Although management of perianal abscess is still controversial, simple drainage of the perianal abscess with additional antibiotic therapy reduces the development of fistula-in-ano. Fistula-in-ano within children has a chance of spontaneous resolution thus the immediate surgical intervention should be avoided.
A rare case of imperforate hymen associated with bicornuate uterus in an infant is presented as a cause of bilateral hydroureteronephrosis and pelvic mass in infancy. The importance of postoperative radiologic evaluation for diagnosis of accompanying uterine abnormalities is introduced. A 8-month-old girl with restlessness and intermittent fever was brought to the daily outpatient clinic by her parents. Ultrasound exam showed bilateral grade 4 hydroureteronephrosis and a large cystic pelvic mass. Magnetic resonance scan of the pelvis revealed marked hematocolpos. A cruciate incision was made over the hymen under general anesthesia. During a 6-month followup gradual resolution of bilateral hydroureteronephrosis was documented. Although the details of the uterine anomaly were obscured in preoperative imaging, postoperative US and MR demonstrated bicornuate uterus. Postoperative pelvic radiologic examination is highly recommended to verify the resolution of hematocolpos and to screen for any concomitant anomalies that can have long-term clinical significance.
Shigella spp. gelişmekte olan ülkelerde bakteriyel ishal ve dizanterinin en sık etkenidir. Şigellozisin klinik bulguları hafif ishalden ciddi dizanteriye kadar değişen geniş bir klinik yelpaze göstermektedir. Beş buçuk yaşında daha önce sağlıklı olan erkek hasta karın ağrısı, kusma ve kabızlık ile başvurmuştu. Fizik muayenede sağ alt kadranda hassasiyet saptandı. Hastaya akut apendisit tanısı ile açık apendektomi işlemi yapıldı. Abdominal kavitenin cerrahi olarak açılması ile perfore apendisit ve yaygın peritonit tespit edildi. Peritoneal sıvı kültüründe Shigella sonnei üredi. Hasta komplikasyon gelişmeksizin tam olarak iyileşti. Şigellozisin seyri sırasında apendisitte dahil olmak üzere cerrahi komplikasyonlar gelişebilmektedir. Literatürde Shigella ilişkili perfore apendisit olgusu oldukça az sayıda bildirilmiştir. Erken cerrahi girişim morbidite ve mortaliteyi önlemde yararlıdır.
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