Although management of perianal abscess is still controversial, simple drainage of the perianal abscess with additional antibiotic therapy reduces the development of fistula-in-ano. Fistula-in-ano within children has a chance of spontaneous resolution thus the immediate surgical intervention should be avoided.

Appendicitis is the most common surgical emergency in pediatric surgery. In the presence of an appendicular mass, surgical management can be difficult. We evaluate the results of appendix mass management both with immediate operation and conservative treatment over a period of 5 years. Forty children who presented with appendicular mass over a period of 5 years were reviewed. Their mean age was 7.6+/-2.7 years, and the mean duration of symptoms was 7.8+/-2.7 days. We evaluated the children in two groups: The first group included 19 children who were operated on immediately, and the second group included 21 children who were managed conservatively, followed by elective appendectomy. In the first group, mean hospitalization time was 8.7+/-3.2 days. The complication rate was found to be high (26.3%). Ileal injury occurred in two patients, intraabdominal abscess developed in one patient, and wound infection developed in another. Appendectomy could not be done in one patient who required another laparotomy 8 weeks later. In the second group, mean hospitalization time was 8.9+/-2.6 days. Two patients (8.6%) failed to respond to conservative management. Elective appendectomy was performed after 2-3 months. Two patients returned with perforated appendicitis 5 months and 12 months later, respectively, because they were not brought back for subsequent appendectomy. It can be concluded that conservative treatment of appendicular mass is safe; we also advocate elective appendectomy because of the probable risk of recurrence.

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Peritoneal dialysis is an effective means of renal replacement therapy in the neonatal period in the management of metabolic disturbances as well as renal failure. Although major complications of procedure are not so common, these patients have high mortality rates due to the serious nature of the primary causes.

We believe that any boy with acute scrotal pain and any suspicion of testicular torsion in physical examination must be applied routine surgical exploration.

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