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Öğe Accidental ingestion of concentrated white vinegar in Hatay children in Turkey(Sciendo, 2023) Atici, Ahmet; Micoogullari, Lina; Ugur, Bahar; Celikkaya, Mehmet Emin; Akcora, BulentWhite vinegar which contains high concentrations (similar to 85 %) of acetic acid is a staple ingredient used in food preparation in many Mediterranean cuisines but in small amounts. Being corrosive, it can cause ulcerative injury to the oropharynx and oesophagus and upset the stomach with resulting nausea and vomiting. This study presents 11 cases of paediatric patients (five boys and six girls, aged between 11 and 89 months) with oesophageal strictures who drank white vinegar by accident. They all received endoscopic oesophageal dilation (with a bougie) ranging from one to 28 per patient, depending on the severity of the injury. Follow-up showed uneventful healing in eight patients, who at the time of the telephone call were able to swallow solids and liquids normally. Two patients who could not be reached by telephone were found healthy by consulting the national database (e-Nabiz). Unfortunately, one patient, who was discharged without any symptoms after the first dilation, suffered massive gastrointestinal bleeding 24 hours after the dilation and died. The loss of this patient shows that ingesting white vinegar can be very dangerous in children, especially if parents delay seeking medical help. We believe that controlling the production and sales of highly concentrated white vinegar and selling it in child-proof containers can help to prevent accidental ingestions by children and tragic outcomes such as the one reported here.Öğe An Arachnoidal Cystoperitoneal Shunt Catheter Which Protruded Via Anus and Caused Subdural Empyema After Colonic Perforation: A Rare Complication(Aves, 2009) Akcora, Bulent; Serarslan, Yurdal; Eris, Ozge; Cavus, Gokhan; Urfali, Boren; Akdemir, GokhanVentriculoperitoneal (VP) and cystoperitoneal (CP) shunt insertion are common surgical treatment methods for hydrocephalus which allow the drainage of cerebrospinal fluid (CSF) into the peritoneal cavity. Although these procedures are safe and effective, they may lead to various intraabdominal complications including colonic perforation. Shunt related colonic perforations have high mortality and morbidity rate because of peritonitis and/or retrograde intracranial infections. We presented here a child who developed hemiparesis due to subdural abscess after colonic perforation.Öğe An atypical bladder diverticulum presented with recurrent peritonitis: case report(Turkish Assoc Trauma Emergency Surgery, 2011) Temiz, Abdulkerim; Akcora, Bulent; Atik, EsinBladder diverticula develop from congenital detrusor muscle defect and frequently present with urinary tract infection, which occurs as a result of urinary stasis in the diverticula. Different clinical presentations, such as bladder outlet obstruction, cyanosis of the lower extremities, intestinal obstruction, ureteral obstruction (which may occur due to direct diverticular compression), and peritonitis due to spontaneous rupture of the diverticula, were reported previously. Here, we report a case with the diagnosis of bladder diverticulum that caused recurrent generalized peritonitis without perforation and mimicked perforated appendicitis.Öğe Bronchoscopy for foreign body aspiration and effects of nebulized albuterol and budesonide combination(Professional Medical Publications, 2017) Akcora, Bulent; Celikkaya, Mehmet Emin; Ozer, CahitObjective: A foreign body aspiration in the tracheobronchial tree is a dangerous medical condition in the childhood period. Although rigid bronchoscopy is a safe procedure, it may cause complications. The aim of this study was to present our bronchoscopy experience and to evaluate the efficacy of pre-operative administration of nebulized albuterol and budesonide combination for reducing intra-operative complications in foreign body aspirated cases. Methods: In this retrospective study our pediatric cases in which a foreign body was removed from tracheobronchial tree in last 8 years were analyzed. After excluding the patients who needed emergent and negative bronchoscopies, the remaining clinically stable 84 patients were compared for the effects of preoperative administration of nebulized albuterol and budesonide combination on bronchoscopy complications. Results: There were 51 boys (60.3%) and 33 girls (39.7%). There were 38 children in the non-nebulized group and 46 children in the nebulized group. We found that the combined albuterol and budesonide nebulization decrease complications such as arterial oxygen desaturation (p<0.05), and bronchospasm (p<0.05) during the bronchoscopic intervention. Conclusion: Preoperative nebulization of albuterol and budesonide combination may decrease perioperative complications of bronchoscopy.