Littoral cell angioma (LCA) is a rare, benign primary vascular neoplasm of the spleen. The tumor originates from the littoral cells lining the sinuses of the red pulp of the spleen. Preoperative distinction of this tumor from other benign or malign splenic lesions is difficult. Radiologically most cases present as multiple nodules. Definitive diagnosis can only be made histopathologically and immunohistochemically following splenectomy. This clinical situation can coexist with various malignancies and autoimmune disorders. Even though, it is mostly benign, since it has the potential to become malignant after splenectomy, long-term follow-up is required. We present an LCA case, which appeared as a solitary mass in the spleen of an 11-year-old girl with abdominal pain admitted to our hospital.

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Acute appendicitis is the most common cause of acute abdominal pain, requiring emergency surgery. Approximately one third of cases have pain unexcepted location due to its various anatomical location. Acute appendicitis is a very rare cause of left lower quadrant pain; if it occurs, a few congenital anomalies should be considered such as Situs Inversus totalis and Midgut Malrotation (MM). MM is a rare congenital anomaly; it occurs due to error in process of rotation or fixation of intestines around the superior mesenteric vessels and it refers to nonrotation or incomplete rotation of intestines. Here we report a case who presented with left lower abdominal pain and was diagnosed with acute perforated appendicitis with intestinal nonrotation. Clinicians should be aware that intestinal nonrotation may be presented with left lower quadrant pain and complicated by acute appendicitis.

Objectives. This study aims to show the clinical value of ischemia-modified albumin (IMA) and Signal Peptide, Complementary C1r/C1s, Uegf and Bmp1–Epidermal Growth Factor Like Domain Containing 1 (SCUBE1) protein in pediatric appendicitis. Methods. Eighty-one pediatric patients hospitalized in the pediatric surgery ward with acute appendicitis and a control group of 62 pediatric patients with unspecific abdominal pain were included in this prospective case-control study. Thirty-nine patients whose pathology specimens confirmed acute appendicitis made up the final appendicitis group. Results. Patients with appendicitis had higher IMA (p<0.001) and SCUBE1 (p<0.001) levels than the control group. In receiver operating characteristic (ROC) analysis, areas under the curve (AUC) were 0.991 (sensitivity=97.4%, specifity=100%, positive likelihood ratio (+LR) infinity, negative likelihood ratio (-LR)=0.03, positive predictive values (+PV)=100%, negative predictive value (-PV)=98.3% for IMA and 0.803 (sensitivity = 89.7%, specificity =64.5%, +LR=2.53, -LR=0.16, +PV=61.4%, -PV=90.9%) for SCUBE1. Conclusions. The present study shows that IMA may be a reliable marker for a more accurate diagnosis of appendicitis. SCUBE1 can be used to exclude diagnosis if used in combination with other laboratory and clinical data.

Objective: To present the follow-up and treatment experiences of two centers regarding primary spontaneous pneumothorax (PSP), which is rare in childhood, in the light of the literature. Methods: Age, gender, height, body mass index (BMI), complaint, radiological findings, pneumothorax percentages, follow-up and treatment records of patients with PSP who admited to two centers between 1 August 2016 and 1 August 2021 were retrospectively analyzed. Results: A total of 23 patients were included in the study. Twenty-one (91.3%) patients were male, 2 (8.7%) were female, and the mean age was 16.4±0.6 years. Mean height was 180.8±7.9 cm, and BMI was 21.1±2.6 kg/m2. The main complaints were chest pain, respiratory distress, cough and shoulder pain. Chest X-ray was taken in all patients. Computed tomography ( CT) was performed in 9 patients (40.9%) who had persistent air leaks, developed recurrence and whose diagnosis could not be determined by X-ray. Conservative treatment (nasal oxygen 2-4 lt/min) was performed to 5 patients with pneumothorax percentage below 15% at the first admission, and tube thoracostomy in 18 patients. Video-assisted thoracic surgery (VATS) was performed in 8 (36.3%) cases. Recurrence developed in 4 (18.1%) cases. Conclusion:There is no standard approach in the diagnosis, treatment and follow-up process of childhood PSP. We think that new and prospective studies are needed in order to provide a standard approach on this issue. We think that VATS is an effective surgical method in the treatment. In addition, we considered that CT can be a useful diagnostic tool in management of PSP.