Browsing by Author "Bilici, S."

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Association of Down Syndrome and Morgagni Hernia
(Medecine Et Hygiene, 2014) Taskin, G. Alpaslan; Tuncer, O.; Demir, N.; Bilici, S.; Aktar, F.; Peker, E.; Uner, A.
Chronic Intussusception in Childhood: Report of Four Cases
(2001) Bakan, V.; Köseoǧlu, B.; Önem, Ö.; Bilici, S.; Demirtaş, I.
Intussusception is a frequent cause of bowel obstruction in infants and toddlers. Correct diagnosis in majority of the patient with acute intussusception is made by typical presentation and symptoms. However, atypical presentation and chronic symptoms may cause delay in diagnosis of chronic intussusception. Four cases of chronic intussusception are reported. There was no leading point in patients and they had mobile colon or poor fixation of colon. A typical presentation and diagnostic delay in chronic intussusception are argued.
Closure of Large Myelomeningocele Defects Using Dorsal Intercostal Artery Perforator Flap
(2011) Isik, D.; Tekes, L.; Eseoglu, M.; Isik, Y.; Bilici, S.; Atik, B.
Small meningomylocele defects can be closed primarily. Other repair techniques are required for closure of meningomyelocele defects of >5 cm. In this anomaly, in which random or musculocutaneous flaps are usually used, the technique for skin defect closure should have the following criteria: a safely harvested flap with good blood supply; minimal morbidity in the donor site; closure with adequate thickness to protect the underlying neural structure; and a repair to prevent leakage of cerebrospinal fluid. The dorsal intercostal artery perforator flap is a new perforator flap with a large skin island that can be used safely in the dorsal region. In this article, repair of large skin defects due to myelomeningocele has been attempted using a dorsal intercostal artery perforator flap, and the results are discussed. Copyright © 2011 by Lippincott Williams & Wilkins.
Congenital Duodenal Obstruction: Ten-Year Results of a Tertiary Center
(Yuzuncu Yil Universitesi Tip Fakultesi, 2018) Avci, V.; Bilici, S.; Düz, E.; Beger, B.; Değer, İ.
The most common place of gastrointestinal obstruction in the newborn is duodenum. In this study, we aimed to present our 10 years of experience about patients that diagnosed with congenital duodenal obstruction by the guidence of literature. Between 2008 and 2017, patients who underwent surgery for congenital duodenal obstruction were evaluated retrospectively in terms of age, gender, birth weight, symptom-findings, additional congenital anomalies, treatment modalities, postoperative complications, average length of hospitalization and morbidity-mortality. A total of 32 patients (18 male, 14 female) with congenital duodenal obstruction were included in the study. The mean birth weight of the patients was 1920 ± 1130 grams. Vomiting (75%) was the most common symptom. Surgical intervention was performed with an average of two days; the most prefered (59%) method was duodenodeudenostomy. The most common complication after surgery was wound infections (22%). 50% of the patients had additional congenital anomalies. Down syndrome was the most common one. Two patients died due to sepsis. The average length of hospitalization was 14 ± 5 days. For a good outcome in congenital duodenal obstruction, the tips of early diagnosis and treatment should be known. © 2018, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Crossed Testicular Ectopia: Report of Six Cases
(Medknow Publications, 2014) Akin, M.; Erginel, B.; Bilici, S.; Gedik, S.; Yildiz, A.; Karadaǧ, C.A.; Dokucu, A.I.
Crossed testicular ectopia or transverse testicular ectopia is an extremely rare anomaly characterised by migration of one testis towards the opposite inguinal canal, usually associated with unilateral inguinal hernia. This report describes six cases of crossed ectopic testes, one of the largest series, and with unusual clinical histories. © 2014 African Journal of Paediatric Surgery. All rights reserved.
The Effectiveness of Extracorporeal Shock Wave Lithotripsy in the Treatment of Ureteral Stones in Children
(verduci Publisher, 2012) Pirincci, N.; Gecit, I.; Bilici, S.; Taken, K.; Tanik, S.; Ceylan, K.
