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Pilonidal sinus disease (PSD) is a common infectious and chronic inflammatory problem in the pediatric age group with no precise incidence data. PSD is more common in the pediatric age group between the ages of 15-17 due to rush routine educational activities in this age group, such as university entrance examinations. It is essential to early back to the daily routine, which the patient and parent highly desire, after treatment in PSD. This study was performed between December 2016 and March 2020. The files of 152 pediatric patients treated for PSD were analyzed retrospectively. The study group included 96 boys (63.2%) and 56 girls (36.8%). Eighty-five patients (55.9%) underwent phenol application, 41 (27.0%) underwent surgery, and 26 (17.1%) children underwent multiple procedures. The mean age of the patients was 16.2±1.39 years. The mean follow-up time was 21.6±12.2 months, and the mean body mass index (BMI) was 25.2±4.4 kg/m2. In the phenol group, the mean age was 16.3±1.2 years, the mean follow-up time was 17.3±9.55 months, and the mean BMI was 24.6±4.31 kg/m2. In the surgical group, the mean age was 16.0±1.74 years, the follow-up time was 35.6±3.82 months, and the mean BMI was 25.6±4.66 kg/m2. The patients' demographic data were gathered age, gender, BMI, type of procedure, number of applications, follow-up, complications, recurrence rate, and postoperative complication. Phenol application has essential advantages over surgical procedures in treating PSD, such as simple application, short hospitalization, cost-effectiveness, and low complication rates. To sum up, the phenol procedure is a straightforward treatment method that reduces complication rates and provides an early return to ordinary life. Abstract Pilonidal sinus disease (PSD) is a common infectious and chronic inflammatory problem in the pediatric age group with no precise incidence data. PSD is more common in the pediatric age group between the ages of 15-17 due to rush routine educational activities in this age group, such as university entrance examinations. It is essential to early back to the daily routine, which the patient and parent highly desire, after treatment in PSD. This study was performed between December 2016 and March 2020. The files of 152 pediatric patients treated for PSD were analyzed retrospectively. The study group included 96 boys (63.2%) and 56 girls (36.8%). Eighty-five patients (55.9%) underwent phenol application, 41 (27.0%) underwent surgery, and 26 (17.1%) children underwent multiple procedures. The mean age of the patients was 16.2±1.39 years. The mean follow-up time was 21.6±12.2 months, and the mean body mass index (BMI) was 25.2±4.4 kg/m2. In the phenol group, the mean age was 16.3±1.2 years, the mean follow-up time was 17.3±9.55 months, and the mean BMI was 24.6±4.31 kg/m2. In the surgical group, the mean age was 16.0±1.74 years, the follow-up time was 35.6±3.82 months, and the mean BMI was 25.6±4.66 kg/m2. The patients' demographic data were gathered age, gender, BMI, type of procedure, number of applications, follow-up, complications, recurrence rate, and postoperative complication. Phenol application has essential advantages over surgical procedures in treating PSD, such as simple application, short hospitalization, cost-effectiveness, and low complication rates. To sum up, the phenol procedure is a straightforward treatment method that reduces complication rates and provides an early return to ordinary life. Özet Pilonidal sinüs hastalığı (PSH), pediatrik yaş grubunda sık görülen, kesin insidans verisi olmayan enfeksiyöz ve kronik inflamatuar bir problemdir. PSH, 15-17 yaşarasındaki pediatrik yaşgrubunda, bu yaşgrubundaki üniversite giriş sınavları gibi rutin eğitim faaliyetlerinin yoğun olması nedeniyle daha sık görülür. PSH'de tedaviden sonra günlük rutine erken dönmekönemlidir, ki bu hasta ve ebeveyninçok istediği birdurumdur.Bu çalışma Aralık 2016 ile Mart 2020 tarihleri arasında gerçekleştirilmiştir. PSH ile tedavi edilen 152 pediatrik hastanın dosyalarıretrospektif olarak incelendi.Çalışma grubuna 96 erkek (%63.2) ve 56 kız (%36.8) dahil edildi. Seksen beşhastaya (%55.9) fenol uygulaması, 41 (%27.0) hastaya ve 26 (%17.1)çocuğa birden fazla işlem uygulandı. Hastaların yaşortalaması16.2±1.39 yıldı. Ortalama takip süresi 21.6±12.2 ay, ortalama vücut kitle indeksi (VKİ) 25.2±4.4 kg/m2idi. Fenol grubunda yaşortalaması16.3±1.2 yıl, ortalama takip süresi 17.3±9.55 ay ve ortalama VKİ24.6±4.31 kg/m2idi. Cerrahi grupta yaşortalaması16.0±1.74 yıl, takip süresi 35.6±3.82 ay ve ortalama VKİ25.6±4.66 kg/m2idi. Hastaların demografik verileri yaş, cinsiyet, VKİ, işlem tipi, uygulama sayısı, takip, komplikasyonlar, nüks oranı ve postoperatif komplikasyon olarak toplandı. Fenol uygulaması, PSH tedavisinde cerrahi prosedürlere göre basit uygulama, kısa hastanede yatış, maliyet etkinliği ve düşük komplikasyon oranları gibi önemli avantajlara sahiptir. Özetlemek gerekirse, fenol prosedürü komplikasyon oranlarınıazaltan ve normal hayata erken dönüşsağlayan basit bir tedavi yöntemidir.

