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Öğe Axial torsion and gangrene of Meckel's diverticulum: The first infantile case report(Turkiye Klinikleri, 2013) Uygun I.; Okur M.H.; Otcu S.Axial torsion of Meckel's diverticulum (MD) is very rare and has been reported in only 9 children and 23 adults within the past 40 years. Herein, we report the first known infant case of axial torsion and gangrene of MD. A 6-month-old male patient presented with acute abdomen. Ultrasonography showed a perihepatic cystic mass and minimal free fluid. Exploratory laparotomy revealed a gangrenous MD measuring 7 × 6 cm due to axial torsion. MD wedge resection was performed and the patient was asymptomatic during 2 years of follow-up. MD and its torsion and gangrene should be considered in surgical cases of acute abdomen. © 2013 by Türkiye Klinikleri.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 Differential expression of CD34, S100, and c-Kit in interstitial cells of Cajal in infantile hypertrophic pyloric stenosis - Immunochemical study(2009) Ozturk H.; Ozturk H.; Yilmaz F.; Okur H.; Otcu S.; Dokucu A.I.Background. The pathogenesis of infantile hypertrophic pyloric stenosis (IHPS) is poorly understood although many hypotheses have been proposed. Objectives. Assessment whether the differential expression of c-Kit, CD34, and S100 may be involved in the development of IHPS. Material and Methods. Specimens from 14 infants with IHPS and seven control subjects were immunohisto-chemically stained for c-Kit, CD34, and S 100. The numbers of CD34+, S 100+, and c-Kit+ cells in five random fields per specimen were compared via light microscopy (x200). Results. In normal pyloric tissue, specific and intense c-Kit immunoreactivity was observed in the muscle layers and moderate staining was observed around the myenteric plexus. In IHPS patients, c-Kit+ cells were either absent or markedly reduced around the myenteric plexus. In control and IHPS patients, CD34+ cells were not observed around the myenteric plexus. In the vascular endothelium, moderate CD34 staining was observed in specimens from control subjects, whereas intense staining was observed for IHPS patients. In normal pyloric tissue, moderate S 100 immunoreactivity was observed in the muscle layers and intense staining was observed in the myenteric plexus. In IHPS patients, few S100+ cells were observed in the pyloric muscle layers and S100 immunoreactivity decreased markedly around the myenteric plexus. Conclusions. These results suggest that the numbers of c-Kit+ and S100+ cells are markedly decreased in the pyloric muscle layers and around the myenteric plexus in IHPS patients. Thus a lack of c-Kit and S100, but not CD34, expression may be a critical factor in the pathogenesis of IHPS and may serve as a useful prognostic tool in the treatment of this disease. © Copyright by Wroclaw Medical University.Öğe Effects of urokinase on postoperative intraabdominal adhesion formation and healing of bowel anastomosis(1997) Otcu S.; Onen A.; Dokucu A.I.; Ozer M.; Isik B.; Deveci E.; Ozdemir E.Urokinase with its' proteolytic enzyme activity, has been frequently used in experimental studies on postoperative intraperitoneal adhesion formation. As wound healing process may be effected with the same mechanism, we aimed to investigate if intraperitoneal administration of urokinase increases the rate of anastomotic complications. For every ten rats of the control and urokinase group, laparotomy and colonic anastomosis are performed. In the urokinase group abdominal cavities are irrigated with 2000 IU of urokinase. All the rats are sacrificed at postoperative seventh day and adhesion scoring, anastomosis bursting pressure and histopathological findings are investigated. There is no anastomotic leakage in both groups. Adhesion score in control group (2.6±0.52) was significantly higher than urokinase group (1.1±0.74). Differences in anastomotic bursting pressure between the groups were not statistically significant. Although serosal and mucosal continuity were not achieved properly due to excessive fibroblastic activity in control animals, it could be obtained in the urokinase group sufficiently. Our findings support the efficacy of urokinase in preventing the postoperative intraabdominal adhesion formation, while the healing process at the anastomotic site is not alter with its' intraperitoneal administration.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 A rare cause of acute abdomen in childhood: primary omental torsion(2002) Ozturk H.; Kaya M.; Otcu S.; Kilinc N.We examined the fact that 12 years old obese girl who applied to our clinic with acute abdomen symptoms and we determined primer omental torsion (POT) at laparotomy in this case. This disease is rare in childhood and imitates the signs of acute appendicitis. Obesity and anatomic variations ofthe omentum are predisposingfactorsfor POI ln this study we wanted to share our experiences in diagnosis and treatment ofPOIÖğe 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.