PURPOSE: In our study, we evaluated retrospectively the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of ureteral stones in children. MATERIALS AND METHODS: Between the dates of 2005-2010, 62 children who were applied ESWL due to the ureteral stone in our Clinic and consisted of 42 males and 20 girls whose mean age was 6.6 +/- 3.1 were evaluated. 31(50%) of the patients were upper ureteral stone, 10 (16.1%) of them were middle ureteral stone and 21(33.9%) of them were lower ureteral stone. The sizes of the stones were 4 to 17 mm, the average was 7.1 mm. ESWL was performed in the supine position for upper ureteral stones, in the supine/prone position for middle and lower ureteral stones. RESULTS: Stone-free rate was determined as 93.5% in three-month follow-up of the patients. Re-treatment was done at 14.5% of the patients. The implementation of ESWL was ended unsuccessfully at 4 children (6.5%). A significant difference was not detected between three-month stone-free rates in terms of the size of the stones and location. There was not any serious complication at any of the patients. CONCLUSIONS: According to these findings ESWL with its high stone-free rates and negligible complications is the first method to be refered in the treatment of ureteral stones in children.
An Interesting Coexistence of Patau Syndrome; Spigelian Hernia and Undescended Testes
(Medecine Et Hygiene, 2014) Demir, N.; Tuncer, O.; Peker, E.; Bilici, S.; Yavuz, A.
Management and Treatment of Foreign Bodies Ingestion in Childhood
(2011) Melek, M.; Cobanoglu, U.; Bilici, S.; Beger, B.; Kizilyidiz, B.S.; Melek, Y.
Ingestion of foreign bodies (FBs) is a significant problem that causes morbidity and mortality in childhood. The aim of this retrospective study was to report our experience of foreign body ingestion in pediatric patients. The medical records of 165 patients who were hospitalized for foreign body (FB) ingestion in pediatric and chest surgery departments between 2005 and January 2010 were evaluated retrospectively. X-ray films and abdominal ultrasound scan were used for the diagnostic approach of the patients. The common complaints were odynophagia-dysphagia (n=107), hypersalivation (n=81), cough (n=21), vomitting (n=20) and asymptomatic in 34 patients. Radiological examinations showed that FB was located in the esophagus in 81.2% (n=134) of the patients, in the stomach of 6.74% (n=11) patients, in the intestinal segments in 10.4% (n=17), in the rectum in 1.21% (n=2) and in the liver parenchyma 0.6% (n=1) patients. Endoscopic examination performed in 134 (81.2%), FB proceeded uneventfully in 23 (13.9%) in follow up period and 8 (4.8%) patients underwent surgery. The type of ingested FB varied widely. The coins (n=54, 32.7%) and pieces of plastic toys (n=29, 17.5%) were the most frequently ingested FBs. Foreign body ingestion is a major problem in childhood. Management depends on carefully and close follow up for complications and favorable treatment choice.
Mean Platelet Volume in Diagnosis of Acute Appendicitis in Children
(Makerere Univ, Fac Med, 2011) Bilici, S.; Sekmenli, T.; Goksu, M.; Melek, M.; Avci, V
Background: The clinical diagnosis of acute appendicitis (AA) in children is still problematic in status. Objectives: To investigate the diagnostic value of mean platelet volume (MPV) in acute AA at childhood. Methods: One hundred patients diagnosed as AA patients and 100 healthy individuals. Laboratory tests were studied in the hematology laboratory of the hospital. Results: The MPV was found to be lower than normal in 48 cases in the AA group, and it was normal or higher than normal in 52 cases. In the control group, while MPV was found to be lower than normal in 13 cases, it was normal or higher than normal in 87 cases. The MPV was significantly lower in the AA group compared to the control group (p<0.001). Conclusion: Our study indicated that MPV significantly decreased in pediatric AA patients. Hence, we believe that taking the MPV decrease into consideration along with the White Blood Cell Count elevation would be beneficial in patients with suspicion of AA.
New Suggestions for Correction of the Severe Hypospadias Complications
(Turkish Society of Plastic Reconstructive, and Aesthetic Surgery, 2015) Işik, D.; Bilici, S.; Canbaz, Y.; Gecit, I.; Yüce, S.; Atik, B.