Background: Anaesthesia is known to reduce gastric emptying and motility, which can cause gastroesophageal reflux (GER) in some patients. Monitoring pH is a reliable method for detecting reflux. In this study, we aimed to show whether GER is a risk factor for post-operative nausea and vomiting (PONV) with oesophageal reflux measures in paediatric patients undergoing laparoscopic appendectomy. Methods: After obtaining approval from ethics committee, 55 paediatric patients were included. An oesophageal pH metre catheter was inserted through the nasal passage to 3 cm above the lower oesophageal sphincter. pH measurements were evaluated with DeMeester score. It was accepted as acid reflux if the score was >14.7. The patients’ demographic data, history of GER and verbal descriptive scale (VDS) to assess PONV and pH values were analysed with Statistical Package for the Social Sciences (SPSS) version 21 (IBM SPSS Corp.; Armonk, NY, USA). Results: Of the 55 patients, 41.8% were girls, 58.2% were boys, the mean age was 13.2 years, the mean fasting period was 7.47 hours and the mean operation time was 1.1 hours. Mean fasting and operation times did not differ statistically according to VDS. There was no significant association between VDS group and gender or pH. None of the patients had a history of GER. Thirteen patients had DeMeester score >14.7. Conclusion: This is the first study about the relationship between gastric pH and PONV in paediatric patients. Although some studies have shown an association between anaesthesia and reflux, we detected reflux in nine of our patients and reflux was not statistically associated with PONV in our study. Further studies with larger patient groups are needed to provide a clearer opinion.

The increased intra-abdominal pressure during laparoscopic surgical procedures was reported to be a factor in the development of gastroesophageal reflux. This study evaluated the presence of gastroesophageal reflux and associated factors using 24-h pH monitoring in children undergoing laparoscopic appendectomy.Children who underwent laparoscopic surgery for presumed acute appendicitis between June 2017 and June 2018 were included in the study. After pre-operative endotracheal intubation, pH catheters were placed for 24-h esophageal pH monitoring. Relationships between gastroesophageal reflux and procedure time, pre-operative fasting time, age, weight, and body mass index (BMI) were evaluated.A total of 60 pediatric patients were included in the study. Their mean (SD) age was 11.82 (3.71) years (range, 4-17 years). The mean (SD) body weight was 41.27 (16.72) kg (range, 15-90 kg) and the mean (SD) BMI were 17.96 (4.37). The mean pre-operative fasting time was 15.52 (12.1) h, while the mean operative time was 38.42 (17.96) min. Lower age and weight were significantly associated with the presence of post-operative gastroesophageal reflux (p0.05). Mean procedure time, mean pre-operative fasting time, and BMI were not significantly associated with intra- or post-operative gastroesophageal reflux (p0.05).The lack of a significant relationship between mean procedure time and gastroesophageal reflux suggests that the mean duration of the laparoscopic procedures performed in this study is safe in terms of gastroesophageal reflux. The results also indicate that young age and low weight should be considered risk factors for gastroesophageal reflux in pediatric patients undergoing laparoscopic appendectomy.

