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    Diagnostic difficulties in anomalies of intestinal rotation and fixation
    (Logos Medical Publishing, 2012) Turan C.; Arslan S.; Güzel M.; Küçükaydın M.
    Objective: To emphasize difficulties in the diagnosis of intestinal rotation anomalies and choice of diagnostic techniques. Material and Methods: Patients with operative diagnosis of malrotation and fixation anomalies between January 2000-December 2010 were studied retrospectively. Diagnostic methods, preoperative and operative diagnosis, surgical techniques, additional anomalies observed and complications were noted. Results: A total of 25 patients, 13 males and 12 females aged between 1 day and 5.5 years (mean age 28 days) were evaluated. 19 patients were operated with diagnosis of intestinal (10 patients) or duodenal (6 patients) atresia and congenital diaphragmatic hernia (3 patients) established after plain erect xrays. There was intestinal atresia with malrotation in only 4 of 10 patients with diagnosis of intestinal atresia and only malrotation in the remaining 6 patients (one of them had midgut volvulus). Of the six patients operated due to duodenal atresia, duodenal atresia and malrotation were found in 3 and only duodenal atresia in 3 patients. On the other hand, there was malrotation in patients with omphalocele (1) and congenital megacolon (1) during the operation. In only 4 patients (16 %), true diagnosis of malrotation was possible with baryum enema and serial xrays with oral contrast. Incision of Ladd's bands was made to remove obstruction due to malrotation and appendectomy (8 patients) and fixation of caecum (3 patients) were added to this procedure. One patient died due to sepsis and one patient who was operated for midgut volvus died from short bowel syndrome. Conclusion: It is believed that the most useful diagnostic method for malrotation is to establish the caecal position by baryum enema and serial xrays with oral contrast. © 2019 Polish Academy of Sciences. All rights reserved.
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    Management and treatment of splenic trauma in children
    (Edizioni Luigi Pozzi S.r.l., 2015) Arslan S.; Guzel M.; Turan C.; Doğanay S.; Kopru M.
    AIM: TO assess types of splenic traumas, accompanying injuries, their management and results. METHODS: We studied the reports of 90 patients (64 boys, 26 girls) who were treated for splenic injuries as a result of blunt abdominal trauma between 2005-2012. Age, sex, hospitalization time, mechanisms of traumas, accompanying injuries and management methods were recorded. RESULTS: Causes of trauma were falls from height (46 patients, 51 %), pedestrian traffic accidents (17 patients, 19%), passenger traffic accidents (11 patients, 12%), bicycle accidents (10 patients, 11%) and falling objects from height (6 patients, 6.6%). Splenic injury alone was observed in 57patients (63.3%) and other organ injuries together with splenic injury in 33 patients (36.7%). Splenectomy was performed in six patients (6.6%) due to hemodynamic instability and small intestine repair due to small intestine injury in one patient (1.1%). None of these patients died from their injuries. CONCLUSION: A large proportion of splenic injuries recover with conservative therapy. Some of the advantages of conservative therapy include short hospitalization time, less need for blood transfusion, and less morbidity and mortality. Falls from height and traffic accidents are important factors in etiology. The possibility of other organ injuries together with splenic injuries should be considered.