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1.
Pediatr Surg Int ; 37(6): 807-813, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33856512

RESUMEN

BACKGROUND: The aim of this study was to present our experience in the use of crystallized phenol (CP) to treat pediatric patients with 'simple' and complex' Pilonidal sinus disease (PSD). MATERIALS AND METHODS: Patients who underwent CP treatment in between January 2015 and January 2020 were evaluated retrospectively, using prospectively collected data. The patients were divided into simple and complicated groups. The groups were assigned depending on the number of sinuses and clinical presentation. The groups were compared in terms of age, sex, number of sessions, cost analysis, body mass index (BMI), recurrence, time resolution, cosmetic results, results /improvement, and complications. RESULTS: This study included 54 patients: 28 (52%) girls and 26 (48%) boys. The mean number of sinuses was 2.4. Symptoms included discharge in 50 (92%) patients, and pain in 42 (78%) patients. Fifty (93%) patients experienced mild pain during the procedure, whereas four (7%) patients had moderate pain. The mean number of CP sessions was 2.9; mean numbers of CP sessions were 2.2 and 4.2 in the Simple and Complicated groups. In total, 5 of 54 patients (9%) had recurrence.At the end of treatment, therapeutic success was achieved in 49 of 54 (91%) patients: 31 of 33 (94%) patients in the Simple group and 18 of 21 patients (86%) in the complicated group. The mean treatment cost for the whole cohort was $17.40. One patient (2%) presented with moderate skin burns. Cosmesis was deemed acceptable by patients, although there was evidence of minor skin burns following the procedure. CONCLUSIONS: The findings showed that the CP procedure was advantageous for treatment of PSD, because it was minimally invasive, cost-effective, provided good cosmesis, and had a high success rate and low complication rate. Furthermore, it did not require prior examination, and could be performed under local anesthesia. Therefore, the CP procedure may be useful as a first-line treatment option in children with PSD.


Asunto(s)
Fenol/uso terapéutico , Seno Pilonidal/tratamiento farmacológico , Adolescente , Niño , Estudios de Cohortes , Femenino , Humanos , Masculino , Recurrencia , Estudios Retrospectivos , Soluciones Esclerosantes/uso terapéutico , Resultado del Tratamiento
2.
Pediatr Surg Int ; 32(11): 1067-1073, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27666540

RESUMEN

AIM: The objective of the present study was to evaluate the diagnostic methods, concomitant organ injuries, factors affecting mortality and morbidity, treatment methods, and outcomes of patients treated for traumatic gastrointestinal (GI) perforation. MATERIALS AND METHODS: We conducted a retrospective review of the medical records of 96 patients who had been treated for GI perforation between January 2000 and October 2015. Data were collected and organised according to the following categories: general patient information, age, gender, hospitalisation period, trauma mechanisms, concomitant injuries, radiological assessment, diagnosis and treatment methods, treatment forms, and complications. The cases were divided into two groups, blunt and penetrating traumas, and the patients within each group were compared. Colorectal trauma cases were not included in this study. Patients suspected of a GI perforation were assessed by standing plain abdominal radiograph (SPAR) and ultrasound scan (US). Patients who had a normal SPAR, and showed free or viscous fluid in the abdomen on US underwent computed tomography (CT) scanning. Surgery was performed if patients displayed free air in the abdomen on a SPAR or CT scan, showed viscous fluid without any additional injury, provided normal radiological images but displayed signs of peritonitis, or were clinically unstable. The patients were scored according to the Injury Severity Score (ISS) system. RESULTS: In total, 96 patients, with an average age of 10.3 ± 4 years (1-17 years) and diagnosed with a GI perforation, were reviewed retrospectively. The patients included 88 (91 %) males and 8 (9 %) females. The presence of free air on SPAR was detected in 42 (52 %) patients, whereas no free air was detected in 39 (48 %) patients. Non-specific significant findings were detected in 45 (76 %) out of 59 patients by USS, and in 78 % of patients by CT (viscous fluid, fluid, free air). The most affected organ was the ileum, which was detected in 37 (39 %) patients. Primary repair was performed on 71 (74 %) patients, while resection was performed on 22 (23 %); 3 (3 %) patients underwent an ostomy. Ten (10 %) patients experienced complications and five (5 %) patients died. The ISS scores for blunt and penetrating traumas were 14, 15 and no significant difference was detected between the scores (p > 0.05). CONCLUSIONS: Although the complication rate for patients with penetrating trauma was higher than for those with blunt trauma, the rate of mortality increased in patients with blunt trauma. Free air may not be detected by SPAR even if a GI perforation exists. Since diagnostic challenges may increase the rate of mortality and morbidity in GI perforations, we believe that a combination of radiological imaging and rapid abdominal examination is important in cases where SPAR cannot detect free air.