Öğe Can olive oil prevent distal colon mucosal atrophy caused by disuse in rats with colostomy? An experimental animal study(Index Copernicus Int, 2021) Atia, Ahmet; Demir, Emel; Gursoy, Didar; Celikkaya, Mehmet Emin; Akcora, BulentAim: This study aims to investigate the effects of pure olive oil on mucosal atrophy of the distal colon in rats. Material and methods: The study included 28 male albino Wistar rats weighing 300-350 g. A total of 28 animals were randomly allocated to four groups: group 1: control group (n = 6); group 2: ostomy group (n = 6); group 3: ostomy + saline group (n = 8); group 4: ostomy + olive oil group (n = 8). By definition, group 1 did not undergo any procedure. The same surgical procedure was performed for groups 2, 3, and 4 as described below. In all animals from these groups, a two-centimeter-long mid-line incision was made and the colon was divided into 5 cm sections, measured from the distal colon to the caecum. Proximal and distal stomas were created 2 cm apart in the midline with the use of single-layer interrupted sutures. All rats were kept under close daily observation until they were terminated postoperatively after the 1st month. Animals from group 2 did not undergo any additional procedures, while those fromgroups 3 and 4 were given 2 mL of saline and olive oil twice a day, respectively. At the end of the 1st month, the rats were re-operated through the same approach. Biopsies were taken from the proximal and distal stomas of all rats in the same manner for further histopathological analysis. Results: Group 1 showed no significant differences in terms of mucosal thickness, muscular thickness, wall thickness or colonic lumen diameter between the proximal and distal segments of the colon. Although there were significant differences between the proximal and distal colostomies for each parameter in groups 2, 3, and 4, the mucosal thickness, muscular thickness, wall thickness, and colonic lumen diameter differences for proximal and distal ostomies were very small in group 4 when compared to groups 2 and 3. Conclusion: The administration of pure olive oil through the distal colon before colostomy closure may reduce the difference in diameter between the proximal and distal intestinal segments. As a result, a more straightforward surgical procedure may be achieved.Öğe A common public health problem: corrosive ingestion in children(Dr Behcet Uz Cocuk Hastaliklari Ve Cerrahisi, 2018) Celikkaya, Mehmet Emin; Atici, Ahmet; El, Cigdem; Akcora, BulentObjective: Corrosive substances are both histologically and functionally damaging agents when contacted with the mucosa. Corrosive substance ingestion is still one of the most important and frequent home accidents because of the reasons such as the storage of corrosives in food containers, colored packages, and places where children can reach easily. Methods: The medical records of 125 patients who were followed up because of intake of corrosive substances between 2014 and 2017 were retrospectively reviewed. Patients were evaluated according to age, gender, type of corrosive substance ingested and type of treatment. Results: Of 125 cases 63 were girls (50.4%), 62 were males (49.6%). The median age of the cases was 4.1 years. Among the corrosive substances, most frequently laundry bleach (48%; n=61), vinegar (17%; n=21), drain opener (12.8%; n=16), washing liquid (9%; n=11), olive sweetener (caustic) (n=3; 2.4%), lime dissolver (n=4; 3.2%), salicylic acid (n=3; 2.4%), oil solvent (n=2; 1.6%), wart drug (n=2; 1.6%), and acetonide (n=2; 1.6%) were ingested in respective number of patients. Esophagoscopy was performed only in patients with symptoms. Conclusion: Prevention of the intake of corrosives is much simpler and more economical when compared with long and expensive treatment processes. It is necessary that everyone who cares about children must be carefull. Corrosive substances must kept in sealed packages even in locked cabinets. Also, packages containing corrosive substances should not contain interesting colors and designs for children.