factors would contribute positively to the treatment of intensive care unit patients and shorten their length of stay in the intensive care unit.

Background: Gastro-oesophageal reflux may accompany the corrosive oesophageal damage caused by the ingestion of corrosive substances and affect its treatment. The factors that affect the development of reflux in these cases and their effects on treatment still remain unclear. Aims: Our aim is to investigate the prevalence of gastro-oesophageal reflux in children with corrosive oesophageal strictures, the risk factors affecting this prevalence and the effects of gastro-oesophageal reflux on treatment. Study Design: Case-control study. Methods: We enrolled 52 patients with oesophageal stricture due to corrosive substance ingestion who were referred to our clinic be- tween 2003 and 2010. Groups, which were determined according to the presence of gastro-oesophageal reflux (GER), were compared with each other in terms of clinical findings, results of examination methods, characteristics of the stricture and success of the treatment. Results: The total number of patients in our study was 52; 30 of them were male and 22 of them were female. The mean age of our study population was 4.2±2.88 years. Thirty-three patients had gastro- oesophageal reflux (63.5%). Patients who had strictures caused by the ingestion of alkali substances were 1.6-times more likely to have reflux. There were no differences between patients with or without reflux in terms of number and localisation of strictures. Mean dis- tance of stricture was longer in patients with reflux (3.7±1.8 cm) than in patients without (2.2±1.0 cm) (0.05). Conclusion: Corrosive oesophageal stricture was usually accompa- nied by gastro-oesophageal reflux and the length of stricture is an important risk factor. Negative effects of reflux over dilatation treat- ment have not yet been demonstrated in the short-term. Neverthe- less, this frequent rate of reflux may eventually increase the risk of oesophagitis and Barrett’s oesophagus; therefore, we suggest that these effects should be prospectively evaluated in a large number of patients and these patients should be followed-up routinely in terms of the long-term effects of reflux. (Balkan Med J 2014;31:137-42). Background: Gastro-oesophageal reflux may accompany the corrosive oesophageal damage caused by the ingestion of corrosive substances and affect its treatment. The factors that affect the development of reflux in these cases and their effects on treatment still remain unclear. Aims: Our aim is to investigate the prevalence of gastro-oesophageal reflux in children with corrosive oesophageal strictures, the risk factors affecting this prevalence and the effects of gastro-oesophageal reflux on treatment. Study Design: Case-control study. Methods: We enrolled 52 patients with oesophageal stricture due to corrosive substance ingestion who were referred to our clinic be- tween 2003 and 2010. Groups, which were determined according to the presence of gastro-oesophageal reflux (GER), were compared with each other in terms of clinical findings, results of examination methods, characteristics of the stricture and success of the treatment. Results: The total number of patients in our study was 52; 30 of them were male and 22 of them were female. The mean age of our study population was 4.2±2.88 years. Thirty-three patients had gastro- oesophageal reflux (63.5%). Patients who had strictures caused by the ingestion of alkali substances were 1.6-times more likely to have reflux. There were no differences between patients with or without reflux in terms of number and localisation of strictures. Mean dis- tance of stricture was longer in patients with reflux (3.7±1.8 cm) than in patients without (2.2±1.0 cm) (0.05). Conclusion: Corrosive oesophageal stricture was usually accompa- nied by gastro-oesophageal reflux and the length of stricture is an important risk factor. Negative effects of reflux over dilatation treat- ment have not yet been demonstrated in the short-term. Neverthe- less, this frequent rate of reflux may eventually increase the risk of oesophagitis and Barrett’s oesophagus; therefore, we suggest that these effects should be prospectively evaluated in a large number of patients and these patients should be followed-up routinely in terms of the long-term effects of reflux. (Balkan Med J 2014;31:137-42).