Asunto(s)
Traumatismos Abdominales/cirugía , Perforación Intestinal/cirugía , Heridas no Penetrantes/cirugía , Heridas Penetrantes/cirugía , Traumatismos Abdominales/diagnóstico por imagen , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Perforación Intestinal/diagnóstico por imagen , Masculino , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Ultrasonografía , Heridas no Penetrantes/complicaciones , Heridas no Penetrantes/diagnóstico por imagen , Heridas Penetrantes/diagnóstico por imagen
3.
Pediatr Surg Int ; 32(1): 97-9, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26527581

RESUMEN

Infantile fibrosarcoma is a very rare soft tissue tumor that originates most commonly in the body and extremities. We present a neonate with an infantile fibrosarcoma that originated in the ileocecal region and was detected incidentally without symptoms. This is the first case of fibrosarcoma reported in the ileocecal region.


Asunto(s)
Neoplasias del Ciego/diagnóstico , Neoplasias del Ciego/cirugía , Fibrosarcoma/diagnóstico , Fibrosarcoma/cirugía , Neoplasias del Íleon/diagnóstico , Neoplasias del Íleon/cirugía , Neoplasias del Ciego/congénito , Ciego/diagnóstico por imagen , Ciego/patología , Ciego/cirugía , Diagnóstico Diferencial , Fibrosarcoma/congénito , Humanos , Neoplasias del Íleon/congénito , Íleon/diagnóstico por imagen , Íleon/patología , Íleon/cirugía , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Ultrasonografía
4.
Pediatr Surg Int ; 32(6): 559-63, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26857478

RESUMEN

BACKGROUND: There are insufficient data on pre-screening for pancreatic pseudocysts (PC) following pancreatic trauma. This study investigated the use of radiological and laboratory testing for predicting the development of pancreatic pseudocysts after trauma. MATERIALS AND METHODS: The clinical records of all pediatric patients presenting with pancreatic trauma between January 2003 and December 2014 were reviewed retrospectively. Patients with American Association for the Surgery of Trauma (AAST) scores of Grade 3-5 were enrolled. The patients were divided into groups that developed [Group 1 (n = 20)] and did not develop [Group 2 (n = 18)] PC. The patients were evaluated in terms of their baseline characteristics, additional injuries, Injury Severity Score (ISS), pancreatic injury site, blood amylase levels 2 h and 10-15 days after the trauma, clinical presentation, and duration of intensive care unit (ICU) stay. FINDINGS: We followed 38 patients. Of the patients in Group 1, 70 % had an injury to the tail of the pancreas. The ISS trauma scores and durations of hospitalization and ICU stay were significantly greater in Group 2 (p < 0.05). The mean blood amylase level on Day 1 was 607 U/L (range 183-801 U/L) in Group 1 and 314 U/L (range 25-631 U/L) in Group 2; the respective levels on Day 10 were 838 U/L (range 123-2951 U/L) and 83.2 U/L (range 35-164 U/L). The serum amylase levels were significantly higher (p < 0.001) in Group 1 than in Group 2 on Days 1 and 10. Four patients developed complications and two patients died. CONCLUSION: Pancreatic pseudocyst formation is more likely in patients with AAST Grade 3 pancreatic injury, also serum amylase levels ten times greater than normal 2 h after the trauma, and persistently elevated serum amylase levels 10-15 days following the trauma.


