RESUMO
OBJECTIVES: The relationship hydatid cyst (HC) is a parasitic disease that is endemic worldwide. AIMS: To study the clinical findings and laboratory results of patients with hydatid disease. MATERIALS AND METHODS: Total number of patients (n = 78) who underwent surgery for HC disease from 2000 to 2017 were retrospectively evaluated. The patients' demographic characteristics, reasons for admission into hospital, lesion location and size, laboratory results, and complications were recorded. RESULTS: Of the HCs, 59% and 26.9% were located in the liver and lungs, respectively. The rate of multiple organ involvement was 10.3%. A total of 16 (20.5%) cases had ruptured HCs (7 livers, 7 lungs, 1 spleen, and 1 omentum). There was no significant difference in the rate of eosinophilia between patients with and without cyst rupture (P = 0.9). Indirect hemagglutination (IHA) tests yielded negative results in 38.9% of the patients; among them, 32.1% had ruptured HCs. A negative IHA test result was significantly associated with rupture (P = 0.046). No significant difference between rupture and cyst size or location was found. CONCLUSIONS: HC rupture was not correlated with cyst size. The sensitivity of serological tests and the blood eosinophil count was low, even in cases of ruptured HCs. The recurrence rate can be reduced by open surgery and medical treatments.
Assuntos
Cistos/cirurgia , Equinococose Pulmonar/cirurgia , Equinococose/diagnóstico , Esplenopatias/cirurgia , Criança , Cistos/complicações , Equinococose/cirurgia , Equinococose Pulmonar/diagnóstico , Feminino , Testes de Hemaglutinação , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Omento/diagnóstico por imagem , Omento/patologia , Recidiva , Estudos Retrospectivos , Ruptura , Ruptura Espontânea/complicações , Baço/diagnóstico por imagem , Baço/patologia , Esplenopatias/diagnóstico , Ruptura Esplênica/etiologiaRESUMO
CONTEXT: Snodgrass method (tubularized incised plate urethroplasty [TIPU]) is a widely used technique for hypospadias repair. AIM: It was aimed to compare the outcome of hypospadias repair with stenting using feeding tube compare with those with Foley catheter. SUBJECTS AND METHODS: The demographic characteristics of the 123 patients who underwent hypospadias repair with Snodgrass method, the success of the applied method, and the factors affecting fistula complication were evaluated retrospectively. Patients were divided into two groups: those operated before January 2010 (Group A) and those who were operated after (Group B). In Group A patients, urethroplasty was performed using silicone Foley catheters, in which balloon of these catheters was filled by saline at appropriate size. In Group B, urethroplasty was performed using feeding catheter. RESULTS: Group A and Group B consisted of 32 and 91 patients, respectively. Fistula developed in 10 (31.3%) and 4 (4.39%) patients in Group A and Group B, respectively. There was a statistically significant difference between the two groups in terms of the development of fistula complication (P = 0.0002). CONCLUSION: The use of a feeding catheter in TIPU could be a more advantageous than using a Foley catheter.
Assuntos
Catéteres , Fístula/etiologia , Hipospadia/cirurgia , Pênis/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Stents , Retalhos Cirúrgicos , Procedimentos Cirúrgicos Urológicos Masculinos/instrumentação , Adolescente , Criança , Pré-Escolar , Fístula/cirurgia , Humanos , Lactente , Masculino , Procedimentos de Cirurgia Plástica/efeitos adversos , Estudos Retrospectivos , Stents/efeitos adversos , Retalhos Cirúrgicos/irrigação sanguínea , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos Masculinos/métodosRESUMO
Bochdalek hernia is a congenital abnormality with high morbidity and mortality characterized by passage of the abdominal organs into the thoracic cavity through a diaphragmatic defect. Intrathoracic location of abdominal organs such as kidneys is very rare, with a reported incidence of only 0.25% in the literature. Herein, we present two cases of Bochdalek hernia with a herniation of intra-abdominal organ such as kidney that was treated in our clinic and compare this rare case with those in the literature. In both cases, the functionally normal kidneys were left in situ during diaphragmatic repair. No complications were observed during the postoperative period, and 10- and 1-year follow-ups. In cases with Bochdalek hernia associated with an intrathoracic ectopic kidney, the functionally normal ectopic kidneys were left in situ during repair of the diaphragmatic defect without complications.
