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The optimal dressing is still unclear, despite hypospadias being one of the most prevalent surgical operations. Children’s dressing for hypospadias surgery was searched on PubMed as “dressing for hypospadias,” “postoperative dressing for pediatric hypospadias,” and “dressing AND hypospadias.” Experimental studies, animal studies, reviews, letters, and repetitive publications were excluded from the study. By evaluating these reviewed publications, factors affecting hypospadias dressing, such as surgeon, country, dressing type, characteristics, and why it is preferred, will be revealed. As a result, 17 articles were examined, and the advantages of each were established by examining the results. The type of hypospadias, the surgeon’s choice, and its ease of removal stand out as the crucial factors in treating hypospadias in children, along with the degree of development of the nation.

Background Intestinal volvulus can cause morbidity and mortality. Surgical reduction, on the other hand, could result in ischemia-reperfusion (I/R) injury. Hydrogen rich saline solution (HRSS neutralizes free radicals in the body. This study aimed to investigate the effects of HRSS in I/R injury in experimental intestinal volvulus in rats. Methods Thirty rats were randomly allocated into 5 groups. All procedures were done under general anesthesia and sterile conditions in each animal. Five ml/kg of saline and HRSS were administered intraperitoneally (ip) in Sham (Group 1) and HRSS (Group 2) groups, respectively. Groups 3, 4, and 5 constituted the study groups in which volvulus was created in a 5-cm- long ileal segment 2 cm proximal to the ileocecal valve. After 2 hours the volvuli were reduced and following 2 hours of reperfusion, these segments were removed. In volvulus-I/R group (Group 3) no additional procedure was done. HRSS was administered shortly before reperfusion (reduction of the volvulus) in Treatment I (Group 4) and 1 h before experimental volvulus in Treatment II (Group 5) groups. Blood and intestinal tissue samples were obtained from all rats at the 4th hour. Both tissue and blood total oxidant (TOS) and antioxidant status (TAS) levels were determined and tissue histomorphologies were studied. Oxidative stress indices (TOS ÷ TAS) (OSI) were calculated. Results Tissue TOS and OSI levels and histomorphological injury scores were statistically lower in treatment groups than I/R group, whereas blood TOS and OSI levels were similar between the groups. Conclusions This study provides biochemical and histomorphological evidence that HRSS prevents intestinal damage in I/R injury caused by volvulus.

Intussusception is a common disease in children. Most intussusception is idiopathic and approximately 1% develops postoperatively. We present a case of a 6-year-old male patient who underwent surgery for a type 1 common bile duct cyst. In his post-operative 2nd month, the patient presented with a complaint of abdominal pain after eating, but his pain was not accompanied by nausea or vomiting. No pathological findings were evident in the examination or an abdominal X-ray of the patient. Intussusception was detected by ultrasonography and computed tomography. We wanted to introduce this interesting intussusception that originated from the Roux limb that was not seen before.

Background: The rate of bladder injury during inguinal hernia repair in children is not well known. However, it is known that bladder injury during childhood inguinal hernia repair places a serious morbidity burden on children. We sought to determine an algorithm to avoid accidental bladder injuries. Methods: Reports that included pediatric patients with inguinal hernias containing the bladder were searched. Keywords and mesh term searches were conducted in the MEDLINE, Scopus, and Web of Science databases. We reviewed our clinical records and found that two patients had inguinal hernias containing the bladder. Results: Nineteen articles reporting on 26 patients diagnosed with the presence of the bladder within the inguinal canal from 1962 to 2021 were included in this article. Our two patients were added to this group. Diagnoses were made incidentally during genitourinary radiological examinations (n = 3), intraoperatively during hernia repair (n = 7), or due to clinical symptoms and findings (n = 18) after standard hernia repair. Bladder augmentation was required for three patients. Conclusions: During the operation, if there is any suspicion regarding the presence of the bladder in the inguinal region, we suggest performing a preoperative cystogram to confirm the position of the bladder and its injury. We recommend that the sac should be opened and the contents inspected before performing transfixion during high ligation of the hernia sac.