Asunto(s)
Traumatismos Abdominales/complicaciones , Seudoquiste Pancreático/etiología , Heridas no Penetrantes/complicaciones , Traumatismos Abdominales/diagnóstico , Adolescente , Niño , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Páncreas/cirugía , Seudoquiste Pancreático/diagnóstico , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Heridas no Penetrantes/diagnóstico
5.
J Invest Surg ; 34(4): 408-416, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31288583

RESUMEN

INTRODUCTION: We investigated the therapeutic effects of carvacrol in an experimental esophageal burn rat model with immunohistochemical techniques. Materials and Methods: Three groups were included in this study, composed of eight Wistar albino rats each. The control group was given 1 mL 0.9% (wt/vol) NaCl; esophageal burns were induced in groups 2 and 3 by administration of 1 mL 40% NaOH in the distal 2 cm of the esophagus. The treatment group was administered 75 mg/kg carvacrol in 2 mL 0.9% NaCl for 10 days. After a routine histological examination of the tissues, sections were stained with vascular endothelial growth factor (VEGF) and caspase-3 for immunohistochemical analysis and were examined under a light microscope. Results: In the control group, there were regular cells in the cornified epithelial tissue and cylindrical cells in the basal layer, which faced toward the apical surface in the mitotic phase. The burn group displayed wide degeneration, necrosis, and abundant apoptotic cells in the epithelial tissue as well as intense inflammatory cell infiltration. In the treatment group, there was an increase in mitotic activity in the basal cells of the epithelial layer and degenerative changes, but a preserved epithelial layer and significant cornified structures. The treatment group showed positive caspase-3 expression in some apoptotic cells within the epithelial layer and in connective tissue, and there were only a small number of degenerated cells in the muscle layer. Additionally, in the treatment group, VEGF expression was evident in small numbers of inflammatory cells in the papillary region of the epithelium, and in dilated vascular endothelial cells. Conclusions: Carvacrol may contribute to a reduction in fibrosis by decreasing inflammation and preventing cell apoptosis.


Asunto(s)
Células Endoteliales , Factor A de Crecimiento Endotelial Vascular , Animales , Caspasa 3 , Cimenos , Ratas , Ratas Wistar
6.
Ulus Travma Acil Cerrahi Derg ; 26(6): 927-931, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33107956

RESUMEN

BACKGROUND: In this study, we aimed to present the results of patients treated for esophageal leakage with a different conservative approach. METHODS: Ninety-eight patients with esophageal atresia and tracheoesophageal fistula (EA) who underwent surgery in our clinic between February 2013 and January 2018 were retrospectively reviewed in this study. Patients' anastomosis leakage, gestational week, gender, body weight, referral date, recovery time and stenosis were recorded. After leakage detection, the nasogastric catheter was fluoroscopically converted into a nasojejunal catheter using a guidewire and feeding continued. RESULTS: Anastomotic leakage developed in 18 (18.3%) patients. The average gestational age at birth was 35.4 weeks; the patients included ten girls and eight boys of average weight 2.41 kg; the average referral period was 2.1 days after birth and the average time of surgery was 2.4 days after birth. The average recovery time was 21.1 days (range: 8-60 days). Eight patients developed stenosis that recovered with dilatation. CONCLUSION: Our findings suggest that our conservative treatment approach, which uses a nasojejunal catheter, is an effective method that would reduce complications, enable earlier feeding, and reduce the cost compared to other treatment approaches.


Asunto(s)
Anastomosis Quirúrgica/efectos adversos , Fuga Anastomótica/cirugía , Atresia Esofágica/cirugía , Fístula Traqueoesofágica/cirugía , Femenino , Humanos , Recién Nacido , Masculino , Estudios Retrospectivos
7.
J Invest Surg ; 31(1): 1-8, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28402715

RESUMEN

OBJECTIVE: To investigate the role of cordycepin in testicular ischemia/reperfusion injury in rats. MATERIALS AND METHODS: Forty Wistar albino rats were randomly divided into four groups, as follows: group one, control (C); group two, torsion and ischemia (I); group three: detorsion with ischemia-reperfusion (IR); and group four, detorsion/cordycepin. The rats were then analyzed macromorphologically and histopathologically, and blood tests were performed. Specifically, the total oxidant status (TOS) and total antioxidant status (TAS) were determined, and malondialdehyde (MDA), tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1ß levels were analyzed. In addition, pyknotic nuclei, spermatozoa, edema, and hemorrhage were assessed. RESULTS: When the IR and cordycepin groups were compared with the other groups, there was a statistically significant decrease in TNF-α and MDA levels (p < 0.05). Increased TAS levels were observed in the cordycepin group compared with the control group. TOS levels were significantly increased in the I and IR groups, but decreased in the cordycepin group (p < 0.05). Similar effects were observed in tissue biochemistry analysis. Histopathological evaluations revealed that the spermatozoa count was decreased in the I and IR groups. However, there was an increase in the cordycepin group, as well as a statistically significant difference between the IR and cordycepin groups (p < 0.01). Finally, edema and inflammation were increased in the I and IR groups, but decreased in the cordycepin group. CONCLUSIONS: Histological and biochemical findings revealed that cordycepin protected against IR-induced testicular injury.