Amac: Cocukluk doneminde karsilasilan tiroid nodullerinde tanisal yaklasimi ve cerrahi yonetimi degerlendirmek. Yontem: Tiroid nodulu nedeni ile Ocak 2012 ve Ocak 2015 yillari arasinda ameliyat edilen 14 cocuk hastanin dosyalari geriye donuk olarak incelendi. Hastalarin yasi, cinsiyeti, klinik bulgulari, tiroid fonksiyon testleri, ultrasonografi raporlari, sintigrafi raporlari, ince igne aspirasyon biyopsi (IIAB) raporlari, yapilan ameliyatlar, patoloji sonuclari ve postoperatif komplikasyonlar degerlendirildi. Bulgular: Olgularin 12’i kiz ve ikisi erkekti. Ortanca yas 14 (8-17) yil idi. 14 hastada boyunda ele gelen sislik, birer hastada gece terlemesi ve yutma guclugu saptandi. Bir hastada boyuna radyoterapi uygulama oykusu mevcuttu. Tiroid nodulleri USG bulgularina gore degerlendirildiginde dokuz hastada hipoekoik, dort hastada hipo-hiperekoik, bir hastada solid nodul saptandi. Tiroid sintigrafilerinde, 10’unda hipoaktif nodul, ikisinde hiper-hipo aktif nodul saptandi, iki hastada ozellik saptanmadi. IIAB’nde birer hastada benign sitoloji ve onemi belirlenemeyen folikuler neoplazi, uc hastada malignite suphesi, yedi hastada folikuler neoplazi saptandi, iki hastada materyal yetersiz bulundu. Patoloji preparatlarinda 9/14’sinde (%64.2) malignite saptandi. Dokuz hastaya total tiroidektomi (altisina patoloji sonucu tamamlayici tiroidektomi) tiroidektomi, bes hastaya lobektomi yapildi. Yedi hastaya boyun disseksiyonu uygulandi. Sonuc: Cocuklardaki tiroid nodulleri yuksek malignite riski nedeni ile hizla degerlendirilmeli ve guncel kilavuzlar esliginde multidisipliner olarak yaklasilmalidir.

Background/aim: Intraabdominal pressure (IAP) is one of the main reasons for gastroesophageal reflux (GER). This study investigates whether IAP during laparoscopic surgery leads to GER in a time-dependent manner.Materials and methods: In a laparoscopy model, 15 mmHg IAP was created in 8 Wistar albino rats in the Trendelenburg position (TP). A 5 mm laparotomy was performed in the left lower abdominal region, and a 6 Fr catheter was placed intraabdominally. Air was insufflated into the abdominal cavity, and the pressure was kept constant at 15 mmHg. Esophageal pH alterations were measured by pH sticks for 4 h every 30 min.Results: The basal median esophageal pH value was 9 (8-10), the value after placing the catheter was 9 (7-10) (P = 0.47), and the median pH value after placing the subjects in TP was 9 (8-10) (P = 0.70). In our experimental model, esophageal pH values were found to decrease significantly at the 150th minute in TP and at 15 mmHg IAP (P < 0.05). Two rats died: one at the 120th minute and the other at the 240th minute (P > 0.05).Conclusion: Esophageal pH values decreased and continued to remain low following IAP increase and TP in this experimental rat model. Prolonged laparoscopic procedures can particularly lead to GER that requires instant recognition and rapid and appropriate intervention.

Inflammatory myofibroblastic tumor (IMT) can be seen in all age groups, although it is more common in children and adolescents. We report the FDG PET/CT findings in an 8-year-old boy with endobronchial IMT. Endobronchial IMT is more commonly seen in young adults.

