Person: KIYAN, GÜRSU
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KIYAN
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GÜRSU
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Publication Open Access Laparoscopic approach for removing a coin trapped in Meckel's diverticulum(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2017) KIYAN, GÜRSU; Karadeniz, Kivilcim; Kalyoncu, Aybegm; Erbarut, Ipek; Kiyan, Gursu; Dagli, Tolga EmrullahForeign body ingestion is a common problem in children. Most of these foreign bodies spontaneously pass through the gastrointestinal tract. When there is a persistent foreign body in the abdomen, it is impossible to make a diagnosis without exploration. We herein present the case of a child who was admitted to our hospital with a coin trapped in Meckel's diverticulum and our laparoscopic approach in this case. The diagnosis of Meckel's diverticulum should be considered when there is a prolonged lodgment of a foreign body in the right lower quadrant, and the laparoscopic approach is the preferred choice in these cases.Publication Open Access An unusual case of childhood sarcoidosis(SOC ARGENTINA PEDIATRIA, 2013-10-01) KARADAĞ, BÜLENT TANER; Gokdemir, Yasemin; Ersu, Refika; Karadag, Bulent; Karakoc, Fazilet; Kiyan, Gursu; Kaya, Handan; Kasapcopur, Ozgur; Erdem, Ela; Dagli, ElifSarcoidosis is a systemic granulomatous disease of unknown etiology that may affect many systems, mainly lungs. Most of the patients present at stages I and II lung involvement. Pulmonary infiltrates without hilar lymphadenopathy (state III) rarely occurs. Extrapulmonary organ involvement is common in pediatric sarcoidosis. The aim of this report is to present an unusual case of childhood sarcoidosis with stage III lung involvement without any extrapulmonary organ involvement. A 7-year-old girl presented with the complaints of malaise, fatigue, weight loss and dyspnea. There was patchy, bilateral ground glass view at high resolution computer tomography. Video assisted thoracoscopic lung biopsy was performed and histopathological examination showed nonnecrotising epitheloid-cell granulomas with giant cells. She did not have any hilar or extrapulmonary organ involvement and pulmonary sarcoidosis at stage III was diagnosed. Sarcoidosis should be considered in the differential diagnosis of children with interstitial lung disease.Publication Metadata only Horner's Syndrome as a rare complication of tube thoracostomy: Case reports and review of literature(W B SAUNDERS CO-ELSEVIER INC, 2013) KIYAN, GÜRSU; Thomas, David Terence; Dagli, Tolga E.; Kiyan, GursuHorner's Syndrome (HS), caused by the interruption of the oculosympathetic pathway, is a rare yet morbid complication of tube thoracostomy. However, literature regarding HS secondary to tube thoracostomy is limited to case reports, with little comprehensive information available. We report two cases and review all cases from the published literature to assess the outcome of this complication. HS secondary to tube thoracostomy leaves sequelae in 45.8% of patients. Immediate removal or repositioning of the tube does not affect prognosis. Therefore, precautions must be taken to avoid this complication. (c) 2013 Elsevier Inc. All rights reserved.Publication Open Access Catheter-related Saccharomyces cerevisiae Fungemia Following Saccharomyces boulardii Probiotic Treatment: In a child in intensive care unit and review of the literature(2017-03) KIYAN, GÜRSU; Atıcı, Serkan; Soysal, Ahmet; Karadeniz Cerit, Kıvılcım; Yılmaz, Şerife; Aksu, Burak; Kıyan, Gürsu; Bakır, MustafaPublication Open Access Making decisions for surgical intervention in neonates with necrotizing enterocolitis and the selection of appropriate surgical intervention(MARMARA UNIV, FAC MEDICINE, 2017-01-15) MEMİŞOĞLU, ASLI; Karadeniz Cerit, Kivilcim; Ergelen, Rabia; Abdullayev, Tural; Unkar, Zeynep Alp; Memisoglu, Asli; Kiyan, Gursu; Dagli, E. TolgaObjective: Necrotizing enterocolitis (NEC) is one of the most common conditions requiring surgical intervention in the neonatal period. The decision for surgical intervention in NEC is difficult and the surgical procedures differ according to the condition of the patient. This study assesses the decision for surgical intervention in patients being followed with a preliminary diagnosis of NEC and the appropriate surgical procedure. Material and Method: The files of patients undergoing surgery with a diagnosis of NEC at the Marmara University Hospital Neonatal Intensive Care Unit between 15.07.2013-15.07.2015 were studied retrospectively. Patients were evaluated for the following: gestational age, birth weight, gender, time of onset of symptoms, abdominal distention, tenderness, presence of abdominal erythema, hypotension, acidosis, thrombocytopenia, radiological findings, surgical timing and post-operative follow up. Results: A total of 10 neonates (7 boys, 3 girls) were treated surgically with an NEC diagnosis. The average gestational age of the patients was 27.6 weeks (22-37 weeks), and the median birth weight was 710 grams (400-3750). Average onset of symptoms was found to be 8.1 days (2-30) postnatally. Abdominal distention and tenderness (10), hypotension (4), and abdominal erythema (3) were observed in patients upon physical examination. Acidosis (7) and thrombocytopenia (6) were observed in patients in laboratory findings. Free fluid (4), thickening of the intestinal wall ans (3), pneumatosis intestinalis (1), portal venous gas (1) were observed in patients during the assessment of the abdominal ultrasonography (US). Three patients whose direct x-ray evaluations were grade III underwent peritoneal drainage. The drain site of one of these patients closed by itself, and there was no need for further surgery for the patient. Laparotomy was carried out a day after clinical stabilization was