Background:  A significant proportion of cases of tracheobronchial foreign body aspiration due to life‐threatening condition is observed during childhood. The aim of the present study was to describe our experience with the diagnosis and treatment of foreign body aspirations during childhood and review published literature. Methods:  One hundred and eighty‐four patients under 16 years of age with a tentative diagnosis of foreign body aspiration were retrospectively evaluated according to age, sex, patient delay symptoms at presentation, foreign body type, localization and the diagnostic and therapeutic methods used. Results:  The most frequently aspirated objects were shelled nuts and seeds such as sunflower seeds, pistachio and hazelnuts. The chief symptom was cough. On physical examination, the most frequent findings were unilateral decrease of respiratory sound on the affected side with coarsening and bronchi. While 51% of cases presented a radiological finding, chest X‐ray was normal in the other. All patients underwent rigid bronchoscopy under general anesthesia and a foreign body was identified in 137 (74.3%). The rigid bronchoscopy intervention was used in some cases, especially in the presence of tracheal foreign bodies of organic origin. Conclusions:  Tracheobronchial foreign body aspiration is a significant cause of childhood morbidity and mortality. Early diagnosis and treatment is of utmost importance. Rigid bronchoscopy under general anesthesia should be performed in all patients suspected of foreign body aspiration, which could minimize mortality and morbidity if performed by experienced personnel with safe methods.

The prevalence of chest trauma in children due to blunt injuries is high in Turkey. Extremity injury is thought to be the most commonly associated extra-thoracic injury. However, thoracic trauma in children can be managed conservatively in most of the cases.

Pneumothorax progresses quickly in newborns and can lead to death. This study collected data prospectively over a 2-year period on risk factors, clinical course and prognostic factors of newborn cases diagnosed and treated for pneumothorax. Thirty patients were evaluated for risk factors including concurrent disease, method and duration of chest drainage, oxygen saturation and mechanical ventilation. Pneumothorax developed mostly in male and mature infants during the first 48 h following birth; risk factors included concurrent respiratory distress syndrome and meconium aspiration. Mechanical ventilation was undertaken in 18 (60%) of the patients. Closed-tube drainage was used in 28 (93%) of the patients. Nine out of 10 patients (90%) whose oxygen saturation remained < 90% died. Thus, pneumothorax may develop during the neonatal period, especially in the presence of risk factors, and neonates with < 90% oxygen saturation, despite treatment, have a high mortality rate.

Between 1976 and 1986 one hundred and ten children with pulmonary hydatid disease were treated surgically. Sixty five of the patients were males and 45 were females. We diagnosed hydatid cyst in 36 cases submitted in our clinic with hemoptysis. Thirty of the patients had cough, 16 had chest pain and dyspnea, 12 had purulent sputum and 8 cases had fever and anaphylactic phenomena. In most of the patients hydatid cysts were localised in the right lung. However, they had affinity for the lower lobes of both lungs, rather than the upper lobes. The radiological examination was found to be the most reliable diagnostic method. In the majority of our cases we performed thoracotomy + cystotomy + capitonnage, while in some cases we performed resection, like cystectomy, wedge resection and lobectomy. We did not encounter any serious operative and postoperative complications, except for one pleural empyema and a single case of mortality.

Bilateral pneumothorax may require extended hospital stay and could result in death. We think that tube drainage is appropriate and effective for most cases of bilateral pneumothorax.

ABSTRACT

Background: This study aims to evaluate the effectiveness of pleurodesis procedure by ensuring the expansion of the lung and occluding lung parenchyma leaks with an autologous blood patch. Methods: A total of 24 patients (17 males, 7 females; mean age 59.9±12.2 years; range, 30 to 86 years) who underwent autologous blood patch pleurodesis in our clinic between November 2015 and November 2019 were retrospectively analyzed. The patients were not eligible to undergo chemical pleurodesis due to a non-expandable lung or poor general condition. Demographic and clinical characteristics of the patients and postoperative data were evaluated. Results: The air leak stopped within 48 h after autologous blood patch pleurodesis in seven patients. The air leak significantly decreased in 13 patients, while it remained unchanged in four patients. A Heimlich valve was placed in the patients in whom the air leak stopped or significantly decreased. The follow-up chest X-rays showed that the respective lungs of these patients became completely expandable. Conclusion: Our study results suggest that the autologous blood patch procedure is a favorable option for the patients who are unable to benefit much from the conventional chemical pleurodesis methods due to contraindications to surgery or the presence of non-expandable lungs.

196 cases of peripheral arterial injury presented to our clinic between 1976 and 1986 are summarised. Most of the cases were between 11 and 30 years of age and most of the injuries were by fire-arms and sharp weapons. The most common localisations were a. femoralis (29% cases), a. poplitea and branches (28%), a. brachialis injury (20%). The most common surgical measures were end-to-end anastomosis (43% cases) and venous orthograft replacement (17%). There were 5 mortalities. Factors affecting treatment success are discussed.