To evaluate the predictability of the initial endoscopic evaluation of the effectiveness of endoscopic balloon dilatation (EBD) in childhood esophageal strictures caused by corrosive ingestion.Medical records of 635 endoscopies caused by corrosive ingestion between January 2000 and December 2015 in children between the ages of 0 and 18 years were retrospectively analyzed. Among them, five children with grade 2a and 15 with grade 2 b who developed esophageal strictures were evaluated for the effectiveness of endoscopic balloon dilatation.The stricture rate was 5/136 (3.6%) in grade 2a and 17/25 (68%) in grade 2 b esophageal burns. Strictures with grade 2a burn had seven (1-10) EBD sessions, and grade 2 b had 8.8 (1-30) EBD sessions. For grade 2a burns, the treatment period was 15 months and 18.8 months for grade 2 b burns. Three patients with grade 2 b and two patients with grade 2a are still on the EBD program.Initial endoscopy for caustic ingestion and esophageal injury grading may help to provide healthcare givers with information about future stricture formation and management.

WOS: 000406457100009 PubMed: 28616621 Isolated tubal torsion -a rare cause of acute abdomen in children-is usually difficult to diagnose because of non-specific findings. Surgical salphingectomy is required in delayed diagnosis in most cases. Three sexual inactive adolescents diagnosed in isolated tubal torsion (ITT) were discussed for its diagnostic features and surgical management. Laboratory tests and radiological studies including ultrasonography (US), color doppler ultrasound were performed in all patients after evaluation for acute lower abdominal pain in emergency department and they underwent surgical intervention with laparotomy (n:2) and laparoscopy (n:1). One of the patients in this study had salpingectomy. Detorsion of the fallopian tube and cyst excision were performed in the remaining two patients who also had paratubal cysts. There was no recurrence in these patients during the follow-up for 3 and 2 years. The isolated tubal torsion should be kept in mind and early surgical management is essential in order to preserve fallopian tube because of its importance in fertility. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Pectus carinatum deformity repair is a major surgery. In this report we present a video presentation of a minimal invasive extra-thoracic pre-sternal compression using a metal bar for correction of pectus carinatum deformity and focus on technique details. A 14 year old boy with severe pectus carinatum deformity admitted to our pediatric surgery department. He was unwilling to go to school or join daily activities with friends because of his outlook. His physical examination, thoracic CT except the deformity, pulmonary function test, echocardiography, electrography was normal. There were no perioperative complications. He was discharged the following day of surgery. Follow-up was 24 months. The patient is very satisfied with the result and in good humor. Abrahamson technique is minimal invasive, effective and safe for correction of pectus carinatum deformity.

Purpose Subureteral injection of bulking agents in the endoscopic treatment of vesicoureteral reflux is widely accepted therapy with high success rates. Although the grade of vesicoureteric reflux and experience of surgeon is the mainstay of this success, the characteristics of augmenting substances may have an effect particularly in the long term. In this retrospective study, we aimed to evaluate the clinical outcomes of the endoscopic treatment of vesicoureteric reflux (VUR) with two different bulking agents: Dextranomer/hyaluronic acid copolymer (Dx/HA) and Polyacrylate polyalcohol copolymer (PPC). Materials and Methods A total 80 patients (49 girls and 31 boys) aged 1-12 years (mean age 5.3 years) underwent endoscopic subureteral injection for correction of VUR last six years. The patients were assigned to two groups: subureteral injections of Dx/HA (45 patients and 57 ureters) and PPC (35 patients and 45 ureters). VUR was grade II in 27 ureters, grade III in 35, grade IV in 22 and grade V in 18 ureters. Results VUR was resolved in 38 (66.6%) of 57 ureters and this equates to VUR correction in 33 (73.3%) of the 45 patients in Dx/HA group. In PPC group, overall success rate was 88.8% (of 40 in 45 ureters). Thus, Thus, this equates to VUR correction in 31 (88.5%) of the 35 patients. Conclusions Our short term data show that two different bulking agent injections provide a high level of reflux resolution and this study revealed that success rate of PPC was significantly higher than Dx/HA with less material.

