No abstract

Totally implantable venous access devices (TIVADs) increase the quality of life in children with hematologic and oncologic diseases or organ failures. The aim of this study is to determine the reasons for port removal. The port catheters, implanted and removed in patients between January 2000 and June 2013 were evaluated retrospectively. The patients were divided into two groups, whose port catheters were removed due to completed therapy (completed therapy group, CTG) and whose port catheters were removed because of a port catheter-related complications (complication group, CG). In the CG, the patients whose port catheters are removed for infectious reasons are investigated for whether there is a relationship with age, gender, body mass index (BMI), height and weight at the time of port implantation and removal. In total, 242 patients who underwent port implantation and removal were included in the study. The male to female ratio was 1.32/1 and the mean age of the patients was 9.4±4.9 years (0-24 year). Patients were enrolled in CTG (n=170, 70.2%), and CG (n=72, 29%). There is a positive correlation between BMI and infections (p<0.05). In the CG, patients under steroid treatment had higher incidence of non-infectious causes than infectious causes (p<0.05). Oppositely, non infectious complications were higher in steroid free patients (p<0.05). There was no catheter related mortality in the entire study group.The hematological malignancies and solid tumors are the most common underlying primary disease in patients with port removal because of complications. Infectious complications are most common cause of port removal in children and despite other microorganism, fungi should be considered as a cause of catheter related infections.

A 16-year-old male patient presented to the pediatric surgery outpatient clinic with a complaint of abdominal pain persisting for approximately two weeks. Laboratory tests revealed a mild elevation in liver enzymes ALT and AST (80 mg/dL and 85 mg/dL, respectively). The viral hepatitis panel and hydatid cyst serology were negative. Abdominal ultrasonography showed the absence of the right kidney and the presence of a dense cystic mass in the posterior of the bladder. Abdominal tomography confirmed right kidney agenesis and identified a 7.5x7.5x10 cm cystic mass extending from the posterior of the bladder to the central zone of the prostate. The patient, with persistent fever (38.4 °C) and worsening abdominal pain, underwent surgery. The complicated seminal vesicle cyst located in the posterior of the bladder was opened laparoscopically. After the cyst was opened, a significant amount of cystic fluid, believed to be purulent ejaculate, was aspirated, and then the cystic mass was completely removed. The patient was discharged on the third postoperative day. A month later, liver enzymes returned to normal.

A AB BS ST TR RA AC CT T Primary omental torsion is an extremely rare condition which is usually encountered in adults. Clinical presentation of primer omental torsion usually mimics a variety of acute abdominal surgical diseases including acute appendicitis, cholecystitis and ovarian torsion. We reported a twelve years old boy presented with suspected acute appendicitis whose final diagnosis at laparotomy revealed primary omental torsion with a normal appeared appendix. The patient was treated with resection of twisted omentum. When an abdominal exploration is negative for appendicitis or other common abdominal pathologies, primary omental torsion should be considered and resection of involved omentum should be the treatment of choice.K Ke ey y W Wo or rd ds s: :: : Child; adolescent; omentum; laparotomy Ö ÖZ ZE ET T Primer omentum torsiyonu genellikle erişkin yaş grubunda görülen ve oldukça nadir rastlanan bir durumdur. Primer omentum torsiyonu genellikle akut apandisit, kolesistit ve over torsiyonu gibi birçok cerrahi nedenli akut batın tablosunu taklit etmektedir. Bu yazıda akut apandisit şüphe-siyle ameliyat edilip apendiksi normal bulunan ve primer omentum torsiyonu tespit edilen 12 yaşında bir erkek hasta sunulmuştur. Hastamızda tedavi yöntemi olarak torsiyone olan omentumun rezeksiyonu tercih edildi. Apandisit veya diğer cerrahi akut batın nedeniyle abdominal eksplorasyon yapılan hastalarda apandisit ve diğer cerrahi nedenler tespit edilemediği zaman omentum torsiyonu mutlaka akla gelmelidir. Tedavi yöntemi olarak ise torsiyone olan omentum kısmının rezeksiyonu tercih edilmelidir.A An na ah ht ta ar r K Ke el li im me el le er r: : Çocuk; adölesan; omentum; laparotomi T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J C Ca as se e R Re ep p 2 20 01 16 6; ;2 24 4( (3 3) ): :2 23 31 1--3 3

An alternative method to cope with increasing demand for circumcision in summer: Circumcision with plastic clamp