Paraurethral or Skene's duct cysts are rare causes of interlabial masses in neonates. The diagnosis of Skene's duct cysts in the neonatal period is based on its location, in relation to the urethra, and the demonstration of transitional epithelium in the cyst wall. The distinguishing features of paraurethral cysts are the displacement of urethral meatus by the mass and a cyst containing milky fluid. Thus, we report a case of a Skene's duct cyst in a newborn which was treated by incision and drainage.
Giriş ve Amaç: Hemanjiyomlar kan damarlarının iyi huylu proliferasyonlarıdır. Kafa içi, karın ve cilt gibi birçok lokalizasyonda olabildikleri gibi, Kasabach Meritt, Klippel Trenaunay Weber Sendromu gibi sendromlarla beraber de olabilirler. Dev hemanjiyomların postnatal erken dönemde opere edilerek olası geç komplikasyonların önüne geçilebileceğini vurgulanması amacıyla olgumuz sunulmuştur. Olgu Sunumu: 26 günlük erkek olgu sağ aksiller bölgede 10x10 cm dışarıya doğru büyüyen kitle nedeniyle yatırıldı. Kitlenin üzerinde kılcal hemanjiyomların gözlenmesi nedeniyle hemanjiyom olduğu düşünüldü. Trombositopeni izlenmeyen hastada kranial ve batın ultrasonografisi (US) normal bulundu. Ekokardiografik incelemede ASD, ince PDA ve periferik pulmoner stenoz saptandı. Manyetik rezonans görüntüleme (MRG) incelemede; sağ aksiller arterden geniş bir pedikülle beslenen, sağ hemitoraks duvarı posterolaterali ve aksiller fossayı dolduran ve toraks duvarına invazyon izlenmeyen yaklaşık 12 cm boyutunda damarsal yapıdan zengin hemanjiyom olduğu düşünülen kitle izlendi. Ameliyat sırasında kitle pedikülünün 11 mm çapında çok geniş olduğu görüldü ve kitle total eksize edildi. Ameliyat sonrası beşinci gün sorunsuz olan taburcu edilen hastanın birinci yıl kontrolünde nüks saptanmadı. Sonuç: Hemanjiyomlar ilk 3 yıl içinde kendiliğinden regrese olabileceği bilindiği için klinik olarak takip edilmektedir. Ancak dev kavernöz hemanjiyomlar, trombositopeni ve kanamaya eğilimleri yanısıra kardiak yetersizliğe neden olabilecekleri için bu olguların erken postnatal dönemde ameliyat öncesi hazırlıklarının tamamlanması ve takiben opere edilmesi; kozmetik iyi sonuç ve olası komplikasyonları önleme açısından gereklidir.
Yazar AS, Erdoğan S, Şahin C, Güven Ş. Reliability of ultrasonography and the Alvarado scoring system in acute appendicitis. Turk J Pediatr 2018; 60: 173-179.In this study, we aimed to evaluate the diagnostic performance of ultrasonography, the Alvarado score, mean platelet volume and C-reactive protein in the diagnosis of acute appendicitis.Patients admitted to the pediatric emergency department with abdominal pain who were operated on with a preliminary diagnosis of acute appendicitis were evaluated. The patients who had acute appendicitis diagnosis in the histopathological assessment were considered as the Appendicitis (App) Group, while patients who did not have acute appendicitis according to histopathology were considered as the Non-app Group.Of 200 patients assessed in the study, 137 (68.5%) were male and 63 (31.5%) were female. Of the patients operated on; 170 (85%) had acute appendicitis, while the pathological results of 30 (15%) were not consistent with acute appendicitis. The Alvarado score of the patients in App Group was significantly higher than those in Non-app Group (p=0.001). The sensitivity and specificity of the Alvarado score and ultrasonography were 60%, 81.18% and respectively, for the diagnosis of appendicitis. There were no significant differences (p> 0.05) in terms of average white blood cell, absolute neutrophil count, platelet count, mean platelet volume and C-reactive protein between the two groups.According to our study the use of Alvarado Scoring System with ultrasonography is more effective and accurative than ultrasonography performing alone. We recommend performing ultrasonography on patients with right lower quadrant pain and suspected appendicitis admitted to the emergency department and to operate on patients with a ultrasonography-supported appendicitis diagnosis and an Alvarado score of 7 and above. Patients with an appendicitis diagnosis not supported by ultrasonography and an Alvarado score lower than 7 should be closely monitored.
Ingestion of foreign objects such as one more magnets may cause intestinal perforation in early stages. If the object stays in the same location shown by repeated X-rays, surgical intervention should not be delayed.
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