Öğe Duodenal perforation: an unusual complication of sickle cell anemia(African Field Epidemiology Network-Afenet, 2014) Acipayam, Can; Aldic, Guliz; Akcora, Bulent; Celikkaya, Mehmet Emin; Askar, Hasan; Dorum, Bayram AliDuodenal perforation in childhood is a rare condition with a high mortality rate if not treated surgically. Primary gastroduodenal perforation is frequently associated with peptic ulcer and exhibits a positive family history. Helicobacter pylorus is the most significant agent. Secondary gastroduodenal perforation may be a finding of specific diseases, such as Crohn disease, or more rarely may be associated with diseases such as cystic fibrosis or sickle cell anemia. A 14-year-old boy presented with abdominal and back pain. The patient was operated on for acute abdomen and diagnosed with duodenal perforation. Helicobacter pylorus was negative. There was no risk factor to account for duodenal perforation other than sickle cell anemia. Surgical intervention was successful and without significant sequelae. Duodenal perforation is a rare entity described in patients with sickle cell anemia. To our knowledge, this is the first report of duodenal perforation in a patient sickle cell anemia.Öğe The efficacy of shear-wave elastography - performed simultaneously with Doppler sonography - for differentiating between testicular torsion and epididymo-orchitis(W B Saunders Co-Elsevier Inc, 2019) Atici, Ahmet; Kayali, Alperen; Celikkaya, Mehmet Emin; Akcora, Bulent[Abstract Not Available]Öğe Gradual detorsion of torsioned rat testis attenuates ischemia reperfusion injury(W B Saunders Co-Elsevier Inc, 2008) Akcora, Bulent; Altug, Muhammed E.; Balci, Ali; Hakverdi, Sibel; Yonden, Zafer; Akbas, Ali; Ozturk, AtakanAim: This study was designed to investigate effect of gradual detorsion on testicular ischemia reperfusion injury. Materials and Methods: A total of 21 male rats were divided into 3 groups, each containing 7 rats. Torsion was created by rotating the left testis 720 degrees in a clockwise direction. Group I underwent sham operation. Group 2 (sudden detorsion) served as a torsion/detorsion group, receiving 2 hours torsion and 2 hours detorsion. In group 3, 360 degrees detorsion was done for 20 minutes after 720 degrees torsion for 2 hours. Then, testis was done full detorsion for 100 minutes. At the end of the experiments (fourth hour), left orchiectomy was performed to measure the tissue levels of malondialdehyde (MDA), superoxide dismutase, and glutathione peroxidase and to perform histologic examination in testes. Results: The MDA levels of testis tissues were significantly increased in the sudden detorsion group as compared with the sham group. We found decrease of the MIDA level in gradual detorsion group, but it was not a statistically significant amount. Significant decrease was found in the superoxide dismutase and glutathione peroxidase activities in the sudden detorsion group as compared with the sham and gradual detorsion groups. Histologic examinations were in accordance with the testicular tissue MDA levels. Conclusion: In the light of our biochemical and histopathologic findings, we can say that gradual detorsion has a trend to decrease the degree of testicular reperfusion injury in the rat torsion/detorsion model. (C) 2008 Elsevier Inc. All rights reserved.Öğe Graves' Disease with Exophtalmia in a Two-Year Old Child(Galenos Yayincilik, 2011) Yalcin, Hulya; Akcora, Bulent; Balci, AliThyrotoxicosis is one of the rare disorders diagnosed in childhood and adolescence. The most frequent cause is Graves disease. One of the Graves' disease complications is thyroid-associated orbitopathy. A 2-year-old girl was referred to our hospital for decreased weight gain. Her physical examination was normal except for a palpable thyroid tissue and exophtalmia. After laboratory examination, she was referred to the departments of nuclear medicine and radiology for the diagnosis of hyperthyroidism and Graves ophthalmia. When evaluated with the physical examination, laboratory and imaging results the patient was diagnosed as Graves' disease with orbital involvement. So the patient was taken on methimazole treatment.