Objective. This study aims to evaluate whether alpha-lipoic acid and/or coenzyme Q10 can protect the prepubertal ovarian tissue from ischemia-reperfusion injury in an experimental rat model of ovarian torsion. Materials and Methods. Forty-two female preadolescent Wistar-Albino rats were divided into 6 equal groups randomly. The sham group had laparotomy without torsion; the other groups had torsion/detorsion procedure. After undergoing torsion, group 2 received saline, group 3 received olive oil, group 4 received alpha-lipoic acid, group 5 received coenzyme Q10, and group 6 received both alpha-lipoic acid and coenzyme Q10 orally. The oxidant-antioxidant statuses of these groups were compared using biochemical measurement of oxidized/reduced glutathione, glutathione peroxidase and malondialdehyde, pathological evaluation of damage and apoptosis within the ovarian tissue, and immunohistochemical assessment of nitric oxide synthase. Results. The left ovaries of the alpha-lipoic acid + coenzyme Q10 group had significantly lower apoptosis scores and significantly higher nitric oxide synthase content than the left ovaries of the control groups. The alpha-lipoic acid + coenzyme Q10 group had significantly higher glutathione peroxidase levels and serum malondialdehyde concentrations than the sham group. Conclusions. The combination of alpha-lipoic acid and coenzyme Q10 has beneficial effects on oxidative stress induced by ischemia-reperfusion injury related to ovarian torsion.

Objective:In this study, thermocautery, plastic clamping, and conventional (open surgical) circumcision techniques were compared in terms of their complications.Methods:Male patients who underwent circumcisions between May 2014 and May 2015 in two separate pediatric surgery clinics were retrospectively analyzed using the hospital registry system. These patients were evaluated in terms of age, accompanying pathologies, anesthesia techniques, complication rates, duration of surgery, and circumcision techniques. A statistical analysis of the data was performed, with a P<0.05 considered to be statistically significant.Results:The patients were divided into three groups according to the circumcision method: conventional surgical circumcision (n=833), thermocautery (n=1011), and plastic clamp (n=218). Complications were observed in 21 cases (1%): bleeding (11), infection (2), trapped penis (6), meatitis (1), and scrotal injury (1). There were significantly fewer complications in the thermocautery technique when compared to the clamping and surgical circumcision techniques. The plastic clamping and thermocautery techniques were superior to a surgical circumcision in terms of the operation time.Conclusion:The thermocautery circumcision technique can be used easily in both the operating theatre and in designated circumcision rooms, with a lower complication rate, when compared to plastic clamping and surgical circumcisions.

OBJECTIVE: Hiatus hernia is frequent in adults and rare in children; congenital hiatus hernia is even rarer. In this study, we describe a group of infants with congenital hiatus hernia and discuss its management. METHODS: Records of patients (male: 3, female: 4) who were diagnosed with congenital hiatus hernia between 2010 and 2016 were extracted. Demographic data, presenting symptoms, diagnostic investigations, operative details, postoperative follow-up, and early and late postoperative complications were evaluated retrospectively. RESULTS: Four patients were female and three were male. One patient was diagnosed prenatally while the mean age at diagnosis for others was 18.6 months. Four patients had type IV hernia, 2 had type III hernia, and one had type I hernia. The diagnosis was confirmed by chest X-ray, computerized tomography (CT) and/or upper gastrointestinal series. The hiatal repair was done in all patients either by laparotomy or laparoscopy. During the procedure, 2 patients had Nissen fundoplication and 3 patients had Thal fundoplication. Recurrence of hernia occurred in the 2 patients who had Thal fundoplication. CONCLUSION: Recurrence of sliding hernias with Thal fundoplication seem more frequent in the series. If the esophagogastric junction is present in the thorax, mediastinal dissection of the esophagus may be required to achieve a good abdominal esophagus structure, which will prevent a recurrence.

Objective:To evaluate the effect of inguinal operations performed with a modified Ferguson technique upon testicular volume and blood flow.Methods:This study involved 23 children receiving surgery for inguinal hernia, hydrocele, and cord cyst. This was a prospective study performed between April 2016 and June 2016 in a medical faculty pediatric surgery unit. The color Doppler ultrasound (CDUS) was used to assess testicular volume and blood flow before and after a modified Ferguson technique surgery. The pre- and post operative testicular volume and blood flow were compared with the contralateral testes. SPSS software was used to statistically analyze the data arising; the Mann-Whitney U test and Friedman test were used to compare samples, and P<0.05 was accepted as statistically significant.Results:Preoperative and postoperative testicular volumes were not statistically different when compared to contralateral testes. In patients with right sided inguinal pathology, testicular blood flow on the right side was significantly lower than that on the left side (P=0.023). The testicular blood flow was not statistically different compared with the contralateral testes during the first week evaluation and first month evaluation. The blood flow, probably reduced due to the pressure caused by inguinal pathology, was normalized through surgery.Conclusions:The modified Ferguson technique do not change the testes volume and blood flow.