Asunto(s)
Desoxiadenosinas/farmacología , Estrés Oxidativo/efectos de los fármacos , Sustancias Protectoras/farmacología , Daño por Reperfusión/tratamiento farmacológico , Testículo/efectos de los fármacos , Animales , Antioxidantes/farmacología , Antioxidantes/uso terapéutico , Desoxiadenosinas/uso terapéutico , Modelos Animales de Enfermedad , Humanos , Interleucina-1beta/sangre , Interleucina-6/sangre , Masculino , Malondialdehído/sangre , Sustancias Protectoras/uso terapéutico , Ratas , Ratas Wistar , Daño por Reperfusión/sangre , Daño por Reperfusión/etiología , Daño por Reperfusión/patología , Recuento de Espermatozoides , Espermatozoides/efectos de los fármacos , Testículo/irrigación sanguínea , Testículo/patología , Factor de Necrosis Tumoral alfa/sangre
8.
Ulus Travma Acil Cerrahi Derg ; 24(1): 61-65, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29350370

RESUMEN

BACKGROUND: Non-operative management (NOM) is a standard treatment method for solid organ injuries worldwide. There is no consensus on the management of gunshot wounds (GSW) because of the higher frequency of hollow viscus injuries (HVI) and the unpredictable depth of tissue damage produced by kinetic energy transfer during retardation of the bullet. Here we aimed to reevaluate indications for surgery and NOM based on our pediatric patients with abdominal GSW. METHODS: We performed a retrospective analysis of patients evaluated and treated for abdominal GSW at University of Dicle between January 2010 and October 2016. Patients with hemodynamic instability, signs of peritonitis on serial abdominal examination, and free air in the abdomen underwent laparotomy; these were included in group I (n=17). Patients managed non-operatively were included in group II (n=13). RESULTS: Our statistical analysis showed significantly lower Hb levels and systolic blood pressure levels (p<0.001) and higher pulse rate, higher mean injury severity score, and longer length of stay at intensive care unit in patients in group I than in those in group II (p<0.001). We further detected colon perforation (n=10) and small bowel perforation (n=7) in patients in group I; liver laceration (n=4), splenic injury (n=1), and renal injury (n=3) but no solid organ injury or HVI (n=5) were detected in patients in group II. CONCLUSION: The major drawback of NOM is the difficulty in diagnosing HVI in abdominal GSW, which may delay treatment. We suggest that patients with solid organ damage who are hemodynamically stable and exhibit no signs of peritonitis upon serial abdominal exam may be treated with NOM.


Asunto(s)
Traumatismos Abdominales/cirugía , Niño Hospitalizado , Tiempo de Internación , Heridas por Arma de Fuego/cirugía , Traumatismos Abdominales/mortalidad , Adolescente , Niño , Preescolar , Femenino , Humanos , Puntaje de Gravedad del Traumatismo , Riñón/lesiones , Laparotomía , Hígado/lesiones , Masculino , Estudios Retrospectivos , Bazo/lesiones , Turquía , Heridas por Arma de Fuego/mortalidad
9.
Ulus Travma Acil Cerrahi Derg ; 23(4): 273-278, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28762461

