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Öğe A Newborn With Esophageal Atresia, Tracheoesophageal Fistula and Feeding Problems(Trakya Üniversitesi, 2019) Mutlu, Arda Ulaş; Kızılkaya, Oğuz; İnan, MustafaAims: Esophageal atresia is the most common congenital malformation of the esophagus. It can be diagnosed in the prenatalperiod, during the delivery or at the neonatal intensive care unit. With the operation, the respiratory system and digestive tractare being corrected to the anatomic position. In this case, we wanted to emphasize that patients with esophageal atresia maycontinue to have functional problems even after successful surgical treatment. Case Report: After preterm delivery, a femalepatient was consulted to Trakya University Department of Pediatric Surgery, at one day of age with the symptom of regurgitationof saliva. There were no abnormalities on physical examination. Due to the inability to pass an orogastric tube to the stomach,esophageal atresia was suspected. Thus, radiocontrast x-ray study was performed: the proximal esophageal pouch was identified,and malformation was diagnosed. After the diagnosis, tracheoesophageal fistula has been ligated. The patient received physicaltherapy after the operation, and she was followed-up for 10 months. A full recovery was observed, and the patient was able toswallow food. Conclusion: Esophageal atresia with distal tracheoesophageal fistula is not an uncommon malformation. Thepatients can have problems with swallowing in their infancy even they are treated surgically in the neonatal period.Keywords: Esophageal atresia, tracheoesophageal fistula, newbornÖğe A Case Report: Gastroschisis(Trakya Üniversitesi, 2016) Yılmaz, Jülide; İnanç, İrem; İnan, MustafaAims: Anterior abdominal wall defects are one of the frequently encountered congenital anomalies. The prenatal diagnosis is important in terms of giving birth in optimal conditions. In this paper, it is aimed to report a case with gastroschisis operated in our hospital, also utilizing the current literature. Case Report: During the ultrasonography examination performed to the mother in the fourth month of pregnancy, followed up in Lüleburgaz Public Hospital regularly, an image associated with anterior abdominal wall defect was detected and prenatal diagnosis was established. Thereupon transferred to our center, the pregnancy of the patient was followed up cautiously and the baby was born at 38th week. The patient followed up after birth in the newborn intensive care unit, was operated in postnatal first day considering the diagnosis of gastroschisis. When the patient came for follow-ups at postoperative 1st and 3rd months, patient’s health was good. Conclusion: With our case it was aimed to emphasize the importance of delivering these babies before their 40th week by diagnosing them in their prenatal early period and transferring them to an experienced center regarding health of both mother and the baby.Öğe Hepatic hydatid cyst cases(2008) İnan, Mustafa; Başaran, Ümit Nusret; Aksu, Burhan[Abtract Not Available]Öğe Çocuklarda kasıkta ortaya çıkan ve yaşamı tehdit eden bir sorun: Boğulmuş fıtık(2007) İnan, Mustafa; Başaran, Ümit Nusret; Aksu, Burhan; Dereli, Murat; Dötdoğan, ZaferAmaç: Çocuklarda görülen en sık cerrahi hastalık kasık fıtıklarıdır ve %5-18 oranında boğulma riski taşır. Bu çalışmada bebek ve çocuklarda görülen boğulmuş kasık fıtığının klinik özellikleri incelendi. Hastalar ve Yöntemler: Ocak 1994-Haziran 2006 döneminde boğulmuş kasık fıtığı nedeniyle takip ve tedavi edilen 33 çocuk olgunun (30 erkek, 3 kız; ort. yaş 2; dağılım 20 gün-6 yaş) kayıtları geriye dönük olarak incelendi. Bulgular: Kasıkta şişlik (n=33), kusma (n=19) ve skrotumda krepitasyon (n=10) en sık görülen semptomlardı. Olgulardan 26'sında elle geri itme girişimi başarılı oldu ancak yedi olguda acil cerrahi girişim yapılması gerekti. Fıtık kesesinde en çok sıkışan organ ince bağırsaklardı (n=22). Olgulardan üçünde testis iskemisi, ikisinde ince bağırsak, birinde ise kalın bağırsak iskemisi gelişmişti. Boğulmuş kasık fıtığı nedeniyle iki hasta (%6.0) kaybedildi. Sonuç: Bölgemizde boğulmuş kasık fıtığı olgularının hastaneye getirilmesinin geciktirildiği düşüncesindeyiz. Çocuklarda kasık fıtığı görüldüğünde mümkün olan en kısa zamanda ameliyat edilmelidir. Böylece boğulmuş kasık fıtığının yol açtığı yaşamsal sorunlar ortadan kaldırılmış olacaktır.