Assuntos
Hérnias Diafragmáticas Congênitas/cirurgia , Herniorrafia/métodos , Rim/anormalidades , Rim/cirurgia , Hérnias Diafragmáticas Congênitas/complicações , Hérnias Diafragmáticas Congênitas/diagnóstico , Humanos , Lactente , Laparoscopia , Masculino , Volvo Gástrico/etiologia , Volvo Gástrico/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
Testicular torsion (TT) is a common urological problem in the field of pediatric surgery. The degree and duration of torsion determines the degree of testicular damage; however, its effects on the expression of octanoylated ghrelin and nucleobindin 2 (NUCB2) /nesfatin-1 synthetized from testicular tissue remain unclear. We explored the effects of experimentally induced unilateral TT on serum and contralateral testicular tissue ghrelin and NUCB2/nesfatin-1 levels, and determined whether N-acetyl cysteine (NAS) treatment had any effects on their expression. A total of 42 Wistar Albino strain rats were divided into 7 groups: Group (G) I control, GII sham, GIII 12-hour torsion, GIV 12-hour torsion + detorsion + 100 mg/kg NAS, GV 24-hour torsion, GVI 24-hour torsion + detorsion + 100 mg/kg NAS, and GVII 100 mg/kg NAS. Octanoylated ghrelin and NUCB2/nesfatin-1 concentrations were evaluated in serum using the ELISA method and in testicular tissue with immunohistochemical methods. Immunoreactivity of octanoylated ghrelin significantly increased in GI compared to GIII, GV, and GVI (p<0.05). NUCB2/nesfatin-1 immunoreactivity increased in GV and GVIII relative to GI (p<0.05). In the 12-hour torsion group, a significant decrease in octanoylated ghrelin levels with NAS treatment was observed; however, in the 24-hour torsion group, a significant decrease was not observed. In the 12-hour torsion + NAS treatment group, a significant change was not observed in NUCB2/nesfatin-1 expression. Following 24-hour torsion, an increase in NUCB2/nesfatin-1 levels was observed, and NAS treatment did not reverse this increase. It was determined that increases in the expression of octanoylated ghrelin and NUCB2/nesfatin-1, the latter of which was a result of TT, reflect damage in this tissue. Importantly, NAS treatment could prevent this damage. Thus, there may be a clinical application for the combined use of NAS and octanoylated ghrelin in preventing TT-related infertility.
Assuntos
Acetilcisteína/uso terapêutico , Proteínas de Ligação ao Cálcio/metabolismo , Proteínas de Ligação a DNA/metabolismo , Grelina/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Torção do Cordão Espermático/tratamento farmacológico , Torção do Cordão Espermático/metabolismo , Acetilcisteína/farmacologia , Animais , Antioxidantes/metabolismo , Células Intersticiais do Testículo/efeitos dos fármacos , Células Intersticiais do Testículo/metabolismo , Células Intersticiais do Testículo/patologia , Lipídeos/sangue , Masculino , Nucleobindinas , Estresse Oxidativo/efeitos dos fármacos , Ratos Wistar , Torção do Cordão Espermático/sangue , Torção do Cordão Espermático/patologiaRESUMO
PURPOSE: The aim of this study was to review our 20 years of experience determining the common mechanisms of perineal trauma and initial management to evaluate the effects of classification for treatment. METHODS: A total of 75 children with perineal injuries were reviewed retrospectively, including patient demographics, mechanism of injury, associated injuries, injury severity score, presenting symptoms and methods of diagnosis and treatment. RESULTS: Amongst the 75 children (55 females and 20 males; mean age, 8 years), fall from height, followed by motor vehicle crash and sexual abuse were the most common reasons for injury. The most common symptom on presentation was bleeding, followed by abdominopelvic pain and tenderness. Eleven patients were allowed to heal secondarily, and 64 were examined under general anaesthesia. The affected area was repaired in 48, further diagnostic tools were needed in 20 and 11 cystoscopic, 10 rectoscopic, and 5 vaginoscopic evaluations were performed. Six patients with full-thickness injuries that extended to the peritoneum were treated with colostomy, and all were victims of motor vehicle crashes. CONCLUSION: The genital injury score is a useful genital trauma scale for predicting anogenital injury severity. Identifying the mechanism and severity of perineal and associated injuries under general anaesthesia may facilitate appropriate classification and management.
Assuntos
Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Abuso Sexual na Infância/estatística & dados numéricos , Lacerações/diagnóstico , Anamnese , Períneo/lesões , Dor Abdominal , Adolescente , Distribuição por Idade , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Escala de Gravidade do Ferimento , Lacerações/terapia , Masculino , Dor Pélvica , Períneo/patologia , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Centros de TraumatologiaRESUMO
CONTEXT: Bladder perforations in children occur due to several different reasons. AIM: In this clinical series study, we focused on bladder perforations due to the pelvic injury, and our aim also was to create awareness for a rare type of bladder injuries. SETTING AND DESIGN: This was a retrospective study of the patients who were treated in our clinic for bladder perforation between 2006 and 2011. SUBJECTS AND METHODS: We reviewed the documents of childhood bladder perforations, and demographic and clinical characteristics of the patients were obtained. No statistical analyses were used because of the limited number of cases. RESULTS: There were ten patients who suffered from bladder perforation in 5-year period; 5 were male, and 5 were female. The mean age of the patients was 4.35 years. Four patients (40%) experienced iatrogenic perforation and six patients (60%) experienced perforation due to the accident. Common symptoms were hematuria, abdominal tenderness, and inability to urinate. Three patients were diagnosed via emergency laparotomy, without any radiological examinations performed before surgery. Four patients suffered from the intraperitoneal perforation, three patients suffered from extraperitoneal injury and three of them both of intraperitoneal and extraperitoneal injuries. Mean recovery time for patients was 15 days. One patient developed a urinary tract infection and one newborn died due to accompanying morbidities. Nine patients were discharged from the hospital. CONCLUSION: If the patients had a pelvic injury, surgeons must pay attention for the bladder perforation. Isolated bladder perforations are rare, and they are generally associated with iatrogenic injuries. Clinicians should pay attention to findings such as anuria, inability to insert a urinary catheter, and free fluid in the abdomen in order to diagnose the bladder perforation in newborns. Novice surgeons should pay more attention to avoid causing iatrogenic bladder perforation during inguinal hernia repair.