RESUMEN

BACKGROUND: The aim of the present study was to investigate whether cordycepin prevented adhesion formation in a rat model. METHODS: Rats were randomly assigned to 3 groups of 10 rats. CONTROL GROUP: The absence of adhesion was confirmed via laparotomy. Adhesion group: The cecum was removed from the abdomen and scraped with a dry gauze bandage until petechial hemorrhagic foci developed. Cordycepin group: The same surgical procedure was performed as in the adhesion group, and 10 mg/kg cordycepin was administered intraperitoneally. After 15 days, the rats were sacrificed humanely via cardiac blood withdrawal under anesthesia. The rats were then analyzed morphologically and histopathologically, and hydroxyproline (OH-p) and malondialdehyde (MDA) levels were measured. RESULTS: Macroscopic analysis revealed significantly less adhesion in the cordycepin group than in the adhesion group (p<0.01). Furthermore, significant histopathological improvement was also evident in the cordycepin group compared to the adhesion group (p<0.05). The levels of OH-p and MDA in blood and tissue were higher in the adhesion group than in the control group, and lower in the cordycepin group than the adhesion group. Interestingly, MDA level was significantly lower (blood: p<0.05; tissue: p<0.01) in the cordycepin group than in the adhesion group, whereas only tissue OH-p was significantly lower in the cordycepin group compared with the adhesion group (p<0.05). One rat in both adhesion group and cordycepin group died postoperatively. CONCLUSION: Results indicated that cordycepin effectively reduced adhesion in a rat abrasion model. Thus, this agent may be valuable to prevent postoperative adhesion.


Asunto(s)
Cavidad Abdominal/cirugía , Desoxiadenosinas , Adherencias Tisulares , Animales , Desoxiadenosinas/efectos adversos , Desoxiadenosinas/uso terapéutico , Distribución Aleatoria , Ratas , Adherencias Tisulares/tratamiento farmacológico , Adherencias Tisulares/prevención & control
10.
Urol J ; 13(1): 2502-8, 2016 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-26945654

RESUMEN

PURPOSE: Using percutaneous nephrolithotomy (PNL), it is easy to reach stones in various parts of the kidney via a single access tract. In the current study, we set out to demonstrate that the intravenous catheter is a safe way to gain renal access, and that PNL is safe in children. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who underwent PNL as a treatment for renal stone disease at our center between September 2013 and December 2014. There were no specific exclusion criteria. We used 14 gauge intravenous catheter for renal access in all cases. RESULTS: Eleven of the 32 patients (34.4%) were female and 21 (65.6%) were male. The mean ± SD patient age was 4.7 ± 3.71 years (9 months-16 years). Six patients (18.7%) were infants less than 1 year of age. Fifteen of the stones (46.8%) were located in the right kidney, and 17 of the stones (53.1%) were located in the left kidney. The average stone size was 13.9 ± 4.8 mm (range, 12-28). The average duration of operation was 69.7 ± 10.4 minutes (range, 50-110), and the average duration of fluoroscopy was 2.21 ± 1.06 minutes (range, 1-6). There were complications in 5 of the cases (15.6%). CONCLUSION: The access and dilatation stages are quite important. We propose that the intravenous catheter is a safe and inexpensive tool for renal access in PNL in pediatric age group patients.


Asunto(s)
Catéteres , Cálculos Renales/terapia , Riñón/diagnóstico por imagen , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Nefrostomía Percutánea/instrumentación , Niño , Preescolar , Diseño de Equipo , Femenino , Fluoroscopía , Humanos , Lactante , Cálculos Renales/diagnóstico , Masculino , Proyectos Piloto , Estudios Retrospectivos , Resultado del Tratamiento
11.
Urol J ; 13(6): 2916-2919, 2016 12 08.
Artículo en Inglés | MEDLINE | ID: mdl-27928814

