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    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.
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    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.
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    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.