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Öğe Diaphragmatic injuries in childhood(2000) Dokucu A.I.; Ozturk H.; Otcu S.; Onen A.; Bukte Y.; Yucesan S.Injury to the diaphragm is rare in children. From 1983 to 1998, 23 children were treated for diaphragmatic injury at our institution and they were reevaluated for etiologic, diagnostic, therapeutic and prognostic factors. There were 20 boys and 3 girls, ranging in age between 3 to 15 years. Fifteen patients sustained penetrating trauma and eighth patients sustained blunt trauma. Rupture was diagnosed preoperatively in 11 patients. All patients underwent exploratory laparotomy with repair of the diaphragm. Diaphragmatic injury was found in 14 patients at left side and in 9 patients at right side. Isolated diaphragm injury was found in only 3 patients. Twenty patients had associated injuries, most commonly involving the liver, followed by spleen and stomach. Mean Injury Severity Score (ISS) value was measured as 38 in the study. There were two deaths, both unrelated to the diaphragmatic trauma. Diaphragmatic injury must be considered in any child suffering from blunt or penetrating thoracoabdominal trauma. Associated intraabdominal organ injuries are frequent in diaphragmatic rupture and therefore they should be treated by laparotomy. Morbidity and mortality can be minimized by a high index of suspicion, prompt recognition and surgical repair of even in the smallest diaphragmatic injury.Öğe Giant-cell reparative granuloma of the tibia(2003) Subasi M.; Kapukaya A.; Buyukbayram H.; Bukte Y.Giant-cell reparative granuloma (GCRG) occurs in the jaw, temporal bone, and short tubular bones of the hands and feet. Although GCRG can affect long bones, only small numbers of such cases have been sporadically reported. This report describes a giant-cell reparative granuloma in the proximal tibia in a 60-year-old woman, describes features of GCRG in long bones and reviews the literature. A 60-year-old female patient was referred to us with complaints of moderately tender swelling of the right leg. Whole-body scintigraphic scanning was performed, which incidentally also disclosed a distal femoral lesion. The patient was admitted for surgery and incisional biopsies were performed on both lesions. Pathology analysis of the specimen from the tibia showed new bone lamellæ encircled by osteoblasts and multinucleated giant cells which were more numerous in the hæmorrhagic regions of the stroma; the latter displayed fibroblasts, histiocytes and inflammatory cells. The specimen from the femoral lesion showed typical features of a benign enchondroma. The patient was readmitted for surgery. The femoral enchondroma was curetted and the cavity was packed with bone graft. The tibial GCRG was treated with marginal resection, autogenous and allogenous bone grafting and intramedullary nailing. Follow-up examination after two years showed no clinical or radiological evidence of a recurrence. Although GCRG is uncommon, it should be considered whenever a lucent, expansile, and possibly destructive lesion of a long bone is encountered. It should be distinguished from true giant cell tumours occurring in the same locations because they have different biologic behaviours.Öğe Isolated complete transection of the common bile duct following blunt abdominal trauma(1999) Dokucu A.I.; Ozturk H.; Bukte Y.; Otcu S.; Onen A.; Yucesan S.Isolated complete transection of the common bile duct following blunt trauma in children is extremely rare. Clinical findings in the early and late period of trauma are different. Here, we presented a 3-year-old girl who had a delayed admission to hospital for blunt abdominal trauma and was diagnosed to have an isolated complete transection of the common bile duct during laparotomy. The diagnostic difficulties of this rare injury were discussed.Öğe An unusual cause of acute abdominal pain in children: Biliary ascariasis(1999) Dokucu A.I.; Ozturk H.; Bukte Y.; Ece A.; Otcu S.; Yucesan S.Ascariasis is one of the most common worldwide helminthic disease that may cause various complications. The presence of this worm in the biliary tree, however, is a rare condition, especially in children. We describe a child with biliary ascariasis who was presenting clinical symptoms mimicking surgical acute abdomen. The diagnosis was made by ultrasound. The child was successfully treated with mebendazole and antispasmolytic. Biliary ascariasis should be added to the differential diagnosis of acute abdominal pain in patients, even in children, from endemic areas.