RESUMEN

PURPOSE: Adrenal gland injury (AGI) caused by trauma may cause bleeding and life-threatening problems in children.The objective of this study was to analyze the prevalence of AGI in final diagnoses of trauma. MATERIALS AND METHODS: The records of 458 patients with abdominal trauma (out of a total 8,200 pediatric patientswith trauma of any sort), who were referred to our clinic between January 2009 and July 2014, were reviewed retrospectively.The numbers of patients with AGI and their ages, gender, trauma patterns, affected organs, pediatrictrauma scores (PTSs), and injury severity scores (ISSs) were recorded, as well as the associated ultrasound (US)and tomographic scan data, treatments, and complications. Computed tomography (CT) scans obtained after traumawere subjected to both primary and secondary evaluation. RESULTS: In total, 28 patients with AGI were detected; their average age was 8.54 ± 4.09 (3-17) years. Twenty(71%) patients were male and 8 (29%) were female. Nineteen (68%) patients had fallen from heights; the mostcommonly injured organs were the kidneys, spleen, and lungs. Injuries were right-sided in 26 (92.9%) patients.The mean ISS was 13.2 (range 5-50) and the mean PTS 8.6 (range 0-11). Seven patients had ISS > 16 and ninehad PTS < 8. AGI was diagnosed by CT in 14 (50%) patients and in 3 (9%) by US at primary evaluation. Uponsecondary scan inspection focusing on the possibility of adrenal gland injury, such injury was ultimately detectedin 28 patients. All patients underwent conservative follow-up, and one died. CONCLUSION: We recommend calculation of the PTS, as well as other trauma scores, when pediatric patients sufferingmultiple or blunt abdominal trauma(s) present to the emergency . In addition, we believe that in children withtrauma involving the liver, spleen or kidneys, careful evaluation using a CT scan would increase the diagnosis ofAGI and reveal a realistic rate of AGI in trauma cases.


Asunto(s)
Glándulas Suprarrenales/diagnóstico por imagen , Glándulas Suprarrenales/lesiones , Tomografía Computarizada por Rayos X , Ultrasonografía , Heridas no Penetrantes/diagnóstico por imagen , Heridas no Penetrantes/epidemiología , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Prevalencia , Estudios Retrospectivos
12.
J Invest Surg ; 29(6): 399-404, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27191817

RESUMEN

OBJECTIVE: Ecballium elaterium (EE) is a plant from Cucurbitaceae family. Its anti-inflammatory role in sepsis is not well understood. We investigated the effects of EE on serum levels of proinflammatory cytokines and further explored the mechanisms underlying histological changes in liver and ileum following EE administration in a polymicrobial sepsis model. METHODS: Thirty rats were divided into three groups of 10 rats each. Rats were subjected to sham laparotomy plus normal saline administration (control group, CG), laparotomy with cecal ligation and puncture (CLP) (sepsis group, SG), and laparotomy with CLP plus 2.5 mg/kg EE administration (experimental group, EG). Twenty-four hours after laparotomy, animals underwent cardiac puncture, and blood was collected for interleukin 1 (IL-1), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) assessment. Whole sections of liver and ileum tissues were collected for histologic examination. RESULTS: The serum level of IL-6 was significantly lower in EG as compared to SG. Although IL-6 levels were shown a statistically significant (p < 0.0001) decline to near control values, no significant changes were observed in serum levels of IL-1 and TNF-α after EE treatment. Histologic examination revealed statistically significant reduction in collagen formation (p = 0.001) on serosal surface of ileum and hepatic venous congestion (p = 0.040) in EG as compared to SG. CONCLUSION: EE might play a protective role in sepsis prevention and treatment by decreasing IL-6 production and reducing liver damage and may influence bacterial translocation by reinforcing intestinal barrier function.


Asunto(s)
Cucurbitaceae , Citocinas/sangre , Íleon/efectos de los fármacos , Hígado/efectos de los fármacos , Sepsis/tratamiento farmacológico , Animales , Evaluación Preclínica de Medicamentos , Íleon/patología , Hígado/patología , Masculino , Fitoterapia , Extractos Vegetales/farmacología , Extractos Vegetales/uso terapéutico , Ratas Wistar , Sepsis/sangre , Sepsis/patología
13.
Afr J Paediatr Surg ; 12(4): 273-9, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26712295

RESUMEN

BACKGROUND: Isolated oesophageal atresia without tracheo-oesophageal fistula represents a major challenge for most paediatric surgeons. Here, we present our experience with six neonates with isolated oesophageal atresia who successfully underwent immediate primary anastomosis using multiple Livaditis circular myotomy. MATERIALS AND METHODS: All six neonates were gross type A isolated oesophageal atresia (6%), from among 102 neonates with oesophageal atresia, treated between January 2009 and December 2013. Five neonates were female; one was male. The mean birth weight was 2300 (range 1700-3100) g. RESULTS: All six neonates successfully underwent immediate primary anastomosis using multiple myotomies (mean 3; range 2-4) within 10 (median 3) days after birth. The gap under traction ranged from 6 to 7 cm. One neonate died of a major cardiac anomaly. Another neonate was lost to follow-up after being well for 3 months. Three anastomotic strictures were treated with balloon dilatation, and four anastomotic leaks were treated conservatively. The mean duration of follow-up was 33 months. CONCLUSIONS: To treat isolated oesophageal atresia, an immediate primary anastomosis can be achieved using multiple myotomies. Although, this approach is associated with high complication rates, as are other similar approaches, these complications can be overcome.