Abstract Background Uroterocele causes atony and stagnation in the ureter, thus predisposing the patient to stone formation. Multiple calculi in uroteroceles are common in adults but very rare in children. Case presentation We describe the case of a 3-year-old boy who presented with hematuria and was found to have multiple ureteral and ureterocele stones. The diagnosis was made during endoscopic lithotripsy. A holmium/yttrium–aluminum–garnet (Ho–YAG) laser was used to excise the uroterocele and for lithotripsy. Conclusions In appropriate cases, minimally invasive techniques, for example, Ho–YAG laser lithotripsy and ureterocele excision may be preferred.

Laryngotracheoesophageal clefts (LTECs) are rare congenital defects that are often accompanied by additional anomalies. The major issues in the treatment of these patients are intraoperative exposure insufficiency, technical difficulty of the operation, and anesthesia problems originating from the respiratory tract. Problems originating from mechanical ventilation and respiratory tract, eating disorders and relapse of fistula are among the problems encountered following surgery. Most of the time, concomitant additional anomalies also worsen the clinical picture. It was our aim with these case reports to report our experience in two cases with Type IV LTEC ranging from the inoperable type IV LTEC due to additional anomalies mounted up to severe respiratory distress to the carina that we operated on with a single stage anterior cervicothoracic approach on its fifth day on life.

Background: Our aim is to share our experiences regarding patients who cannot be fed effectively through the gastrostomy tube, but were inserted feeding jejunostomy through the gastrostomy orifice using scopic fluoroscopic techniques utilised by the interventional radiology. Patients and Methods: Between January 2010 and May 2013 the patients that were inserted jejunostomy tube through the gastrostomy orifice using fluoroscopic techniques were retrospectively analysed. Data including primary indication for gastrostomy, sex, concomitant disease and the requirement for gastroesophageal reflux disease (GERD) were all recorded. Results: There were five patients with these criteria. They all received either medical or surgical GERD therapy; nevertheless enteral feeding failed to reach an effective level, they all had vomiting and did not gain any weight. Following conversion, all the patients gained minimum 2 kg in 2-5 months; all the patients tolerated enteral feeding and were discharged in the early period. There were neither procedure related complications such as perforation, bleeding nor sedation related complications. Procedure took no more than 30 min as a whole. There was no need for surgical intervention. However in one patient re-intervention was required due to accidental removal of the catheter. Conclusions: In case of feeding difficulties following the gastrostomy; instead of an invasive surgical intervention; physicians should consider jejunal feeding that is advanced through the gastrostomy, which does not require any anaesthesia.

Objective Data on the prevalence of patent processus vaginalis (PPV) and hernia in patients with cryptorchidism are controversial. While some pediatric surgeons do not dissect the processus vaginalis (PV), most prefer to do so to prevent hernia formation and to achieve an effective orchiopexy outcome. This study was performed to evaluate the importance of dissection and high ligation of the PV during treatment of undescended testis (UT). Methods The clinical findings and surgical procedures of 55 patients with UT were retrospectively investigated. Results The mean patient age was 2.5 (range 1.0–12.0) years. Non-palpable testis (NPT) was located on the right and left side in 39 and 16 patients, respectively. Ultrasonography revealed no testis in 10 patients and an atrophic testis in 7 patients. Seven patients had a parent with an inguinal hernia, and the silk sign or a PPV was detected during inguinoscrotal examination in 22 patients. Undescended testis repair was performed by an inguinal approach in all patients. The inguinal canal was opened in all patients; 42 patients had a wider-than-normal internal ring (>2.5 cm), and the posterior wall of the inguinal canal was consequently weakened. Two-stage orchiopexy was performed in 2 patients, and 15 underwent the Prentiss maneuver. In the remaining patients, the dissection was easily done, and the orchiopexy was performed without any difficulty. Scrotal edema and wound infection occurred in five and two patients, respectively. One patient presented with an atrophic testis, and three had recurrent UT. Inguinal hernia was not observed in any of the patients during the study period, and all procedures were performed on an outpatient basis. Conclusion High ligation of the PV is an effective method for successful orchiopexy and prevention of inguinal hernia in patients with NPT and UT.

