Background Video endoscopy, which remains the diagnostic gold standard after ingestion of a corrosive substance, is performed under general anesthesia in children, requires advanced technology, and is costly. Simple and accessible methods are therefore needed to determine the need for endoscopy. The aim of this study was to evaluate the role of the pH and specific gravity of ingested substance in determining endoscopy indications after corrosive ingestion. Methods This prospective study included pediatric patients who presented after ingesting a corrosive substance from June 2018 to June 2019. Relationships between the extent of damage detected by endoscopy and the patient's age, physical examination findings, and the pH and specific gravity of the causative substance were evaluated. Results The degree of damage detected on endoscopy was significantly milder for corrosive substances with a pH between 2 and 12 (P = 0.003). In addition, pH values between 2 and 12 were significantly more common among patients without physical examination findings (P = 0.029). Specific gravity less than 1,005 was associated with mild injury detected by video‐endoscopy (P = 0.011). Patients in whom severe injury was detected by endoscopy had marked findings on physical examination (P < 0.001). There was no significant relationship between physical examination findings and the specific gravity of the substance involved (P = 0.087). Conclusions The results of this study suggest that conservative treatment options can be used without performing endoscopy in patients who have no physical examination finding after corrosive ingestion and where the pH of the substances is between 2 and 12 and the specific gravity of the substances is less than 1,005.

Objective: The majority of antenatal hydronephrosis disappears spontaneously. In our study, we have investigated the effective predictors for surgical decision in antenatal hydronephrosis. Material and methods:Forty-four patients found to have renal pelvic anteroposterior (AP) diameter more than 10-mm on antenatal ultrasonograpy were followed after birth. The study groups were divided into two groups: follow-up and surgery group. On follow-up, longitudinal diameter of the kidney, parenchymal thickness of the kidney, AP diameter of renal pelvis, AP diameter of middle calyces on ultrasonograpy, and differential renal function, 20th minute clearance, half-life of radionuclide tracer (T1/2), Tmax, Tmax-T1/2, normalised residual activity (NORA) on diuretic renography were evaluated. Ultrasonograpy and diuretic renography measurements were compared in patients whose hydronephrosis resolve or proceeded to surgery. Results:Forty-four patients were diagnosed as antenatal hydronephrosis, spontaneous resolution occurred in 23 (52%), and surgery was performed in 21 patients (48%). Mean age at operation was 8.5±6.5 months (3-24 months). Mean AP diameter of renal pelvis was 29.5±14.2 mm for surgery group, 13.6±4.2 mm for follow-up group (p<0.001). Univariate analyses showed significance for all ultrasonographic measurements and only the differential renal function by diuretic renography. Multivariate logistic regression analysis showed significance for AP diameter of renal pelvis (odds ratio 1.37; 95% Cl 1.13-1.66), and differential renal function (odds ratio 1.14; 95% Cl 1.01-1.29).Conclusion: AP diameter of renal pelvis and differential renal function were the most effective parameters for surgical decision. These parameters can be used for appropriate management of antenatal hydronephrosis.

Objective: Post-traumatic pulmonary contusion in children is often asymptomatic at diagnosis and has a good prognosis. The aim of this study was to investigate the clinical significance of the extent of post-traumatic pulmonary contusions and evaluate the timing of complications to determine the safe follow-up period in children with lung contusions. Methods:The study included pediatric patients who presented to the emergency department after blunt chest trauma and had pulmonary contusion detected on chest computed tomography (CT) between January 2017 and January 2020. Based on the percentage of total lung capacity occupied on thorax CT, pulmonary contusions were classified as grade 1: <19% (mild), grade 2: 19%-27% (moderate) and grade 3: ≥28% (severe). The relationship between pulmonary contusion grade and pulmonary functional status; complications and intensive care admission was examined and the mean time to complication development was determined. Results:The mean extent of pulmonary contusion after trauma was 17.8±8.6% (min-max, 5-100%) and mild (grade 1) contusion was significantly associated with spontaneous breathing (p=0.009). Contusion grade was not associated with the development of atelectasis, pneumonia, pleural effusion, pneumothorax (p=0.719) or intensive care admission (p=0.176). The mean time to detection of complications (atelectasis, pneumonia, pleural effusion, pneumothorax) on chest X-ray was 6.33±3.78 days (range, 2-9 days). Conclusion:The results suggest that although no statistically significance between the extent of pulmonary contusion and complications, patients should be hospitalized for at least 48 hours, then followed-up with chest X-ray for 1 week due to possible complications after blunt chest trauma in children.