Background: Severe hypospadias complications are defined as large urethral fistulae, chordee recurrence, and severe scar or skin defect limiting urethral reconstruction from the penis skin, and complications persisting in spite of multiple operations. In this study, new flap techniques applied on six patients with severe hypospadias complications have been introduced. Methods: The 6 patients with hypospadias surgery complicationsand a mean age of 15.5 years, had undergone hypospadias repair operations an average of 4.5 times. Four cases had undergone repair using the Kutlay technique, one was repaired by island-formed penile skin flap, and the remaining case was repaired using a groin flap prefabricated by skin graft. Results: In one of the patients, meatal stenosis was found in the first postoperative month. It was treated by continuous and intermittent urethral catheterization. In another patient, purulent drainage was observed secondary to postoperative soft tissue infection. A 0.2 cm urethra-cutaneous fistula was observed on the subcoronal region in the postoperative sixth month in this patient. Other patients had no chordee recurrence, fistula, urethral stenosis or other complications. Conclusions: In patients with severe hypospadias complications, case-specific and reliable treatment options that may repair each component of the deformity should be used. As the severity of the deformity increases, more complicated and multiple-session techniques may be preferred for treatment.
Oxidative Stress and Antioxidant Enzyme Activities in Newborns With Oesophageal Atresia and Their Mothers
(Sage Publications Ltd, 2012) Melek, M.; Demir, H.; Bilici, S.; Beger, B.; Cobanoglu, U.; Meral, I.; Ozmen, E.
OBJECTIVE: To measure the oxidant/antioxidant status of newborn babies with oesophageal atresia and their mothers, compared with healthy control subjects. METHODS: This case control study included 40 participants: 10 newborns with oesophageal atresia and their mothers, and 10 healthy newborns and their mothers. Whole blood malondialdehyde (MDA) levels and the activities of antioxidant enzymes (catalase, carbonic anhydrase [CA], glucose-6-phosphate dehydrogenase [G-6-PD], and superoxide dismutase [SOD]) were measured. RESULTS: MDA levels and CA activity were significantly higher, and catalase, SOD and G-6-PD activities were significantly lower, in newborns with oesophageal atresia and their mothers than in healthy newborns and their mothers. Although CA activity was similar between the newborns and mothers in the patient group, it was significantly lower in newborns than in mothers in the healthy group. CONCLUSIONS: Increased lipid peroxidation might play an important role in the pathogenesis of oesophageal atresia. Impairment of the free radical/antioxidant balance may lead to increased free radical and decreased antioxidant levels in oesophageal atresia.
A Rare Cause of Jaundice in a Case: Hydatid Cyst Infestation
(Yuzuncu Yil Universitesi Tip Fakultesi, 2016) Demirören, K.; Ağengin, K.; Avcı, V.; Bilici, S.
Although the most common cause of obstructive jaundice is viral infections, there are some rare disorders which can cause this picture. We present a 15-year-old girl, admitted with an obstructive jaundice. Her laboratory tests including viral infections were normal. The diagnosis of hydatid cyst was performed with both ultrasonography and indirect hemagglutination assay. The patient was operated on and hydatid cyst was seen to be ruptured into the choledochus. In conclusion, nonviral causes of hepatitis are less common, but must be considered in the differential diagnosis. An important complication of hydatid disease is rupture to biliary tree. This situation may cause obstructive jaundice. © 2016, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Should Ureteroscopy Be Considered as the First Choice for Proximal Ureter Stones of Children
(verduci Publisher, 2013) Gecit, I.; Pirincci, N.; Gunes, M.; Bilici, S.; Taken, K.; Goktas, U.; Ceylan, K.
OBJECTIVES: In this study, we aimed to analyze the ureter stones that had been treated using rigid ureteroscopy and pneumatic lithotripsy without mechanically dilating the ureteral orifice. PATIENTS AND METHODS: Records of 110 patients who had undergone rigid ureteroscopy and pneumatic lithotripsy due to ureteral stone between February 2005 and May 2011 were retrospectively analyzed. The location and size of the stone and additional anomalies in the urinary tract on the preoperative direct urinary system (DUS) X-Ray, urinary system ultrasonography (USG), intravenous pyelography (IVP) if performed, and computed tomography (CT), were found from the records of the patients. RESULTS: The mean age of the patients was 5.2 (range 1-17 years). 74 (67.2%) of the patients were males and 36 (32.8%) were females. A total of 115 rigid ureteroscopies were performed on 110 patients. 72 (65%) of the stones were located in the lower ureter, 21 (19%) were located in the middle part of the ureter, and 17 (15.4%) were located in the upper ureter. The mean stone size was determined as 7.5 mm (range 5-15). The mean stone size was determined as 7.4 mm in the lower ureter, as 8.3 mm in the middle ureter, and 8.4 mm in the upper ureter. No difference was found between the sizes of the stones in different locations (p = 0.121). The stone free rate was found as 92.2% for all ureteral stones. The total stone free rate according to the location of the stones was determined as 79.2% in the upper ureter, as 94.4% in the middle ureter and 93,8% in the lower ureter (p = 0.022). The total complication rate was 7.6%. Complication rates were 7.2%, 4.1% and 10.7% for the lower, middle and upper ureter, respectively (p = 0.411) (Table I). No difference was found in terms of complication rates according to location of the stone in the ureter. No major perioperative or postoperative complications developed. A double J stent was inserted in 36 (32%) patients for 2-3 weeks. CONCLUSIONS: We suggest that rigid ureteroscopy may be considered as the first choice for treatment of not only distal-middle ureter stones, but also for proximal ureter stones.