Öğe The histopathological effect of tissue adhesive on urethra wound healing process: An experimental animal study(Elsevier Sci Ltd, 2020) Atici, Ahmet; Secinti, Ilke Evrim; Celikkaya, Mehmet Emin; Akcora, BulentIntroduction and Objective: The present study aimed to determine the histopathological effect of Tisseel tissue adhesive on the urethral wound healing process after urethroplasty in a rat model. Study design A total of 24 animals were randomly allocated into three groups: Group 1; control group (n = 6); Group 2; suture-closure group (n = 9); and Group 3; suture + adhesive group (n = 9). In group 2, an incision 4 mm long was made on the ventral skin of the penis along the midline from the glans penis, to open the dartos muscle, corpus spongiosum, and urethra. Next, initially, the urethra alone, and then the layers up to the skin were covered in layers with 8/0 vicryl interrupted sutures. Group 3 underwent the same procedures as group 2, but after the urethra was repaired 0.1 cc of Tisseel tissue adhesive was applied over the urethra. Penile tissue samples were obtained 21 days later, and tissue samples were sent for histopathological analysis. Results Urethral epithelial thickness and connective tissue thickness in group 3 were higher than in group 1 and group 2. Fibrosis in group 3 was higher than in group 2. The difference in inflammation between group 3 and group 2 was not significant. There was no significant difference in microvessel density between group 2 and group 3. Discussion Both increased fibrosis and connective tissue thickness were noted in group 3 compared to group 2 and group 1. These increases may have been caused by the hemostatic effect of the Tisseel adhesive and its triggering of fibroblast growth factors. The epithelial thickness increased significantly in group 3 and group 2 compared to group 1. This increase in tissue thickness without an increased number of epithelial cells can be explained by the development of oedema. Conclusion The present study suggests that while Tisseel tissue adhesive increases connective tissue thickness and fibrosis, it does not demonstrate a prolonged inflammation or increased neovascularization in the urethral wound at 3 weeks after surgery. The data obtained in our study does not support the use of Tisseel in urethroplasty surgery. The results obtained in this study demonstrate a significantly higher formation of fibrosis (scar tissue), which underlines the importance of new studies to identify new treatments for urethral wound healing after urethra trauma or surgery. [GRAPHICS] .Öğe Innocent Children in the Syrian Civil War(Georg Thieme Verlag Kg, 2020) Celikkaya, Mehmet Emin; Atici, Ahmet; Cigdem, E. L.; Akcora, BulentIntroduction Our aim is to present the clinical and surgical characteristics of the children affected by the Syrian civil war. Materials and Methods Medical records were reviewed retrospectively for Syrian war victims between the ages of 0 and 18 who were brought to the emergency department of the Education and Research Hospital between March 2011 and March 2019. Each patient was evaluated with respect to demographic data (gender, age), type of injury, history of operations in Syria, injured organ(s), accompanying traumas and the mortality and trauma score. Results The majority of our study population of 147 patients were male (108/147, 73.46%), and 39 of the total were girls (26.53%). The mean age of the patients was 9 (7.5 +/- 4). The mean age of the girls was 8.5 (range: 7 months to 16 years), and the mean age of the boys was 9.2 (4 months to 17 years). Seventeen patients who had abdominal surgery in Syria were operated on again after clinical and radiological observations. A total of 83 patients were operated on in Turkey. For 66 of those patients, the operation in Turkey was their first surgery on their war injuries. Seventeen patients were operated on in Syria but needed surgery again in Turkey. Conclusion War affects not only the battlefield, but also the neighboring countries in many aspects such as medical, social, and economic. Hollow organ injuries are the most common intraabdominal pathologies. Delayed intervention is associated with increase mortality and morbidity.