Background: It is still difficult to make the diagnosis of acute appendicitis in children with only clinical examination.Objectives: The present study, retrospectively reviewing the data of the patients that underwent appendectomy, aimed at emphasizingthe diagnostic value of ultrasonography findings by comparing them with pathological diagnosis.Patients and Methods: This retrospective study included patients aged under 18, who were operated on for appendicitis between 1January 2015 and 31 December 2015. The relationship between the pathology results of these patients and the results of preoperativeultrasonography performed for the diagnosis of acute appendicitis was investigated.Results: The study included 100 patients, 42 were female and 58 were male, on whom ultrasonography was performed and whosemean age was 11.3±3.7 years. While there were 28 (28%) patients who did not receive a definitive diagnosis of appendicitis pathologically, there were 43 (43%) patients in whom there were no ultrasonography findings supporting appendicitis. While appendicitisdiagnosis was made pathologically in 72 patients (72%), suggestive findings of appendicitis, such as compression and double wallthickness of the appendix (over 6 mm), were detected in 57 patients (57%). In addition, 42% periappendiceal fluid collection, 25% periappendicealfat inflammation, and 14% appendicolith were detected by ultrasonography. While 47 (65.3%) of the 72 patients withpathologically confirmed appendicitis received appendicitis diagnosis by ultrasonography, 25 (34.7%) did not (Pearson square testP = 0.007). The sensitivity and specificity of ultrasonography in the diagnosis of appendicitis were 66.6% (48/72) and 64.28% (18/28),respectively.Conclusions: According to the results of the current study, ultrasonography, in the diagnosis of appendicitis, should only be usedfor the support of clinical diagnosis or for differential diagnosis.

In this study, colonic manometry studies of the patients with repaired anorectal malformations (ARM) were compared with those of patients with severe colonic dismotility due to chronic constipation (CC) and acute pseudo-obstruction (PSO). The patients with repaired ARM were accepted as group #1 (n=10). The patients with CC and acute PSO composed group #2 (n=10). Eight-channel water perfused catheter was inserted into the colon under sedation. Colonic activity was recorded in three phases including fasting, after meal and after bisacodyl installation. The results were assessed by Pearson c2 test, P

Background/Aims: Gastric outlet obstruction (GOO) is a rare condition in childhood, with the exception of infantile hypertrophic pyloric stenosis (IHPS). However, no classification exists from a pediatric gastroenterologist’s perspective. Materials and Methods: The patients with a diagnosis of GOO between 2009 and 2020 were reviewed retrospectively. We classified the patients according to GOO: presence of clinical findings accompanied by radiological and/or endoscopic findings; clinical status: intractable nonbilious postprandial vomiting alone or with abdominal pain, early satiety, weight loss, postprandial abdominal distension, and malnutrition; radiology: delayed gastric emptying and dilated stomach; endoscopy: nonbilious gastric contents after 6-8 hours of emptying and/or failed pyloric intubation; physical examination: visible gastric peristalsis. Results: A total of 30 GOO patients (15 patients with IHPS, 1 patient with annular pancreas, 4 patients with gastric volvulus, 2 patients with duodenal atresia, 2 patients with antral web, 1 patient with late-onset hypertrophic pyloric stenosis (LHPS) had surgical treatment, and remaining 5 patients had medical treatment) were enrolled to the study. The median age was 8 months (range: 3 months-16 years), and 14 patients were female. Mitochondrial disorders, LHPS, metabolic disorders, and eosinophilic gastrointestinal system diseases were added to Sharma’s GOO classification, and the classification has been expanded. Conclusion: This is the first and largest study of GOO in children. From the perspective of pediatric gastroenterology, new diseases will be addressed, and definitions will be highlighted with our classification for GOO in childhood.