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AIM:The study compares the efficiency, side effects and complications of autologous blood pleurodesis with talcum powder and tetracycline.MATERIALS AND METHODS:This prospective study evaluated 50 patients with persistent air leak resulting from primary and secssondary spontaneous pneumothorax between February 2004 and March 2009. The patients inclussded 32 (64.0%) males and 18 (36.0%) females with a median age of 39 years (range 14-69 years). All cases had persistent air leak of more than seven days. Pleurodesis was performed using autologous blood in 20 (40.0%) patients, talc powder in 19 (38.0%) patients and tetracycline in 11 (22.0%) patients through a chest tube. Air leak cessation times after pleurodesis, side effects and pulmonary function tests (PFT) in the first and third months were measured.RESULTS:Recurrent primary spontaneous pneumothorax was the cause of persistent air leak in all cases. Air leaks were expiratory only in 54.0% of cases. We obtained a success rate of 75.0% using autologous blood, 84.2% using talc powder and 63.6% using tetracycline. Mean air leak termination interval was significantly (P < 0.001) shorter in patients treated with autologous blood in comparison to talc powder and tetracycline. We observed a significant (P < 0.05) decline in PFT in patients treated with talc powder compared with tetracycline and autologous blood. Vital capacity, FVC and FEV1 were significantly lower in patients treated with tetracycline compared with autologous blood.CONCLUSION:This study shows that autologous blood pleurodesis compared to talc powder and tetracycline is related with shorter leak cessation time and less pulmonary function decline in patients with persistent air leak. We think further randomized clinical trials of pleurodesis as treatment could increase its use in thorax surgery by demonstrating the safety and the efficacy of this procedure.

with abdominal distention and vomiting. He had tolerated only milk and fluids since birth. The parents were children of first-degree relatives and had six living children. Two brothers of the case died immediately after birth and one sister died at an age of eight months, of unknown causes.On physical examination, epigastric distention was present, but no mass or organomegaly was palpated. Abdominal X-ray on admission showed a dilated stomach (Figure 1). An upper gastrointestinal contrast study demonstrated an axial rotation appearance of the stomach. The transition time of small intestine content was evaluated as normal.At laparotomy, the stomach was significantly dilated and the pylorus seemed to be completely erased at the junction. The wall thicknesses of the duodenum at the first and second parts were increased and similar to the thickness of the antral wall. The jejunoileal walls were thinner than normal and were empty at the distal end. Attempts were made to pass a nasogastric catheter to the jejunum, but the catheter could not go beyond the fourth part of the duodenum. Normal saline, given from the nasogastric catheter, could not pass freely to the distal end, and caused distention of the proximal duodenum. A longitudinal incision was made from the antimesenteric border at the transitional zone. A web, which caused an obstruction just before the Treitz ligament, was observed. In the centre of the web was a hole with a diameter of about 3-4 mm. The web was excised circumferentially. The vertical incision was closed. The nasogastric catheter was taken out on the seventh postoperative day. Abdominal X-rays at early and late postoperative days were normal. A contrast study in the fourth week after the operation revealed a normal duodenal appearance. Case 2A 5 mo-old girl presented to the same institution with abdominal distention and bilious vomiting, mostly seen after meals, for three months. At physical examination, she had mild epigastric distention. There was no mass or organomegaly in the abdomen on palpation. Hematologic parameters and biochemical laboratory findings were normal.An upper gastrointestinal contrast study pre-operatively showed a dilated stomach. The duodenum was dilated in the first and second parts, but the third part was narrow (Figure 2). Abdominal ultrasonography revealed a normal liver size with a hyperechogenic lesion of 30 mm × 25 mm × 20 mm in size, compatible with hemangioma at the caudate lobe.At laparotomy the duodenum was dilated and the wall CASE REPORT Two cases of duodenal obstruction due to a congenital web AbstractWe present two cases of windsock deformity; both were rare in location and one had a rare associated anomaly. In the first case, the windsock was observed in the fourth part of duodenum, causing partial intestinal obstruction. In the second case, the windsock was located in the third part of the duodenum.

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A sliding hernia is more common in female children under the age of 1 year and surgical treatment should be planned within a short period once the diagnosis is made. In addition, this recent statistical value for subjects aged 0 to 1 year and over 1 year can be used in new clinical studies.

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