Introduction: Hydatid cyst is a parasitic disease caused by Echinococcus granulosus, most commonly seen in the liver and lungs. The hydatid cyst is rarely seen in the heart and iliofemoral region, representing less than 2% of all cases. In this article, we report our cases of hydatid cysts in unusual loci. Methods: Between 2015 and 2018, 6 rare cases of hydatid cysts were diagnosed at the Cardiovascular Surgery Department of Harran University. Four of these patients had cardiac localization and two patients had their cysts located in the iliofemoral region, extending to the pelvic zone. All patients were female. Three patients had no other organ involvement. One patient with cardiac hydatid cyst underwent normothermic cardiopulmonary bypass + total pericystectomy + Cooley-like aneurysmectomy. Total pericystectomy was performed in three other patients with intrathoracic locus by normothermic cardiopulmonary bypass. Two patients who were referred to our clinic with palpable iliofemoral mass were evaluated with appropriate imaging methods and diagnosed accordingly. Multiple iliofemoral cysts were managed with pericystectomy and drainage by a single incision made over the inguinal ligament. Conclusion: Hydatid cyst disease can develop in cardiac chambers and inguinal region with or without hepatic or pneumatic involvement. Normothermic cardiopulmonary bypass can be safely used in patients with cardiac hydatid cysts, and capitonnage similar to ventricular aneurysm repair in patients with a widely involved cystic lesion can be very useful for the protection of ventricular functions.

Foreign body and caustic substance ingestion in childhood are common and require accurate and timely diagnosis to provide appropriate management consistent with the ingested substance/foreign body and clinical presentation as well as the associated risk status to prevent significant complications and morbidity. The aim of this paper was to present foreign body and caustic ingestion in childhood in terms of epidemiology, pathophysiology, diagnostic work-up and appropriate management and potential complications in accordance with clinical presentation and the type of ingested substance/foreign body.

Foreign body ingestion is a common clinical situation that is primarily diagnosed by emergency clinicians. Most foreign bodies can be evacuated without difficulty. Although rare, magnets that reach the lower intestinal tract may cause complications such as intestinal fistula formation, perforation, volvulus or appendicitis. We report herein a two-yearold girl who was admitted to our department 3 days ago with abdominal pain and non-bilious vomiting. Upon admission direct abdominal roentgenogram revealed a foreign body consisting of multiple spheric parts bound together forming a circle in the lower quadrants of the abdomen. Her family, unaware of this ingestion, stated that a magnetic toy matching the object present on the plain radiograph was lost several days ago. Surgical intervention showed a magnetic toy in the proximal part of the ileum causing multiple perforations in the intestinal wall and the neighboring mesentery. The ileal portion containing the magnet toy was seen folded over itself forming a blind loop. The patient was discharged uneventfully in the 7th postoperative day. Our case highlights a well known fact that foreign body ingestion in children may not have eye witnesses and should be taken into consideration when evaluating children with abdominal pain.Key Words: Ingested magnets in children; ingested foreign body.Yabancı cisim yutulması sıklıkla acil hekimlerinin karşılaş-tığı bir klinik durumdur. Çoğu yabancı cisim kendiliğinden çıkar. Ancak nadiren de olsa, distal intestinal sisteme ulaşabilen yabancı cisimler fistül, perforasyon, volvulus veya apandisit gibi komplikasyonlara yol açabilir. Bu yazıda, kliniğimize üç günlük karın ağrısı ve safrasız kusma şika-yeti ile başvuran iki yaşındaki kız hasta sunuldu. Başvuru esnasında çekilen ayakta direkt karın grafisinde, karın sağ alt kadranda halka yapısında birbirine bağlı birden fazla sayıda yabancı cisim izlendi. Aile yabancı cisim yutulması ile ilgili herhangi bir öykü vermedi ancak karın grafisinde izlenen yabancı cisme benzer bir oyuncak mıknatısın birkaç gün önce evde kaybolduğunu belirttiler. Cerrahi girişimde proksimal ileumda bağırsak duvarında ve komşu mezenterde çoğul bağırsak delinmesine yol açan halka şeklinde mıknatıslı oyuncak izlendi. Bu yabancı cismin yer aldığı ileal parça yabancı cismin şeklini alarak kendi üstüne katlanmış ve o da halka şeklini almıştı. Hasta ameliyat sonrası yedinci günde sorunsuz olarak taburcu edildi. Bu olgu ile çocuklarda yabancı cisim yutulmasında herhangi bir şahitin olmayabileceği ve karın ağrılarının değerlendirilmesinde bu durumun da hatırlanması gerektiğinin bir kere daha altı çizilmelidir.Anahtar Sözcükler: Çocuklarda yutulmuş mıknatıs; yutulan yabancı cisimler.

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We report here a fetus, who was delivered via cesarean section in 32th gestational week from a 37-year-old mother and sustained multiple gunshots. Post-natal evaluation revealed eight entry-exit holes and the baby was transferred to our clinic.Upon admission, peripheral pulses were nonpalpable, appropriate fluid administration and blood transfusion were conducted and further examinations revealed bladder perforation. Bladder was repaired over a suprapubic catheter and bullet holes were primarily sutured. Left foot drop was observed on follow up and the patient was discharged with no further complication. Although the maternal and the fetal morbidity and mortality rates are high in intrauterine gunshot wounds, appropriate management may provide survival as seen in our case.

Diaphragmatic rupture may be traumatic or may occur spontaneously. Spontaneous diaphragmatic rupture is a rare entity seen almost entirely in adults. We report here a case with spontaneous rupture of a congenital diaphragmatic evantration in a child.

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.