Quality Assessment of YouTube Videos as an Information Source for Bowel Management in Children.

PURPOSE: This study aims to evaluate the quality and reliability of YouTube videos about bowel management in children. METHODS: On April 6th, 2023, the search results for "bowel management in children" on YouTube were rated independently by two authors. JAMA Benchmark Criteria (score 0-4) and a modified DISCERN tool (score 16-80) used for quality and reliability assessment. Data was analyzed by Chi-square test and one-way analysis of variance (ANOVA). RESULTS: Out of 48 videos included, 15 (31.2%) videos were intended for professionals and 33 (68.8%) for the public. The mean number of views was 144.806 and duration was 22 ± 28.4 min. The respective mean duration of videos for professionals 57.7 ± 21.4 min and median number of views was 404.5 (17-8.840) and those for public was 5.7 ± 10.7 min and 8400 (8-5.175.975) (both, p < 0.005). The respective mean DISCERN and JAMA scores of the videos for the public was 45.30 ± 13.18 and 2.93 ± 1.07, and for professionals 75.73 ± 6.52 and 3.8 ± 1.06 (both, p < 0.05). CONCLUSION: Although the reliability of the videos uploaded for the professionals about pediatric bowel management was higher than for public, duration of the videos was longer and the viewing rates were lower. Shorter but comprehensive and easy-to-understand guidance videos for the public may be of help. TYPE OF STUDY: Descriptive study. LEVEL OF EVIDENCE: IV.

Acute peritoneal dialysis in the newborn: A safe and feasible method.

INTRODUCTION: We aimed to evaluate the patient characteristics of neonates treated with peritoneal dialysis (PD) and review our experience with placement of PD catheters. METHODS: Records of neonates treated with PD between January 2019 and January 2022 were retrospectively analyzed. RESULTS: Swan neck curl PD catheters with double cuffs were used in 85 neonates as a bedside procedure with one cuff remaining within the abdomen. There were 44 (51.7%) males and 41 (48.3%) females. Their mean gestational age was 33.6 ± 4.9 (22-40) weeks and the mean birth weight was 2315,5 ± 1039 (500-4700) g. The primary diagnoses were asphyxia (n = 22, 25.9%), prematurity (n = 21, 24.7%), inborn errors of metabolism (n = 11, 12.9%), sepsis (n = 7, 8.2%), necrotizing enterocolitis (n = 5, 5.9%), dehydration (n = 5, 5.9%), hydrops fetalis (n = 5, 5.9%), congenital heart diseases (n = 5, 5.9%) and renal anomalies (n = 4, 4.7%). The mean duration of PD was 11.6 ± 13.7 days (range 1 to 75 days). Catheter-related complications occurred in 7 (8.2%) patients. These were drainage problems (n = 4), leakage (n = 1), incisional hernia (n = 1) and wound dehiscence (n = 1). Mortality because of underlying condition occurred in 57 (67.1%) patients. Mean pre-dialysis pH and sodium levels were statistically higher in surviving newborns than in those with a fatal outcome (7.19 vs 7.09 and 144.4 mmol/L vs 134.6 mmol/L, respectively) (p<0.05). CONCLUSIONS: PD is a safe, simple and effective therapy in neonates. The mortality rate in those treated with PD is high, especially due to serious underlying diseases. Lack of appropriate devices necessitates revisions in the catheters and techniques used for PD treatment. TYPE OF STUDY: Case series LEVEL OF EVIDENCE: IV.

Acute mesenteric ischemia in a newborn with COVID-19: A case report.

Introduction and importance: We aimed to report a case of acute mesenteric ischemia in a newborn with COVID-19. Case presentation: A 1-day-old male baby, with a birth weight of 2050 g, delivered by spontaneous vaginal delivery at 34 weeks of gestation from a 32-year-old COVID-19 infected mother in her third pregnancy, was taken to the newborn intensive care unit. On physical examination, the patient was alive and active. The abdomen was soft. Laboratory values of the patient were within the normal range. Echocardiography and abdominal ultrasonography were normal. COVID-19 PCR test drawn at 48 h of age was positive. On the postnatal 4th day, the patient suddenly had tachycardia and abdominal tension. Free air in the abdomen was detected on direct abdominal X-ray. The patient was taken to surgery urgently. On laparotomy, brownish ascites and necrotic small bowel and colon starting from 20 cm of ligamentum of Treitz to the middle part of the transverse colon were seen. Jejunostomy was constructed at area that 50 cm distal to Treitz with a relatively better appearance (with circulatory disorder but not full-thickness necrosis) and transverse colon mucous fistula without primary anastomosis. The patient died one day after surgery due to cardiorespiratory arrest and multiorgan failure. Conclusions: Although most of the reported symptoms of the COVID-19 are related to the respiratory system, there is concern that the occurrence of serious and life-threatening manifestations such as mesenteric ischemia in the gastrointestinal tract may be overlooked in also neonatal period.

Rare cecum pathologies as a cause of acute abdomen in children.

BACKGROUND: We aimed to present cecum pathologies which are the cause of acute abdomen. METHODS: Between January 2015 and June 2019, patients that were operated with the diagnosis of acute abdomen and patients with the primary cecum pathologies were evaluated retrospectively. RESULTS: There were eight patients, five males and three females. The mean age was 7.2±2.9 years. Complaints were abdominal pain and vomiting in all patients. Physical examination was consistent with acute abdomen. In the imaging studies, the preliminary diagnosis was considered as two patients had acute appendicitis, two had invagination (one due to Meckel diverticulum and one with mesenteric cyst), two had ileus, one had perforated appendicitis, and one had cecum diverticulum. In surgery, five patients had cecum mass, one had cecum diverticulitis, one had cecum volvulus, and one had inflamed necrotic cecum. All patients underwent cecum resection and ileocolonic anastomosis. Histopathologic examination was resulted as Burkitt's lymphoma in three patients, cecum diverticulum in two, duplication of cecum in one, tuberculosis of cecum in one, and gangrenous necrosis due to volvulus in one patient. The mean follow-up period was 25 months (2 months-4 years). Follow-up was uneventful. CONCLUSION: Primary cecum pathologies are very rare. This leads to lack of standardization in treatment planning. Considering the patients with malignancy in the series, ileocolonic anastomosis with cecum resection is an adequate and appropriate treatment option in children with primary cecum pathology.

