No abstract

Objective: Hydatid cysts can occur in any place such as the liver, lung, spleen, kidney, brain, and soft tissue. Pulmonary hydatid cysts are more prone to rupture than liver hydatid cysts. In this study, we aimed to present the demographic characteristics, clinical symptoms, radiological findings, surgical findings, type of surgery performed, and postoperative complications of patients with pulmonary hydatid cysts.Materials and method: The files of 94 patients who were operated on for pulmonary hydatid cysts in our clinic between January 2011 and October 2021 were retrospectively analyzed. The patients were divided into two groups: ruptured pulmonary hydatid cysts and non-ruptured pulmonary hydatid cysts.Results: A total of 120 pulmonary hydatid cysts were detected in 94 patients who were operated on for pulmonary hydatid cysts. Cyst rupture was detected in 63 (52.5%) patients. Rupture was found significantly higher in cysts with a diameter of <10 cm (p=0.005). Complaints of fever and hemoptysis were found significantly higher in the ruptured group. Pneumothorax was detected in six patients after the operation with an average of two months, one of which was the patient who underwent video-assisted thoracoscopy (VATS).Conclusion: Pulmonary hydatid cyst should be kept in mind in children presenting with lower respiratory tract symptoms in regions where echinococcosis is endemic. Parenchyma-sparing methods should be the first choice in the management of pulmonary hydatid cysts. Patients who develop early postoperative complications should also be followed closely for late impediments.

Background and objectiveAbdominal pain is one of the most common problems in children presenting to the pediatric emergency departments and is often a diagnostic challenge for the physician. Clinical studies have been carried out on adult patients to differentiate between ureteral stones and acute appendicitis (AA) in which neutrophillymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were analyzed in the complete blood count, and it was found that NLR and PLR could help in the differential diagnosis. In this study, we investigated whether complete blood count parameters in pediatric patients could be helpful in the differential diagnosis between AA and right ureteral stones. MethodsThe files of pediatric patients who were followed up and treated for AA and right ureteral stones between January 2019 and March 2021 were reviewed retrospectively. The demographic characteristics of the patients and their WBC, NLR, PLR, and red cell distribution width (RDW) values were evaluated to determine whether there was a difference between the two groups. ResultsIn this study, 77 patients with AA and 48 patients with right ureteral stones were included. Univariate regression analysis revealed that age, gender, WBC, PLR, and NLR were factors likely responsible for AA. As per multivariate linear regression analysis, NLR level (odds ratio: 0.407; 95% CI: 0.293-0.566; p<0.001) was an independent predictor of AA. ConclusionBased on our findings, NLR can help in establishing the diagnosis in pediatric patients who present to the emergency department with right lower quadrant pain, and in whom physical examination, routine laboratory tests, and imaging methods cannot help distinguish between AA and ureteral stones.

ObjectiveTo retrospectively evaluate the success rates of fluoroscopy-guided pneumatic reduction in children with intussusception and to determine the risk factors and patient characteristics affecting the success of this method.Materials and methodsRetrospective evaluation was made of a total of 183 children diagnosed with ultrasonography (USG) and treated in the pediatric surgery clinic between August 2010 and December 2017. Data related to gender, age (month), date of presentation, invaginated segment localizations and treatment modalities were retrieved from the patient files.In children who underwent pneumatic reduction, surgical success was determined as the visualization of air flow through the small intestine on fluoroscopy and patients who received reduction were followed up in our clinic. No progress of the air given or failure to see the air flow to the small intestine despite some progression of the air was evaluated as failure and surgical procedure was started in 39 patients. All patients were followed up at the hospital for at least 24 to 48 hours after the procedures.Patients with perforation, peritonitis, vital instability, or general condition disorder during presentation at our clinic (n = 29) were directly admitted for surgery.ResultsThe study included a total of 183 children, comprising 116 (63.4%) males and 67 (36.6%) females with a mean age of 61.3 ± 34.3 months. While mesenteric lymphadenitis (n = 7) was determined as the most common lesion in cases where a pathologic lead point was detected (7.6%), Meckel’s diverticulum was observed in four patients, polyps in two patients, and an involvement associated with Henoch Schönlein Vasculitis in one patient. Pneumatic reduction procedure was applied in 154 (84.1%) patients and successful results were obtained in 115 (74.7%) patients, while surgical intervention was required in 39 (25.3%) patients.While frequency of admission to direct surgery following the failure of pneumatic reduction in children under the age of two years was determined to be higher than the frequency of healing, the successful pneumatic reduction and admission to direct surgery rates in children between the ages of 0-4 years was found to be significantly higher than those in other age groups (p < 0.001). The pneumatic reduction success rate was determined to decrease significantly in children aged ≥6 years (p < 0.001). The mean hospitalization duration of the patients who underwent surgery after pneumatic reduction (five days) was determined to be significantly longer compared to that of the patients who underwent direct surgery and for whom a successful pneumatic reduction was ensured (p = 0.001 and p = 0.008, respectively).ConclusionFluoroscopy-guided pneumatic reduction has a high success rate and is still one of the first option methods in the treatment of idiopathic intussusception. The application of the method under operating room conditions is more appropriate for patient safety. It is considered that the non-operative reduction success may increase with the detailed ...

BACKGROUND: Testicular torsion is a urological emergency that requires urgent surgical intervention which results in testicular loss if not diagnosed and treated in a timely fashion. Ischemic tissue damage with oxygen deficiency, which starts with the decrease in blood flow to the tissue, continues to increase with the reoxygenation of the damaged tissues as soon as reperfusion is achieved. In various studies, osthole has also been shown to reduce cerebral, spinal cord, intestinal, renal, and myocardial ischemia/perfusion (I/R) damage. The aim of this study is to examine the effects of osthole on testicular I/R injury. METHODS: 28 Wistar-albino rats were randomly divided into four experimental groups (n=7). Group 1 was the sham operation group. In Group 2 (I/R), 3-h ischemia was created by rotating the testis 720° clockwise, followed by 3 h of reperfusion. In Group 3 (I/R + single dose of Osthole), 20 mg/kg ostol was administered intraperitoneally half an hour before detorsion after 3 h of torsion. The testis was detorsioned. Three h of detorsion was applied. In Group 4 (I/R + twice doses of Osthole), 20 mg/kg ostol was administered intraperitoneally half an hour before detorsion, followed by 3-h torsion. The testis was released and detorsioned. Half an hour after the detorsion, an intraperitoneal dose of 20 mg/kg osthole was administered again. Detorsion was done for 3 h. All rats were sacrificed after 6 h and right orchiectomy was performed for blood for biochemical analysis and histopathological sample. RESULTS: Glutathion, nuclear respiratory factor 2, Superoxide dismutase, and 8-hydroxydeoxyguanosine levels were decreased in I/R rats, while interleukin-6, malondialdehyde, and myeloperoxidase levels were increased. While caspase 3, caspase 8, caspase 9, and TUNEL showed moderate immunopositive tissues immunohistochemically in rats with I/R damage, mild immunopositive tissues were detected in Group 3 and Group 4. In the histochemical examination, degenerative tubule structure and separation of epithelial cells were observed in I/R rats, while partially healed testicular tissue was detected in Group 3 and Group 4. CONCLUSION: In our study, we observed that osthole reduced oxidative damage, suppressed the inflammatory process, prevented apoptosis, and reduced cell damage. We think that with repeated doses, cellular damage would gradually decline.