Asunto(s)
Atresia Esofágica/cirugía , Esófago/cirugía , Anastomosis Quirúrgica/métodos , Procedimientos Quirúrgicos del Sistema Digestivo , Atresia Esofágica/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Recién Nacido , Masculino , Estudios Retrospectivos , Factores de Tiempo , Fístula Traqueoesofágica , Resultado del Tratamiento
14.
Turk J Pediatr ; 57(4): 409-412, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-27186708

RESUMEN

Xanthogranulomatous pyelonephritis (XGPN) is a very rare, unusual variant of pyelonephritis characterized by destruction of renal parenchyma. It usually occurs in adults with a history of recurrent urinary tract infections. The condition is rare in children and the disease can imitate renal tumors. Here, we describe a 12-year-old boy who presented with abdominal pain. He did not have any history of urinary tract infection. Computed tomography and magnetic resonance imaging showed a cystic lesion in the left upper kidney. The patient underwent radical nephrectomy with a provisional diagnosis of Wilms tumor however histopathological examination of specimen revealed XGPN. Xanthogranulomatous pyelonephritis should be kept in mind in the differential diagnosis of renal lesions in childhood, during surgery if any suspicion from the diagnosis, a frozen biopsy should have been taken.


Asunto(s)
Neoplasias Renales/diagnóstico , Riñón/patología , Pielonefritis Xantogranulomatosa/diagnóstico , Tumor de Wilms/diagnóstico , Niño , Diagnóstico Diferencial , Humanos , Neoplasias Renales/cirugía , Imagen por Resonancia Magnética , Masculino , Nefrectomía/métodos , Tomografía Computarizada por Rayos X
15.
Acta Clin Croat ; 54(1): 96-8, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26058250

RESUMEN

Foreign body ingestion is a common problem in children, but magnet ingestion is relatively rare. However, when it occurs, it tends to have a high rate of complications. This is a case report of a 3-year-old child who swallowed multiple magnetic toys, subsequently developing jejunoileal perforation and volvulus. This case report indicates that it is best to surgically remove multiple ingested magnets without delay to avoid intestinal perforation, fistula, and other complications such as volvulus.


Asunto(s)
Cuerpos Extraños/complicaciones , Íleon , Perforación Intestinal/etiología , Vólvulo Intestinal/etiología , Yeyuno , Imanes/efectos adversos , Preescolar , Cuerpos Extraños/diagnóstico , Cuerpos Extraños/cirugía , Humanos , Perforación Intestinal/diagnóstico , Perforación Intestinal/cirugía , Vólvulo Intestinal/diagnóstico , Vólvulo Intestinal/cirugía , Masculino
16.
Case Rep Gastrointest Med ; 2015: 362478, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26294983

RESUMEN

Cases of neonatal gastrointestinal system (GIS) obstruction are quite complex for pediatric surgery clinics. A rare cause of intestinal obstruction is the duplication cyst (DC). A three-day-old male patient presented at our clinic with a history of abdominal distension and bilious vomiting on the second day following birth. Although pathology had not yet been determined from observation and examination, surgery was performed when the patient could not tolerate oral feeding. An ileal DC forming an incomplete obstruction was observed. Ileoileal anastomosis was performed on the patient. Because DCs can present with different clinical symptoms, it is quite difficult to diagnose them in neonate patients. Lacking an imaging method that can provide an exact diagnosis, the diagnostic laparotomy is a suitable approach for both diagnosis and treatment to avoid delays in treatment.

