Risk Factors and Outcome of Neonatal Pneumothorax in Tuzla Canton.

AIM: The aim of this study was to analyze risk factors and outcome of neonatal pneumothorax in Tuzla Canton. METHODS: Neonates with chest X-ray confirmed pneumothorax in University Clinical Center of Tuzla, within a three-year period, from January 2015 to December 2017, were retrospectively studied. Participants were evaluated for baseline characteristics, predisposing factors of neonatal pneumothorax, accompanying disorders and mortality. RESULTS: During the observed three-year period 11425 neonates were born in Tuzla Canton, with 7.33 % of preterm births, and 604 neonates were treated in NICU, with 265 neonates who required mechanical ventilation. Neonatal pneumothorax (NP) was diagnosed in 22 patients (9 term, 13 preterm), 12 (54.5%) were male. The incidence was 0.20% of total births, respectively 3.64% of those treated in NICU. The mean gestational age were 35.1 ± 3.0 weeks and birth weight 2 506.8 ± 727.7 grams. NP was mostly unilateral (72.7%) and right-sided. The most commonly associated diseases were: respiratory distress syndrome, intracranial haemorrhage, pneumonia, transient tachypnea and sepsis. In 8 (36.4%) neonates, the underlying cause of NP could be mechanical ventilation (secondary), whereas in 14 (63.6%) NP was spontaneous, without previous mechanical ventilation, although 11 of them required mechanical ventilation after pneumothorax. CONCLUSION: All perinatal risk factors were investigate, and significant differences in two observed groups related to mechanical ventilation were found for birth weight, gestational age, Caesarean section, length of mechanical ventilation, surfactant replacement therapy and outcome. Three (13.64%) neonates with NP died, and among risk factors with poor outcome, significant was only Apgar score in the first minute ≤ 5.

Risk factors for post-colectomy adhesive small bowel obstruction.

OBJECTIVE: The purpose of this study was to assess the risk factors for adhesive small bowel obstruction (SBO) following colectomy for colorectal cancer. PATIENTS AND METHODS: In this retrospective study we analyzed 284 patients who underwent surgery for colorectal cancer at the Department of Surgery University Clinical Center Tuzla in the period from 1st January 2009 until 31st December 2014. All patients underwent open colectomy. The length of follow up was from 6 months to 6 years (median follow up 3 years and 6 months). The study included all patients who underwent surgery due to colon cancer. The study excluded patients with postoperative small bowel obstruction after colon cancer surgery with different comorbidities. RESULTS: In the analyzed sample of 284 patients, a small bowel obstruction occurred in 13.7% patients after surgery for colon cancer. The highest correlation of risk factors and the occurrence of postoperative small bowel obstruction after colectomy for colorectal cancer in multivariate regression analysis was found to be for Tumor-Node-Metastasis ≥3 (or =3.680), and postoperative complications (or =30.683). CONCLUSIONS: Postoperative SBO have many causes, but in this study the highest risk factors were the Tumor-Node-Metastasis ≥3, and postoperative complications.

Cyst of the canal of nuck in a two year old girl.

The canal of Nuck is analogous to a patent processus vaginalis in a male, which normally loses its communication to the peritoneal cavity within the first year of life. Failure of obliteration of this tract can result in a hydrocele. We present a rare case of a 2-year-old girl with left-sided groin swelling, diagnosed as inguinal hernia. Patient underwent surgical exploration and establishes definitive diagnosis as cyst of the canal of Nuck.

Unilateral pulmonary agenesis and gastric duplication cyst: a rare association.

Lung agenesis and gastric duplication cysts are both rare congenital anomalies. Gastric duplication cysts can present with nausea, vomiting, hematemesis, or vague abdominal pain. Unilateral pulmonary agenesis can present with respiratory distress which usually occurs due to retention of bronchial secretions and inflammations. We report the unique case of right pulmonary agenesis associated with gastric duplication cyst.

Both-sided large abdominoscrotal hydrocele associated with testicles atrophy.

Abdominoscrtoal hydrocele is unusual condition with large scrotal hydrocele, which communicates through narrow inguinal channel with abdominal component. Abdominoscrotal hydrocele is not a benign condition, because complications such as acute appendicitis, testicular dismorphism, ureterohydronephrosis, paratesticular malignity have been described earlier. This case study describes one year old boy with both-sided abdominoscrotal hydrocele. Abdominal masses connected with hydrocele need to induce a suspicion of this condition. Early diagnosis and existing surgical techniques for treatment of this disorder are the key factors in prevention of complications associated to this disorder.

Angiosarcoma of the ovary in an 11 year old girl: case report and review of the literature.

Sarcomas of the female genital tract in general are rare and ovarian sarcomas comprise less than 1% of ovarian malignancies. In the literature there are 15 reported angiosarcomas of patients 21 year old and younger with no one originated in the ovary. We report a case of ovarian angiosarcoma in an 11 year old girl, presented with left side hip pain. MRI of abdomen and pelvis confirmed expansive solid and cystic mass occupied both ovaries. Imunohistochemistry staining was performed, CD34, Factor VIII, CD31, in order to confirm the diagnosis. Final diagnosis was angiosarcoma. The patient received 6 cycles of chemotherapy, according to the CWS-2002P protocol. 8 months after the diagnosis was established, there were no signs of any tumors according to the ultrasound, CT scan, and MRI. Although, extremely rare, angiosarcoma can also affect children and this diagnosis should be considered carefully in tumor with rich vascular network, necrosis and brisk mitotic activity.

Initial experiences with propranolol treatment of infantile hemangiomas: report of three cases.

Infantile hemangiomas (IH) are common benign tumors in infancy, affecting 5-10% of all infants and they can still cause disfigurement and serious complications depending on their location and size, which can be associated with ulcerations and haemorrhage. Since 2008, propranolol has become the first choice of therapy for complicated IH, compared to conventional approach with systemic corticosteroid therapy as first-line treatment and then interferon or vincristine as second- or third-line therapeutic agents. We report three cases of hemangioma, successfully treated with propranolol. Oral propranolol was given for a period of 6 months with monthly follow up. All cases showed dramatic response without any relapse after stopping the treatment. Propranolol is novel and safe medication for treatment of infantile hemangioma.