Intrauterine midgut volvulus as a rare cause of intestinal obstruction: a case report.

BACKGROUND: Intrauterine midgut volvulus is a very rare, life-threatening condition, and prenatal diagnosis is difficult. In this article, we present a case of midgut volvulus followed by a pre-diagnosis of antenatal jejunal atresia. CASE PRESENTATION: A 1-day-old Turkish male baby, who was followed with a diagnosis of antenatal jejunal atresia, with a birth weight of 3600 g, delivered by cesarean section at 38 weeks of gestation from a 19-year-old mother in her fourth pregnancy, was taken to the newborn intensive care unit. The patient underwent surgery on the postnatal first day with a preliminary diagnosis of jejunal atresia. It was observed that the small intestine was rotated two full cycles from the mesenteric root. Bowel blood circulation was good. Volvulus was untwisted. There was malrotation. Ladd's procedure was performed. The baby was discharged on the seventh postoperative day with full oral feeding. The patient is still in the first postoperative year and follow-up has been uneventful. CONCLUSION: Intrauterine midgut volvulus has been associated with high mortality in the literature. Differential diagnosis of midgut volvulus in patients with antenatal intestinal obstruction, close prenatal follow-up, appropriate delivery and timing of surgical intervention may significantly reduce morbidity and mortality.

Laparoscopic repair of Morgagni hernia in children.

AIM: We aimed to present our laparoscopic treatment experience in Morgagni hernia repair. METHODS: The patients who underwent laparoscopic surgery with diagnosis of Morgagni hernia between 2016 and 2019 were evaluated retrospectively. RESULTS: Their mean age at diagnosis was 4,1 ± 2,6 years (1 year-13 years). All patients were male. The presenting complaints were respiratory tract infection in 3 patients and vomiting in 3. Two patients were diagnosed incidentally. Associated Down's Syndrome was detected in 3 (38%) cases. The defect was left-sided in 7 (87.5%) patients and bilateral in 1 (12,5%). Omentum was herniated in 2 patients, colon and omentum were in 6 and colon, omentum and stomach were in one. All patients underwent primary repair extracorporeally by removing sutures from single incision, without removal of the hernia sac. There were no complications or recurrence in the mean 19,2 ± 15,8 months (6-42 months) follow-up period. CONCLUSIONS: Minimal invasive repair of Morgagni hernia is efficient and safe. It should be the first choice because of fast recovery and better cosmetic results. In this series, it was seen that leaving the hernia sac had no effect on early and late complications. Leaving the hernia sac may prevent potential complications due to unnecessary dissection.

Definition of giant inguinoscrotal hernias in infants and evaluation of reliable surgical approach in a single-center study.

OBJECTIVE: Inguinal hernia surgery is the most common surgery performed by pediatric surgeons. Giant inguinoscrotal hernia has not been clearly defined yet. The definition of giant inguinoscrotal hernia and the reliability of the surgical procedure were investigated in this study. MATERIALS AND METHODS: Sixtyfour of totally 1548 male patients who have been operated with inguinal hernia from May 2015 to January 2018 were included in the study considering the diagnosis of giant inguinoscrotal hernia. The criteria for the diagnosis of giant inguinoscrotal hernia were determined as, observing that the hernia sac was filled with intestinal loops from the inguinal region to the scrotum during the physical examination, herniation of the intestines to the scrotum again as soon as the hernia was reduced and 2 cm and above inner ring diameter. High ligation and hernioplasty to 29 (45.3%) patients and hernioplasty using Zig maneuver to 35 (54.6%) patients were performed during the study. RESULTS: Postoperative wound infection was observed in 2 patients (6.8%) with high ligation and 1 (2.8%) patient with hernioplasty with Zig maneuver. Scrotal edema was detected in all the patients, which persisted until postoperative month 1. Recurrence was seen in 6 (20.6%) of 29 patients who operated using the high ligation method while it was seen in 2 (5.7%) of other 35 patients. None of the patients had testicular atrophy and/or iatrogenic undescended testis. CONCLUSION: Giant inguinoscrotal hernias should be defined and evaluated as a group apart from classical inguinoscrotal hernias. Recurrence and morbidity rates were lower in patients who underwent hernioplasty using Zig maneuver.

Juvenile Papillomatosis of the Breast in a Pre-Pubertal Girl: An Uncommon Diagnosis.

Juvenile papillomatosis of the breast represents a rare benign proliferative disorder that affects women younger than thirty years of age. Although it is a localized lesion, it does not have well-demarcated margins. These patients tend to have a strong family history for cancer. As it has similar clinical presentation with that of a fibroadenoma, it usually receives the diagnosis of the latter in the preoperative period. Nonetheless, it has distinct microscopic features such as ductal papillomatosis and cysts that are helpful in the diagnosis. In this article, a case of juvenile papillomatosis diagnosed in a young girl who presented due to a mass of the breast was presented. For the fairly rare case, a total mass excision was performed with preserved breast tissue. The exact diagnosis was made by postoperative histopathological examination.