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    Factors affecting early mortality and morbidity in congenital duodenal obstruction: summary of a 20-year experience
    (Int College of Surgeons, 2021) Aydoğdu, Bahattin; Tireli, Gülay; Demirali, Oyhan; Güvenç, Ünal; Beşik, Cemile; Kavuncuoğlu, Sultan; Göya, Cemil; Okur, Mehmet Hanifi; Sander, Serdar
    The duodenum is the most frequently obstructed region of the gastrointestinal tract, an important cause of mortality and morbidity in neonatal period. The objective of the present study was to summarize the causes of early mortality and morbidity in infants with congenital duodenal obstruction (CDO). Data on a total of 94 patients with CDO diagnosed in our clinic, and treated surgically between January 1993 and December 2012, were studied retrospectively. Patients were divided into 3 groups in terms of diagnosis: annular pancreas (n = 45), duodenal atresia (n = 31), and duodenal web (n = 18). The groups were compared in terms of sex, birth weight, age at the time of operation, and morbidity and mortality rates. Of the patients, 54 were male and 40 female, and the mean birth weight was 2278 g (range, 1180-3400 g). The average age at the time of the operation was 6.96 days (range, 1-38 days). The time to full oral intake postoperatively was 10.32 days (range, 4-38 days). Additional anomalies were found in 61 cases (64.8%). Early morbidity was most commonly associated with an anastomosis problem. Early mortality occurred in 6 cases (6.4%), and the most common causes were sepsis and cardiac anomalies. Elimination of sepsis, cardiac anomalies, and anastomosis problems is critical to ensure continued reductions in infant mortality and morbidity caused by CDO.
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    Öğe
    Treatment of spontaneous rupture of lung hydatid cysts into a bronchus in children
    (W B Saunders Co-Elsevier Inc, 2015) Aydogdu, Bahattin; Sander, Serdar; Demirali, Oyhan; Guvenc, Unal; Besik, Cemile; Kuzdan, Canan; Goya, Cemil
    Purpose: While several publications have reported the treatment of ruptured lung hydatid cysts (HC) in adults, there is limited information on the treatment of children. This study summarizes the treatment approach and outcomes of 11 children with spontaneous rupture of lung HCs into a bronchus. Methods: The complete medical records of 11 patients with spontaneous lung HC bronchus rupture between March 1993 and April 2012 were examined retrospectively. Gender, age at the time of diagnosis, patient symptoms, lung localization, dimensions of the cyst, medical treatment duration, and associated morbidities were evaluated. Routine chest x-rays, ultrasonography, computed tomography and serological tests were used. Result: The study included 11 patients [4 males, 7 females; average age 7.45 (range 5-11) years] presenting to the Emergency Department. The symptoms at the time of presentation were coughing in 81.8% (n = 9), hemoptysis in 54.5% (n = 6), and chest pain in 54.5% (n = 6). The average cyst diameter was 8.71(35-15) cm. The rupture involved the left lung in 7 (63.6%) patients and the right in 4 (36.4%). Serological tests were positive in seven patients and all patients had eosinophilia. The treatment of one patient was discontinued, while all of the other patients were treated medically. Pneumonia developed in four patients and lung abscesses in two. Both patients who developed lung abscesses had cysts with diameters greater than 10 cm. The average follow-up period was 48.4 (range 15-85) months; no mortality occurred. Conclusion: In our experience, medical treatment is adequate for patients with lung HCs progressing to spontaneous bronchus rupture. There was a high rate of abscess development within the thoracic cavity in patients with cysts over 10 cm in diameter; these patients can be treated effectively with a medical approach. (C) 2015 Elsevier Inc. All rights reserved.