Prevalence of cryptorchidism, retractile testis and orchiopexy in school children.

OBJECTIVE: The aim of this study was to determine the prevalence of cryptorchidism, retractile testis and orchiopexy and investigate the effects of these clinical conditions on testicular volume among schoolchildren aged 7-12 years. METHODS: It was a cross-sectional and descriptive study. The participants were stratified by school population and age and 1,800 questionnaires were distributed. The inguino-scrotal examinations and the testicular volumes of the children were recorded. RESULTS: The parents of 1,500 children agreed to allow their children to be examined. The prevalence of cryptorchidism and orchiopexy was found to be 0.73 and 1.3%, respectively. Retractile testis was found in 3.9% of the children. The mean testicular volume of children having retractile testis (1.82 +/- 1.41 ml) was less than the ones who do not (2.38 +/- 1.40 ml, p < 0.05). The prevalence was 1.7%, and 4% in the participants who had inguinal hernia also had hernioplasty. CONCLUSIONS: The prevalence of cryptorchidism and the mean age of orchidopexy are high among schoolchildren aged 7-12. Retractile testis might have some negative effects on the development of testicular volume in children. Parents and healthcare and education professionals should give special attention to inguino-scrotal diseases.

Colon perforation due to pathologic aerophagia in an intellectually disabled child.

Aerophagia, characterized by symptoms related to repetitive swallowing of air, is a functional gastrointestinal disorder. In some cases, severe aerophagia causes massive bowel distention and leads to volvulus, ileus, and even intestinal necrosis and perforation. A 10-year-old intellectually disabled boy was referred to our unit due to severe abdominal distention, bilious vomiting, no passage of feces and flatus during the previous 3 days. He had experienced episodes of severe abdominal distention and flatulence over the past 2-3 years. In the exploratory laparotomy, two old colonic perforations were found. Splenic flexura resection and diverting colostomy were performed. Rectal biopsy showed ganglionic architecture. During the fifth postoperative month, he was admitted to the emergency unit with severe abdominal distention. During this visit, we observed him swallowing air. For this reason, his primary illness was diagnosed as a pathologic aerophagia. The colostomy was closed 11 months following the first operation. His parents did not accept gastrostomy as a desufflator. For this reason, they were taught nasogastric tube installation for gastric distention. Briefly, if abdominal distention increases during the course of the day and increased flatus is observed during sleep, aerophagia could be the primary pathology. If aerophagia could cause complications, gastrostomy should be applied. If the parents refuse gastrostomy, the parents could perform nasogastric tube drainage.

Factors associated with childhood constipation.

AIM: To evaluate factors associated with constipation, determine its risk factors and identify common methods of managing constipation among schoolchildren from ages 7-12 in Edirne, Turkey. METHODS: This was a cross-sectional and descriptive study and 1900 children were stratified by the school population, age and gender. The questionnaire collected information from parents about the prevalence of constipation and associated factors as well. It asked about bowel movements, socio-demographic data, personal and family stressors, parental concern about constipation, and treatment methods. RESULTS: The overall prevalence of constipation was 7.2%. It was 7.3% in boys and 7.2% in girls (P > 0.05). The parameters of siblings with health problems, constipation history in family members, abnormal oral habits, and little regular sporting activity were more common in constipated children than in non-constipated ones (P < 0.05). In the logistic regression analysis, never having used school toilets (OR: 5.9) and having problem to control their bowel after 2 years of age (OR: 3.1) were found to be major risk factors for constipation in schoolchildren ages 7-12 years. Constipated children had a lower consumption rate of fruits and vegetables and a higher consumption rate of milk-group foods, biscuits and macaroni than non-constipated children. Parental concern was at 90% and the rate of medical consultation was 23.2% for constipated children. CONCLUSIONS: The risk factors for childhood constipation may be genetic, psychological or organic. Bowel functions may be affected by dietary habits. Parents, health and education professionals should give special attention to childhood constipation.

Blunt chest trauma in childhood.

BACKGROUND: Although thoracic injuries are uncommon in children, their rate of morbidity and mortality is high. The aim of this study was to evaluate the clinical features of children with blunt chest injury and to investigate the predictive accuracy of their paediatric trauma scores (PTS). METHODS: Between September 1996 and September 2006, children with blunt thoracic trauma were evaluated retrospectively. Clinical features and PTS of the patients were recorded. RESULTS: There were 27 male and 17 female patients. The mean age was 7.1 +/- 3.4 years, and the mean PTS was 7.6 +/- 2.4. Nineteen cases were injuries caused by motor vehicle/pedestrian accidents, 11 motor vehicle accidents, 8 falls and 6 motor vehicle/bicycle or motorbike accidents. The following were noted: 28 pulmonary contusions, 12 pneumothoraxes, 10 haemothoraxes, 9 rib fractures, 7 haemopneumothoraxes, 5 clavicle fractures and 2 flail chests, 1 diaphragmatic rupture and 1 pneumatocele case. The cut-off value of PTS to discriminate mortality was found to be < or = 4, at which point sensitivity was 75.0% and specificity was 92.5%. Twenty-seven patients were treated non-operatively, 17 were treated with a tube thoracostomy and two were treated with a thoracotomy. Four patients who suffered head and abdominal injuries died (9.09%). CONCLUSION: Thoracic injuries in children expose a high mortality rate as a consequence of head or abdominal injuries. PTS may be helpful to identify mortality in children with blunt chest trauma. Blunt thoracic injuries in children can be treated with a non-operative approach and a tube thoracostomy.

[Diagnostic value of pediatric trauma score in blunt abdominal injuries]. / Pediatrik travma skorunun künt karin travmalarindaki tanisal degeri.

BACKGROUND: It was reported that pediatric trauma score (PTS) is an important tool for the initial assessment of injury severity and could help in the triage of injured children as well. The aim of this study is to investigate the prognostic value of PTS in blunt abdominal traumas. METHODS: Between 1997 and 2003, children with blunt abdominal trauma who treated in the Department of Pediatric Surgery, Trakya University Medical Faculty were evaluated with retrospective analysis. PTS was designated for each case. Individual morbidity and mortality were correlated with PTS. Data analysis were performed with Mann Whitney U test and ROC curve statistically. RESULTS: Seventy five patients were included in this study. The mean age of children was 7.5+/-4.2 years (10 months-15 years). Mechanisms of injury were as follows: automobile versus pedestrian 30, falls 18, motor vehicle crashes 14, bicycle accidents 7 and others 6. Forty two abdominal organ injuries were found.. PTS of the patients who had abdominal injuries were different statistically from others (p<0.05). On the ROC curve sensitivity and specificity were found as %74 and %12 respectively in those with PTS scores of 8. CONCLUSION: PTS was found to be of low sensitivity and specificity for blunt abdominal trauma patients.

Acute gastric volvulus due to deficiency of the gastrocolic ligament in a newborn.

UNLABELLED: Gastric volvulus is rare in the neonatal period. Only three cases of gastric volvulus due to deficiency of gastrocolic ligament have been reported until now in the literature. We describe a neonatal case due to absence of the gastrocolic ligament. Stamm gastrostomy was performed for fixation and there has been no recurrence of his symptoms during a 13-month post-operative period. CONCLUSION: Stamm gastrostomy is a viable treatment of gastric volvulus due to lack of the gastrocolic ligament.