Laryngotracheoesophageal clefts (LTECs) are rare congenital defects that are often accompanied by additional anomalies. The major issues in the treatment of these patients are intraoperative exposure insufficiency, technical difficulty of the operation, and anesthesia problems originating from the respiratory tract. Problems originating from mechanical ventilation and respiratory tract, eating disorders and relapse of fistula are among the problems encountered following surgery. Most of the time, concomitant additional anomalies also worsen the clinical picture. It was our aim with these case reports to report our experience in two cases with Type IV LTEC ranging from the inoperable type IV LTEC due to additional anomalies mounted up to severe respiratory distress to the carina that we operated on with a single stage anterior cervicothoracic approach on its fifth day on life.
Background: It is still difficult to make the diagnosis of acute appendicitis in children with only clinical examination. Objectives: The present study, retrospectively reviewing the data of the patients that underwent appendectomy, aimed at emphasizing the diagnostic value of ultrasonography findings by comparing them with pathological diagnosis. Patients and Methods: This retrospective study included patients aged under 18, who were operated on for appendicitis between 1 January 2015 and 31 December 2015. The relationship between the pathology results of these patients and the results of preoperative ultrasonography performed for the diagnosis of acute appendicitis was investigated. Results: The study included 100 patients, 42 were female and 58 were male, on whom ultrasonography was performed and whose
Despite optimal medical therapy patients with end-stage heart failure may deteriorate while waiting for cardiac transplantation. Bridging to transplantation with a ventricular assist device (VAD) may he a life saving procedure for these patients. We report our two cases who were implanted with MicroMed DeBakey VAD. Two male patients, 37 and 41 years old underwent implantation of a MicroMed DeBakey VAD as a bridge to heart transplantation. Both of them had end-stage left heart failure due to idiopathic cardiomyopathy and were listed for cardiac transplantation. Despite optimal medical therapy they developed acute hemodynamic deterioration. Both patients need inotropic support after implantation for adequate right heart function. The doses of the inotmpes tapered in a few days and then stopped. In the early phase after implantation, pump speed was not increased above 9,000 rpm to avoid excessive suction; but after that it was set between 9,000 and 11,000 rpm to achieve mixed venous oxygen saturation of 70% with mean arterial blood pressure more than 65 mmHg. For anticoagulation we started with intravenous heparin and then switched to warfarin sodium, clopidogrel bisulfate and acetyl salysilic acid orally. Both patients are still on the device after 46 and 25 days of uncomplicated pump support. In conclusion, these are first implants of the MicroMed DeBakey VAD in Turkey. From these cases we have learned that this device is appropriate for bridge to transplant purposes.
Background
Uroterocele causes atony and stagnation in the ureter, thus predisposing the patient to stone formation. Multiple calculi in uroteroceles are common in adults but very rare in children.
Case presentation
We describe the case of a 3-year-old boy who presented with hematuria and was found to have multiple ureteral and ureterocele stones. The diagnosis was made during endoscopic lithotripsy. A holmium/yttrium–aluminum–garnet (Ho–YAG) laser was used to excise the uroterocele and for lithotripsy.
Conclusions
In appropriate cases, minimally invasive techniques, for example, Ho–YAG laser lithotripsy and ureterocele excision may be preferred.
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