Surgical Treatment of Right Middle Lobe Syndrome in Children
(Wolters Kluwer Medknow Publications, 2012) Sehitogullari, A.; Sayir, F.; Cobanoglu, U.; Bilici, S.
Objective: Right middle lobe syndrome is a rare entity in children, causing high morbidity. Our experience of these patients including their clinical and laboratory characteristics, indications forsurgical management, postoperative courses, and follow-up results was evaluated. Methods: A retrospective analysis was performed involving 20 children with right middle lobe syndrome who were hospitalized and treated with surgical resection of the right middle lobe in Van Training and Research Hospital and Yuzuncuyil university hospital, Turkey, between January 2002 and January 2011. Results: The mean age of the patients was 10.5 years (range, 5 to 15 years). Twelve patients were boys and eight were girls. The most frequent symptom was chronic cough (75). Hemoptysis was present in two (10) patients. One patient was being treated for asthma. 25 positive cultures were identified among the patients. Streptococcus pneumoniae was the most frequently identified agent in sputum. All patients underwent chest computed tomography. There were bronchiectasis in 11 (55) patients, atelectasis and bronchiectasis in five (25) patients, and destroyed lung in four (20) patients. A narrowed middle lobe bronchus was shown in 15 (75) patients. Bronchoscopy was performed in 18 (90) patients. Stenosis due to external compression was seen in 12 (60) patients, hyperemia and bronchitis in two (10) patients, granulation tissue in two (10) patients, and dense secretions in two (10) patients. A history of doctor-diagnosed tuberculosis was present in two (10) patients. These patients had completed antituberculous treatment. The patients had been symptomatic for the last 1 to 10 years (mean, 4 years) and had received several medical treatments. All patients (totally 20 patients) underwent right middle lobe resection. In one patient, a bronchial abnormality was found intraoperatively. One patient died on postoperative day 10 due to a brain abscess. Three other patients had postoperative complications (15). Mean duration of follow-up of the patients was 4.5 years (range, 2 months to 12 years). Seventeen patients were asymptomatic, and two patients had improved. Conclusions: Children with right middle lobe syndrome unresponsive to medical treatment should undergo early lobe resection to avoid serious complications and the progression of the disease to other segments or lobes.
Uretherorenoscopic Stone Therapy in Children: Our 5 Years of Experience
(Elsevier Science Bv, 2010) Gecit, I; Pirincci, N.; Taken, K.; Bilici, S.; Goktas, U.; Tanik, S.; Ceylan, K.
The Use of Phosphate Enema in the Treatment of Short Segment Intussusception Cases
(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Bilici, S.; Avci, V.
In the treatment of intussusception wide variety of surgical and non-surgical treatment modalities have been applied so far. Nowadays, it is usually treated with hydrostatic and pneumatic reduction. In this study, the reduction of short segment intussusception by using phosphate enema was used as a practical method which was not previously reported. We retrospectively reviewed the cases of intussusception that is named reduction by p hosphate enema applied by rectal administration in the pediatric surgery department. 88 patients were included in the study. Monobasic sodium phosphate + dibasic sodium phosphate containing 67.5 ml solution (Fleet Enema®) or Sodium Dihydrogenphosphate 3,5 gr + Disodium Hydrogenphosphate containing 67.5 ml solution (BT® Enema) was administered rectally in one shot. After defecation, the patients were reevaluated with ultrasonography. The procedure was successful in 80 cases. Eight cases in which the procedure was unsuccessful were treated by ultrasound guided hydrostatic reduction. During childhood, short segment intussusception cases can be managed successfully with phosphate enema, it is easy to apply and a practical treatment. We believe that this approach would be an acceptable treatment when it is validated with larger scale studies. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.