No abstract

A retrospective review was performed of the records of 85 children with urinary-tract calculi evaluated and treated during a 12-year period. The study evaluated the patients' age, sex, initial complaints, etiology, relevant pathological factors, stone location, mode of treatment, and stone analysis. There were 68 boys and 17 girls, a ratio of 4:1. Patient age ranged from 10 months to 16 years (average 8.2 years). Flank pain was the most common manifestation. Seventy patients had calculi in the upper urinary tract and 31 in the lower urinary tract; 16 had stones in more than one site and 15 had bilateral stones. Hypercalciuria was the most common metabolic disorder. Most patients underwent open surgical procedures for removal of their calculi; 5 stones were successfully removed endoscopically. In 3 cases, the stones passed spontaneously. Calcium oxalate and calcium phosphate stones were present in 32 cases, struvite in 5, cystine in 2, and uric acid in 1 Urolithiasis is still one of the most common pediatric urologic problems in Turkey, but as living standards improve, the incidence of the disease has tended to decline in recent years. Anatomic anomalies and metabolic disorders are of great importance in the etiology of stone disease.

Symptomatic OMD remnants in children most commonly presented with GIT obstruction, acute abdomen and umbilical anomalies. Rectal bleeding was not a predominant finding in the present series. Surgery is curative and can safely be done either by way of wedge resection or ileal segmentary resection. Ectopic tissue is detected in approximately one third of symptomatic remnants.

19750 school children, ages 6 to 15 years, were examined by the authors of this study, 1,220 (6.18%) had congenital abnormalities. In this group, 4.23% were boys and 1.88% were girls. Case histories revealed inbreeding amongst the parents (families) of children with congenital malformation to be 8.9% and 8.2% for the rest of the families in this study. There were 27 different congenital abnormalities identified, with prevalence rates of 0.05/1,000 to 15.85/1,000. The most prevalent abnormalities were umbilical hernia (15.85/1000), inguinal hernia (14.50/1,000), pectus carinatum and excavatum (7.68/1,000), undescended testes (9.00/1,000 boys), congenital nevus (3.54/1,000), retractile testis (4.45/1,000 boys), pilonidal sinus (2.63/1,000), pes planus (2.28/1,000), and hemangioma (1.16/1,000). Of the 19,750 children, 70 had multiple anomalies (3.75/1,000).

Objective To evaluate lower genitourinary tract injuries in girls and to propose guidelines for the investigation and initial management of this unusual injury. Patients and methods  The hospital records of 38 girls (aged 2–13 years) treated in our institution because of lower genitourinary (LG) tract injury between 1988 and 1995 were reviewed retrospectively. Urethral ruptures were detected in six patients, but the most frequent injuries were to the vulva (63%) and vagina (53%). There were pelvic fractures in eight patients and femoral fractures in a further five. Eight patients had concomitant anorectal lacerations. Vaginal and perineal lacerations were repaired primarily and a temporary urethral catheter was placed for a mean of 3 days. Partial urethral disruptions were repaired primarily over a stenting catheter in three patients. In one case, vaginal laceration and proximal complete rupture of the urethra was managed through a transvaginal approach with end‐to‐end urethral anastomosis over a stenting catheter. There was a complete rupture of the distal urethra and avulsion of the external meatus in two cases and these patients were managed by urethral advancement and meatoplasty. Results Perineal physical signs did not reflect the severity of the lesions and cystovaginoscopy allowed localization of lacerations in some cases. Primary repair was possible in all cases. Three patients (8%) had wound infection after surgery. One patient had temporary urinary incontinence which was managed conservatively and one patient had faecal incontinence which needed secondary surgery. Conclusion All female paediatric patients with suspected LG tract injury should undergo examination under anaesthesia to determine the degree of injury or possible concomitant injury to the urethra, bladder or rectum. Primary repair of these injuries is recommended.