17.
Int J Surg ; 23(Pt A): 160-4, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26472695

RESUMEN

BACKGROUND: We originally aimed to determine the beneficial effects of Ecballium Elaterium (EE) on acute pancreatitis; however, we observed negative effects of EE on the pancreas. Thus, we used EE in rats to generate a new model of pancreatitis, which we compared with other established pancreatitis models. METHODS: A total of 32 Wistar albino rats were used. Rats were divided into 4 groups, each of which contained 8 rats. Group 1 (Control), Group 2 (L-Arginine (LA), Group 3 (LA + EE), Group 4 (EE): Twenty-four hours after that serum parameters were analyzed in the collected blood. Blood samples were transported on mice to the Biochemistry Laboratory following cardiac puncture. The levels of amylase, interleukin (IL)-6, interleukin (IL) 1-ß (IL-1ß), malondialdhyde (MDA), tumor necrosis factor (TNF)-α, total antioxidant status (TAS), and total oxidant status (TOS) were analyzed. Histopathological analysis: The pancreas and lung tissue samples obtained from the rats. Edema, inflammation, vacuolization, and necrosis of the pancreas were assessed using a scoring system ranging from 0 to 4. Edema, hemorrhage and inflammation of the lung tissue were evaluated using a scoring system ranging from 0 to 3. RESULTS: Histopathological analysis revealed that edema, inflammation, necrosis, and hemorrhage were significantly higher in the LA + EE group than in the control group. Moreover, necrosis was higher in the rats that received LA and EE compared to the rats that received only LA or EE. Increases in inflammatory mediator levels, including IL-6, IL-1ß, TNF-α, MDA, and TOS, were observed in all groups as compared to the control group. Moreover, lower TAS levels were detected in all groups but the control group. The increase in IL-1ß and TNF-α levels and the decrease in TAS were statistically significant in all groups (P < 0.05). CONCLUSIONS: EE may be used to create a successful acute pancreatitis (AP) model, resulting in edema, necrosis, hemorrhage, and inflammation of the pancreas. The major advantage of this model is that it does not require laparotomy, and can be implemented with only an intraperitoneal injection (IP). Moreover, EE may be combined with other agents, such as LA, to create severe pancreatitis. Further molecular studies are warranted to determine the underlying effects of EE on the pancreas.


Asunto(s)
Arginina , Cucurbitaceae , Modelos Animales de Enfermedad , Pancreatitis/etiología , Enfermedad Aguda , Amilasas/metabolismo , Animales , Antioxidantes/metabolismo , Edema/etiología , Hemorragia/etiología , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , Pulmón/patología , Masculino , Malondialdehído/metabolismo , Ratones , Necrosis/etiología , Necrosis/patología , Páncreas/patología , Pancreatitis/metabolismo , Pancreatitis/patología , Ratas , Ratas Wistar , Factor de Necrosis Tumoral alfa/metabolismo
18.
Int J Clin Exp Med ; 7(9): 2677-86, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25356125

RESUMEN

Intestinal obstruction (IO) is an important risk factor for the development of bacteria translocation (BT), a serious condition associated with sepsis and potential mortality. Ankaferd is an herbal extract that is reported to exert anti-hemorrhagic, anti-oxidant, anti-microbial, and anti-inflammatory, effects in the intestine. In this study, we employed an animal model of intestinal obstruction to evaluate the effects of Ankaferd in the prevention of bacterial translocation and the suppression of the inflammatory response. Thirty male Wistar Albino rats were allocated randomly to three groups: Group 1 (sham) underwent ileal manipulation alone; Group 2 (intestinal obstruction, IO) underwent complete ileal ligation; Group 3 (intestinal obstruction + Ankaferd blood stopper, ABS) underwent complete ileal ligation and intraperitoneal Ankaferd injection. All rats were euthanized after 24 hours. Blood samples were collected for the measurement of serum oxidative stress parameters and cytokine expression. In addition, liver, mesenteric lymph node (MLN), spleen, and ileal specimens were obtained for microbiological culture to determine the rate of bacterial translocation. Liver and ileal tissues were collected for histopathological examination. A reduction in oxidative damage, inflammatory cytokine expression and bacterial translocation was observed in the ABS treatment group relative to the IO group (p<0.05). Furthermore, histopathological examination demonstrated a reduction in obstruction-induced mucosal injury in Ankaferd-treated rats. Data derived from this study provided the first evidence that Ankaferd treatment limits bacterial translocation and enhances intestinal barrier function in mice undergoing intestinal obstruction. Ankaferd may be useful in the prevention of BT associated with IO.

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