Death or fatal complications due to childhood trauma may lead to loss of human and human-power, leeway and financial losses. The most important step in preventing trauma and deaths related to trauma is which it is known that the trauma can be prevented it is even an unpredictable event. Therefore, \"the risk of injury\" and \"injury prevention\" in childhood must be comprehended and interested in by anyone. In this review, the problems leading to trauma, prevention methods and preventive medicine of trauma were discussed. [TAF Prev Med Bull 2011; 10(2.000): 243-250]

OBJECTIVE To assess gubernaculum-sparing laparoscopic one-stage Fowler-Stephens orchiopexy (FSO), in the management of high intrapelvic testis. MATERIAL AND METHODS Medical reports of boys who underwent laparoscopic one-stage FSO were retrospectively reviewed. High intrapelvic testis was defined as testis ≥3 cm away from ipsilateral internal ring. Testes were evaluated on physical examination at 3rd, 6th and 18th months after surgery. Children were evaluated as for their demographic data, operative findings, interventional details and outcomes. RESULTS Seven patients met inclusion criteria of the study. Six of 7 testis were small and had abnormal appearance, compared with the contralateral testis. Average distance of the testes from the internal ring was 4.2±1.1 cm (3 to 6). Average age at surgery was 6.1±4.2 years (2 to 12). Average follow-up period was 14±5.8 months (8 to 20), and 5 testis (71.4%) were considered to be normal in volume and scrotal location. Two testes were relatively atrophic and underwent orchiectomy. CONCLUSION Our preliminary results shows a good testicular survival rate for one-stage laparoscopic FSO. Sparing collateral vasculature of the gubernaculum is important.

Cocuklarda kronik oksurugun nadir nedenlerinden birisi de bronsta yabanci cisim bulunmasidir. Dokuz yasinda kiz hasta, alti aydir suren oksuruk sikayeti ile basvurdu. Anamnezde hastanin disini yuttugunu daha once basvurdugu merkezlerde ifade etmesine ragmen astim ve pnomoni tanisi aldigi ve ilaclarla sikayetlerinin gecmedigi ve herhangi bir tetkik yapilmadigi ogrenildi. Fizik muayenesinde dinlemekle sagda ekspiryum uzunlugu olup sag hemitoraksta dinlemekle solunum sesi azalmisti. Kan tetkiklerine hafif lokositoz disinda ozellik yoktu. Akciger grafisinde sag bronsial alanda opak gorunumu mevcuttu. Hasta bu bulgularla solunum yolunda yabanci cisim tanisi aldi. Cocuk cerrahisine konsulte edildi ve bronkoskopi yapildi. Sag bronstan bir adet molar dis cikartildi. Oksuruk sikayeti mudahale sonrasinda gerileyen hastanin takiplerinde sikayeti tekrarlamadi. Olgu kronik oksuruk sikayeti ile basvuran okul cagi cocugunda anamnezin, fizik muayenenin ve akciger grafisinin ne kadar onemli oldugunu vurgulamak amaciyla sunulmustur. Anahtar kelimeler: Yabanci cisim, cocuk, dis, kronik oksuruk

Circumcision is the most common surgical procedure applied worldwide. Besides the medical necessities, it is also common due to religious and cultural reasons. The frequent performance of this surgical procedure increases the importance of the management of the complications arising during/after the operation. In our country performing this procedure under the improper conditions especially by non-medical persons or inexperienced operators increases the likelihood of complications, which sometimes causes non-recoverable tissue and organ loss. The persons performing this surgical procedure must be well acquainted with the complications which may arise during/after a circumcision procedure. For this reason, the possible complications regarding a circumcision procedure should be classified. Within this context, the required suggestions are presented in this article to reduce the complications to a minimal level. [TAF Prev Med Bull 2011; 10(5.000): 605-610]