Öğe Comment on “Acquired Tracheoesophageal Fistula after Esophageal Atresia Repair”(2020) Akçaer, Vedat[Abtract Not Available]Öğe Damage control surgery in the light of a new paradigm: Damage control resuscitation(2012) İnan, MustafaEach year, 6 million people worldwide lose their lives due to serious injuries associated with major traumas. The most common cause of death among trauma patients is uncontrolled hemorrhage and associated coagulopahty. It is believed that 20 per cent of these individuals can be saved1. Damage control surgery is a life-saving treatment modality that emerged by mid-20th century and undergone various changes so far1-3. The damage control surgery consists of 5 steps. Initially, the patient triage must be performed properly. The second step takes place in the theatre. This first attempt must be completed within one hour at most. The temperature in the operation room must be at 26°C. All intravenous fluids should be warm. In this step, the aim would be to control hemorrhage, limit contamination and quickly re-close the surgical incision. During this instance, it is not recommended to execute definitive operation procedures for vessels, intestines or the liver. This means, it is not advisable to perform arterial grafting, vascular anastomosis or intestinal anastomosis. The abdomen must be cleaned, the vessels must be temporarily stitched, tied or pressured using balloon or tamp or shunting should be employed. Intestinal injuries should be temporarily bound and liver should be packed using pads. The abdomen must be closed as quickly and simply as possible. The third phase takes place in intensive care unit. Hypovolemia, acidbase equilibrium issues and coagulation should be tacked to stabilize the patient. The fourth phase entails definitive surgery. The fifth phase is the final step where the reconstruction and rehabilitation is conducted for all issues emerging during other phases2. From past to present, the treatment approach for trauma patient includes protocolized resuscitation, followed by application of damage control surgery and finalized by taking patient into intensive care unit. Stabilizing patients in the intensive care unit, the treatment continues with gradual operations. In fact, it is now recommended to implement damage control resuscitation and damage control surgery in conjunction with each other. According to this recent paradigm, the physician should act in consideration of the patient's physiological state, instead of managing the treatment by following pre-defined protocols. The patient's physiological state must be closely observed through real-time monitoring and the treatment plan must be designed in accordance. In short, damage control surgery and damage control resuscitation must be construed as a single concept2. The principle aim of this approach is to return the patient's body heat to optimal levels, to remedy circulatory issues and to prevent coagulopahty. In this way, patient's life will be saved from the vicious cycle or lethal triad (hypothermia, acidosis and coagulopathy). It is reported that majority of patients that receive this manner of treatment do not require further operation. In this way, even if the problems persist despite all treatment approaches, the surgical treatment applied to the patient will be more effective1-3. In this issue of our journal, we are introducing one of the recently published, significant books on wartime surgery, War Surgery: Field Manual. This book review that you can find in the following pages of our journal presents philosophical changes in the approach to trauma patients, as we expressed above. It is apparent that we are going through a period of fundamental changes in the surgical mentality, similar to the periods following the first and second world wars. Furthermore, some authors even go far as to believe that we are at the beginning of the end for damage control surgery that came under intense discussions during 70s and became popular during 80s3. Now, it is obvious that damage control resuscitation, integrated into damage control surgery, will be subject to further discussion. Hemostatic resuscitation is strongly highlighted both in civilian and military manuscripts and books. It should not be ignored the issues associated with coagulopahty becomes prominent in the treatment of traumatic patients and, unusual results may end up using artificial blood and blood products.