Objective: Endoscopic retrograde cholangiopancreatography may be useful in the diagnosis and management of biliary system parasites. Material and Methods: Investigators retrospectively evaluated patients with biliary system parasites who underwent endoscopic retrograde cholangiopancreatography procedures over an eight-year period. We collected data regarding patient demographics, clinical features, and parasite type. We aimed to determine the utility of endoscopic retrograde cholangiopancreatography as a diagnostic and therapeutic intervention in patients with biliary system parasites. Results: We identified 22 patients with biliary system parasites from a total of 3,450 endoscopic retrograde cholangiopancreatography procedures performed during an eight-year period. Parasite types included Echinococcus granulosus (n=19), Fasciola hepatica (n=2), and Ascaris lumbricoides (n=1). Fifteen patients with liver hydatid cysts underwent endoscopic retrograde cholangiopancreatography prior to surgery due to obstructive jaundice. The endoscopic retrograde cholangiopancreatography procedure enabled definitive treatment without the need for surgery in the remaining two patients. Two patients with fascioliasis underwent endoscopic retrograde cholangiopancreatography due to clinical presentation of cholangitis, cholecystitis, and obstructive jaundice, leading to presumptive diagnosis of cholangiocarcinoma. However, the final diagnosis was made using endoscopic retrograde cholangiopancreatography following inspection of flat, leaf-shaped, motile flukes extracted from the bile duct. In one patient with ascariasis, a longitudinal tubular structure was identified in the bile duct; emergency surgery was required. Conclusion: The diagnosis of parasitic diseases is clinically challenging, and definitive diagnosis requires endoscopic retrograde cholangiopancreatography in some cases. Moreover, endoscopic retrograde cholangiopancreatography provides a therapeutic option for ascariasis, fascioliasis, and some forms of hydatidosis. Accordingly, the use of endoscopic retrograde cholangiopancreatography may change preoperative management and treatment strategies for biliary system parasite infections.

Çocuklarda kostik madde içimi nedeni ile gelişen özofagus yanıkları ülkemiz gibi gelişmekte olan ülkelerde oldukça sık görülmektedir. Bu yazıda yerel ve ulusal firmalar tarafından üretimi olan ve halk arasında "turşu kur" ismiyle bilinen, turşu yapımında kullanılan ürünün içimine bağlı özofagus yanığı gelişen 4 yaşında kız hasta sunulmuştur. Turşu yapım solüsyonları market raflarında kolaylıkla bulunmaktadır ve bazıları içerdikleri asetik asit nedeniyle zararlı olabilirler. Diğer korozif ürünlerin aksine gıda yapımında kullanılması nedeniyle ailelerin tehlikeli görmediği bu ürünler hakkında farkındalığın artırılması amaçlanmıştır.

We report the case of a newborn girl with intestinal cystic lymphangiomatosis who presented with abdominal distension and intra-abdominal bleeding following a prenatal ultrasound diagnosis of intestinal anomaly. Postnatal abdominal ultrasound revealed disseminated submucosal and intramural cystic dilatations of various sizes in the bowel and intestinal lymphangiomatosis was diagnosed. The presence of severe bleeding diathesis and widespread disease led to conservative treatment. The patient died on postnatal day 7 and postmortem examination confirmed cystic lymphangiomatosis. Detection of intestinal hyperechogenicity and/or dilatation in prenatal ultrasonography and the persistence of these findings during pregnancy are suggestive for pathologies such as meconium ileus, meconium peritonitis, and intestinal atresia. Although rare, intestinal lymphangiomatosis should be kept in mind in patients whose prenatal sonographic findings persist until birth.

Omental torsion is a rare cause of acute abdomen and is often confused with appendicitis because of physical examination findings that suggest appendicitis. Here we present a case of an 11-year-old girl with omental torsion who was medically treated. This study aimed to create awareness for omental infarction and help avoid unnecessary surgical procedures for medically treatable pathologies.