Öğe A new term: complete preputial agenesis(W B Saunders Co-Elsevier Inc, 2007) Temiz, Abdulkerim; Akcora, BulentPreputium is the extended part of the foreskin of the penis and covers the glans penis. Several congenital anomalies of the preputium such as disproportionate preputial growth, epidermoid cyst, and phimosis have been reported previously. Although lack of the ventral part of preputium is associated with hypospadias, there are no articles about complete agenesis of the preputium. Here, we report a case with the diagnosis of complete preputial agenesis. This case is the first in our knowledge. (c) 2007 Elsevier Inc. All rights reserved.Öğe Pediatric esophageal perforation due to firearm injuries during the Syrian war and a new suture technique(Elsevier, 2018) Atici, Ahmet; Celikkaya, Mehmet Emin; El, Cigdem; Akcora, BulentThe incidence of esophageal perforation (EP) due to firearm injury (FAI) is markedly low compared with that occurring in other organs. The most frequently reported cause of EP is iatrogenic injuries. The incidence of EP due to penetrating injuries, such as FAI, is very rare and highly destructive. Here we report cases of EP due to FAI in childhood during the Syrian war and elucidate a new suture technique.Öğe The protective effect of darbepoetin alfa on experimental testicular torsion and detorsion injury(Wiley, 2007) Akcora, Bulent; Altug, Muhammed Enes; Kontas, Tunay; Atik, EsinAim: Testicular torsion is a serious urological emergency, usually involving newborns, children, and adolescents which can lead to subfertility and infertility. Prevention of testicular damage caused by torsion is still a clinical and experimental problem. So far many chemicals and drugs have been investigated for decreasing ischemia/reperfusion (I/R) injury in experimental animals. The possible protective effect of darbepoetin alfa, a novel erythropoietic protein, on testicular tissue after I/R injury was examined in this study. Methods: Thirty rats were divided into three groups: sham operation, torsion/detorsion, and torsion/detorsion plus darbepoetin alfa groups. After torsion (2 hours) and detorsion (4 hours), bilateral orchiectomy was performed. Malondialdehyde, nitric oxide and glutathione levels were determined in testicular tissue. Results: Administration of darbepoetin alfa caused a decrease of malondialdehyde and nitric oxide levels and an increase in glutathione levels compared with the torsion/detorsion group. In addition, histological injury scores were significantly decreased in the treatment group more than the torsion/detorsion group. Conclusion: The results suggest that darbepoetin alfa may be a potential protective agent for preventing testicular injury caused by testis torsion.Öğe Pyloric perforation due to stress disorders in an adolescent girl(Elsevier Science Bv, 2018) Atici, Ahmet; Celikkaya, Mehmet Emin; El, Cigdem; Akcora, BulentGastroduodenal perforation is a serious emergency condition. The predominance of duodenal perforation in pediatric age group shifts towards gastric perforation at later ages. However, due to thick muscle tissue pyloric perforation is seen very rarely in all age groups [3]. A 14-year-old female patient with abdominal pain lasting for one day admitted to our pediatric emergency room. During the physical examination, generalized abdominal tenderness and muscular defense were observed in all quadrants of the abdomen. Laparotomy was performed with an upper abdominal median incision. A large amount of serous, non-biliary fluid was observed in the abdomen. A perforation area of nearly 3 mm was identified on the anterior of the pylorus. Primary repair with omentopexy of the pyloric perforation was performed. On postoperative day 7, the patient was discharged without any complication. Pyloric perforation should be considered in the differential diagnosis of patients presented with epigastric pain.