A total of 254 children with cholelithiasis (mean age: 8.9 ± 5.2 years) were recruited to the study. Girls (52.8%) were significantly older than boys (P < 0.001). Symptomatic patients (59%) were significantly older than asymptomatic patients (P = 0.002). Abdominal pain was the most frequent symptom. No risk factors were identified in 56.6% of the patients. Ceftriaxone (20%) was the most commonly associated risk factor. At presentation, at least one of the following complications was seen in 14.1% of patients: cholecystitis (10.9%), obstructive jaundice (2.7%), pancreatitis (1.96%) and cholangitis (1.2%). There was no relationship between gallstone size and symptoms, aetiological factors and complications. The cholelithiasis dissolution rate was higher in younger children (P = 0.032), in those with biliary sludge (P < 0.0001) and ceftriaxone-related cholelithiasis (P < 0.001). Haemolytic anaemia (P = 0.001) and older age (P = 0.002) were associated with stable stones. Ursodeoxycholic acid was administered to 94.4% of patients at presentation. Twenty-nine patients underwent cholecystectomy, and seven patients underwent endoscopic retrograde cholangiopancreotography. Patients who were symptomatic at presentation had significantly more frequent symptoms at follow-up (P < 0.001) CONCLUSIONS: Dissolution rate of cholelithiasis was higher in younger children, biliary sludge formation and ceftriaxone-related cholelithiasis but lower in older children and haemolytic anaemia-related cholelithiasis.

Introduction.The aim was to describe the findings on magnetic resonance imaging (MRI) in children with headache. Population and methods. Retrospective review of the medical records of patients who were admitted to our pediatric outpatient neurology clinics with the complaint of headache between January 2013 and December 2014. Results. A total of 478 patients (273 female, 205 male) were admitted with the complaint of headache. The types of headache were migraine in 218 (45.6%), tension-type in 159 (33.3%), secondary in 39 (8.2%) and unspecified headaches in 62 (13%) patients. Brain MRI was performed in 407 (85%) patients and revealed cerebral abnormalities in 128 (31.4%) patients; 5 patients had cerebral abnormalities relevant with headache, including tumors. Amongst the others 123 patients, the most common findings were 42 cases (10%) of nonspecific white matter abnormalities, 17 cases (4%) of enlarged perivascular spaces, 17 cases (4%) of arachnoid cyst, 16 cases (3.9%) of asymmetric ventricles, 12 cases (2.9%) with Chiari type I and cerebellar tonsillar ectopia. Also, 17 (4.1%) patients had extra-cerebral MRI abnormalities including sinusitis, mucosal thickening and retention cysts of sinuses. Conclusions. In this study, the contribution of brain MRI in the diagnosis and management of the children with headache was still low.

Introduction Detecting renal scar is important in pediatric patients with vesicoureteral reflux (VUR) for deciding on treatment option. The aim of this study is to detect whether freehand elastosonography technique could be an alternative to dimercaptosuccinic acid (DMSA) scan in determining renal scar formation. Materials and Methods Between November 2015 and April 2016, 25 VUR patients, age ranging from 3 to 17 years admitted to our clinic, had urinary ultrasound and elastosonography, and data of approximately 147 renal region were recorded. Data were upper, middle, and lower pole renal parenchymal thickness and echogenicities obtained by ultrasound and these poles strain target (ST), strain reference (SR), and strain index (SI) values obtained by freehand elastosonography. DMSA scan data (differential function and upper, middle, and lower pole parenchymal scar formation) were recorded. Results Scar formation and more than 10% reduction in differential function in renal scan were statistically higher in renal regions in which parenchymal thinning and echogenicity increase was detected by ultrasound. There was no elastosonographic data difference between renal units with and without differential function decrease. Also, there was no elastosonographic data difference between renal units with and without scar formation. Conclusion In this study, we could not find any significant difference in term of tissue tension values (ST and SI) measured by freehand elastosonography between renal units with and without scar formation in renal scan.

ÖZET Amaç: Bu çalışmada, kliniğimizde karaciğer kist hidatiği (KCKH) sebebi ile açık opere edilen hastalar ile girişimsel radyoloji ünitesinde perkütan yöntemle tedavi edilen hastaların tedavi sonuçlarının karşılaştırılması amaçlandı.Gereç ve Yöntemler: 1997-2013 yılları arası KCKH nedeniyle tedavi edilen 114 hasta geriye dönük olarak incelendi. Hastalar demografi k, geliş şikayetleri, kistin özellikleri ve işlemlerin komplikasyonları açısından incelendi.Bulgular: Hastalar yaşları 6 ila 16 yıl arasında olan 47 erkek (% 41.2), 67 kız (%58.8) olgudan oluşmaktaydı. Hastaların %49'u ağrı, %37.7'si karında şişlik ve 1 hasta ise tıkanma sarılığı şikayeti ile başvururken, KCKH insidantel olarak 14 hastada (%12.3) tesbit edildi. KCKH 90 hastada(%79) tek iken, 24 hastada 10'a kadar olan çoklu kist mevcuttu. Sadece karaciğer lokalizasyonlu kist 85(%74,6) hastada mevcutken, 29 hastada (%25.4) ise en fazla akciğer olmak üzere karaciğerle beraber diğer organlarda da kist hidatik tutulumu vardı. Kistin çapı 3-16 cm arasında değişmekteydi. Opere olanlarda kist çapı ortalama 96 mm iken, perkütan tedavi uygulanan grupta ortalama çap 70 mm'di (p=0,001). Hastaların 82'sine (%72) operasyon, 32'sine (%28) perkütan tedavi uygulandı. Toplam 4 hastada nüks (opere), 3 kist enfeksiyonu (opere), 3 uzamış safra drenajı (1'i perkütan tedavi) tespit edilmiştir. Peroperatif safra kanalı ile ilişki opere olan 5 hastada görüldü. Opere edilenlerde başvuruda ağrı şikayeti daha az, kitle şikayeti fazla iken; PAİR (Puncture, Aspiration, Injection, Reaspiration) grubunda bunun tam tersiydi (p=0,001). Perkütan tedavi grubunda, izole KCKH fazla iken KCKH'yla beraber akciğer kist hidatiği cerrahi grupta fazla idi (p=0,002). Gruplar diğer parametreler açısından benzerdi.Sonuç: Perkütan tedavi minimal invaziv, skarsız, düşük morbidite ve mortalite oranlarına ve kısa hastanede kalış süresine sahip olması sebebiyle seçilmiş KCKH olgularında öncelikle uygulanması gereken bir yöntem olmakla beraber komplike olgularda açık cerrahi onarım düşünülmelidir.Anahtar Sözcükler: Çocuklarda karaciğer kist hidatiği, Perkütan tedavi ABSTRACT Objective: The aim of our study was to compare the outcomes of patients who had undergone surgery or percutaneous treatment for liver hydatid cyst (LHC) in our clinic. Material and Methods:A total of 114 patients treated for LHC between the years 1997 to 2013 were evaluated retrospectively from their fi les. Patients were evaluated in terms of demographic characteristics, complaints, cyst characteristics and complications.Results: There were 47 (41.2 %) males and 67 female (58.8%) aged between 6 and 16 years. The complaint was pain in 49% and abdominal swelling in 37.7%, while obstructive jaundice was present in 1 patient at the time of presentation. The cyst was found incidentally in 14 (12%) patients. Only one cyst was present in 90 patients (79%) and there were multiple cysts in 24 patients (maximum 10). The cyst was localized in the liver in 85 (74.6%) patients while there were other cysts, mostly in the lung in 29 (25.6%) patien...