Objectives: This study aimed to investigate diagnostic value of monocyte-tolymphocyte ratio as a novel biomarker in children with appendicitis and to compare with other biomarkers.Methods: A total of 683 children were included in this retrospective study.Patients were categorized as acute appendicitis (AA, n = 254), perforated appendicitis (PA, n = 82), nonspecific abdominal pain (NAP, n = 197), and control (n = 150). The groups were compared for demographics, duration of symptoms, monocyte-to-lymphocyte ratio (MLR), platelet-tolymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), white blood cell count, neutrophil percentage (NP), C-reactive protein (CRP), mean platelet volume, and sodium level.Results: There was a significant difference between all groups for MLR, PLR, and CRP. White blood cell count, NP, and NLR were significantly increased in patients with appendicitis, but there was no significant difference in the differential diagnosis between PA and AA. Sodium levels significantly decreased in patients with appendicitis. No statistically significance was determined between all groups in term of mean platelet volume. Among the biomarkers, MLR showed the highest diagnostic value (area under the receiver operator characteristic curve = 0.798) for AA, while CRP showed excellent diagnostic value (area under the receiver operator characteristic curve = 0.897) for PA.Conclusions: To our knowledge, this is the first study showing that MLR is a valuable parameter to differentiate patients with and without appendicitis. White blood cell, NP, and NLR are also useful parameters. On the other hand, an increased CRP level and hyponatremia are indicators of PA.

Foreign bodies in the airway and esophagus constitute a constant hazard in all age groups, which demands immediate approach and management. Although the rigid endoscopic removal of aerodigestive foreign bodies was successful in this series, the most effective treatment of foreign body accidents is their prevention.

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Placement of ventriculoperitoneal(VP) shunt is a worldwide accepted procedure for treatment of hydrocephalus. This procedure have various intra-abdominal complications, of which pseudocyst formation is a rare one. Common presentations of this complication are abdominal mass, abdominal pain, intestinal obstruction, and shunt dysfunction. In this paper, we report a case of 3 year-old boy with cerebrospinal fluid (CSF) pseudocyst of the VP shunt presenting with hyponatremic seizure. To the best of our knowledge, hyponatremic seizure has not been previously reported as a presentation of abdominal CSF pseudocyst in the literature. Our case has also the largest CSF pseudocyst with respect to body surface area of the child in the literature.KeywoRds: Children, Hyponatremia, Seizure, Pseudocyst, Ventriculoperitoneal shunt ÖZHidrosefali tedavisinde ventriküloperitoneal (VP) şant yerleştirilmesi dünya çapında kabul görmüş bir yöntemdir. Bu yöntemin çeşitli karın içi komplikasyonları vardır. Psödokist oluşumu bu komplikasyonlardan nadir olan biridir. Bu komplikasyon sıklıkla batında kitle, karın ağrısı, barsak tıkanıklığı ve şant fonksiyon bozukluğu ile bulgu verir. Bu yazıda, VP şanta bağlı serebrospinal sıvı psödokisti gelişen ve hiponatremik nöbetle bulgu veren 3 yaşındaki erkek olguyu rapor ettik. Şu andaki bilgilerimize göre, hiponatremik nöbetle bulgu veren batın içi serebrospinal sıvı psödokisti literatürde daha önceden rapor edilmemiştir. Ayrıca olgumuz vücut yüzey alanına göre literatürdeki en büyük psödokiste sahiptir.

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GV should be suspected in any newborn with non-bilious vomiting and epigastric distention. It is also important to focus on the clues in the plain radiographs. Gastric double bubble, abnormal gastric distention despite a nasogastric tube, distended stomach lying in a horizontal plane and an air-fluid level in the epigastrium must alert the physicians to the possibility of GV.

Our data suggest that topical lanolin ointment and bovine type I collagen spray are effective in the treatment of acute anal fissure in children.