Öğe Rectum perforation after anorectal trauma in children: Report of two cases(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2011) Temiz, Abdulkerim; Akcora, Bulent; Temiz, Muhyittin; Aslan, AhmetAnorectal injury is a rare clinical condition in children. Since it may be an initial sign of concomitant rectal and other intrapelvic structural injuries, this clinical condition is important to declare. Case 1: A nine-year-old boy was admitted to the hospital with complaints of abdominal pain and vomiting. Diffuse abdominal tenderness and defense were remarkable. Abdominal X-ray showed pneumoperitoneum. In operation rectum and bladder perforation were detected. Perforation was repaired and sigmoid colostomy was performed. Case 2: A six-year-old girl was admitted tot he hospital with perineal injury after a fall from height. A perineal wound which was 2 cm in diameter was detected at a localization 4 cm from the anal canal. Abdominal X-ray showed pneumoperitoneum. Rectal perforation was detected. Perforation was repaired and sigmoid colostomy was performed. To decrease the morbidity and the mortality of the patients, early and correct diagnosis, defining the type and extent of the injury including intrapelvic structures should be accurately determined and appropriate treatment should be performed. We think that colostomy should be done necessarily in cases when needed.Öğe A significant cause of constipation and growth retardation: hirschsprung's disease(Bayrakol Medical Publisher, 2019) El, Cigdem; Celikkaya, Mehmet Emin; Atici, Ahmet; Akcora, BulentAim: In this study we aimed to draw attention to HD which may lead to mortal complications if early diagnosis and treatment are not provided for infants with gastrointestinal symptoms. Material and Method: In Mustafa Kemal University, Faculty of Medicine, Department of Pediatrics between September 2016 and March 2018 the data of the patients who were diagnosed with Hirschsprung's disease were retrospectively analyzed. In this study age, gender, percentile values of growth and development (height, weight, head circumference), neurodevelopment stages (ability to tonic neck reflex, ability to sit supported and unsupported ability to sit), first meconium time, the most common complaints and physical examination findings were examined. Results: The mean age of the 19 patients was 7.42 months (48 days-40 months). Sixteen (%84) of the patients were male and 3 (%16) of the patients were female. Growth and development values were detected in 8 of the patients in the range of 10-25, 6 of the patients in the 3-10 percentile range and 5 of the patients were under the 3rd percentile. The first meconium excretion time of the patients was an average of 3 days (49 hours-5 days). Discussion: It should be kept in mind that organic causes such as HD should be considered in children with history of delayed meconium passage in the anamnesis and if complaints have been present before the age of one year and in whom growth retardation is detected in theft examinations. In this way, late diagnosis, complications, unnecessary and costly tests and treatments can be prevented in the HD.Öğe Sirenomelia/mermaid syndrome without imperforate anus in a premature infant(Elsevier Science Bv, 2018) Atici, Ahmet; Celikkaya, Mehmet Emin; Arslan, Selda; El, Cigdem; Akcora, Bulent[Abstract Not Available]Öğe Successful Treatment of Major Abdominal Trauma in a 9-year-old Male due to Bomb Explosion(Editura Celsius, 2020) Atici, Ahmet; Ozkan, Mustafa; Celikkaya, Mehmet Emin; Akcora, BulentThe present case report describes a pediatric patient that sustained and survived major abdominal trauma due to an open-air explosion during the Syrian civil war. A 9-year-old male patient was brought to our hospital's paediatric emergency department after a bomb explosion that occurred 8 hours prior to presentation. The patient had a severe flap-like skin defect that extended from the below the umbilicus to the right femur. The defect was embedded with multiple stones, plastic, and soil fragments of varying size. Debridement of the anterior abdominal wall was performed, followed by exploratory laparotomy. Multiple sites of perforation of the small bowel were resected, and anastomosis was performed. Vacuum-assisted closure (VAC) was applied to the large wound area. The VAC dressing was changed every 3 days. Granulation tissue developed post-operatively after 26 days and the defect was repaired using skin grafts harvested from the patient's left leg. The patient was considered fully recovered and was discharged 34 clays post-surgery. The presented case shows that despite the severity of the patient's major abdominal injuries, rapid wound debridement, exploratory laparotomy, VAC therapy and a multidisciplinary approach are crucial in preventing death and achieving a full recovery.