achieved. Our third patient, the lowest birth weight in our series, was lost immediately following the peritoneal drainage process. Peritoneal drainage was planned in two other grade III patients based on the radiological findings. However, due to the appearance of necrotic bowel segments from the incision site, they underwent bowel resection and ileostomy during a bedside laparotomy. One of these patients improved clinically, but the other patient was lost in the early stages. Due to the deterioration seen in the clinical findings of 5 patients who were radiologically grade II, the decision for laparotomy was made initially. All of these 5 patients were discharged after an uneventful postoperative period. Conclusion: In patients who are grade II radiologically, the decision for surgical intervention in an operating room can be made according to clinical deterioration. In infants who are grade III, and whose clinical condition is poor, bedside surgical intervention in the neonatal intensive care unit is preferable..Publication Metadata only Post-traumatic stress disorder in mothers of children who have undergone cancer surgery(WILEY, 2017) TOKUÇ, AYŞE GÜLNUR; Cerit, Kivilcim Karadeniz; Cerit, Cem; Nart, Omer; Eker, Nursah; Kiyan, Gursu; Dagli, Tolga; Ekingen, Gulsen; Tokuc, Gulnur; Karaca, Omer; Corapcioglu, FundaBackgroundThe aim of this study was to investigate the rate of post-traumatic stress disorder (PTSD) and associated risk factors among mothers of children who underwent cancer surgery. MethodThis cross-sectional, multi-center study included a total of 60 mothers whose children underwent major thoraco-abdominal surgery and were under follow up in the outpatient setting between February 2016 and May 2016. Clinical Data Form, Hospital Anxiety and Depression Scale (HADS), and Clinician-Administered PTSD scale were used. ResultsOf all participants, 13 (21.7%) were diagnosed with PTSD. These mothers had shorter duration of marriage, longer duration of hospital stay after surgery, and higher HADS scores, compared with the others without PTSD. Thoughts of guilt such as I am being punished or tested were more frequent in mothers with PTSD. Insomnia, irritability, concentration problems, and psychological reactivity were the most common symptoms. ConclusionPost-traumatic stress disorder is a severe disorder that may worsen the daily functioning of mothers and may also have an unfavorable effect on child. It is therefore of utmost importance for clinicians to recognize PTSD and the associated risk factors in order to guide these parents.Publication Open Access The effectiveness of non-operative treatment in high-grade liver and spleen injury in children(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2018) KIYAN, GÜRSU; Cerit, Kivilcim Karadeniz; Ergelen, Rabia; Abdullayev, Tural; Tugtepe, Halil; Dagli, Tolga Emrullah; Kiyan, GursuBACKGROUND: Although a nonoperative treatment approach is preferred for blunt liver and spleen trauma in childhood, there are significant differences between clinics in the algorithms used. The approach to high-grade liver and spleen injury is still controversial, particularly as grade V liver and spleen injuries are not included in the American Pediatric Surgical Association guideline. The aim of this study was to present experience with a non-operative treatment approach to children with high-grade liver and spleen injuries. METHODS: Pediatric patients who were referred to Marmara University Hospital's emergency department between January 2012 and January 2017 due to liver and spleen injury related to blunt abdominal trauma and who were followed up in the clinic were included in the study. The data were analyzed retrospectively in terms of age, sex, type of trauma, degree of organ damage, accompanying organ damage, duration of intensive care unit (ICU) and hospital stay, need for transfusion, and treatment method (operative-nonoperative). Grade I, II, or III organ damage was classified as low-grade, while grade IV and V organ lesions were classified as high-grade. RESULTS: Of 2800 patients who were diagnosed by radiological imaging with liver and spleen injuries due to blunt abdominal trauma and hospitalized in the clinic, 88 were included in the study. Isolated liver injury was determined in 41 patients, while 39 had an isolated spleen injury, and 8 had injuries to both organs. An accompanying organ injury was observed in 30 (34%) patients. In all, 83 (94%) patients underwent non-operative treatment and a surgical approach was required for 5 patients (6%). Patients with high-grade liver injury had a significantly longer period of hospitalization, duration of ICU stay, and greater transfusion requirement, compared with patients with low-grade liver injury (p=0.001, 0.001, and <0.001, respectively). A surgical approach was more common among patients with a high-grade liver injury than for patients with a low-grade injury (p=0.045). There was no significant difference between patients with a high- or low-grade spleen injury in terms of age, sex, duration of hospitalization, duration of ICU stay, transfusion requirement, or accompanying organ injury (p=0.254, 0.739, 0.114, 0.135, 0.057, 0.721, respectively). Similarly, there was no significant difference in terms of non-surgical or surgical treatment approach between the patients with high-grade spleen injury and those with low-grade spleen injury (p=0.488). CONCLUSION: Non-operative treatment is a feasible treatment method in pediatric patients with a high-grade blunt liver or spleen injury. Nonetheless, pediatric surgeons should bear in mind that patients with high-grade liver damage may require more surgical treatment.Publication Open Access An adolescent with idiopathic pleuroparenchymal fibroelastosis. Case report(SOC ARGENTINA PEDIATRIA, 2018-02-01) KARADAĞ, BÜLENT TANER; Atag, Emine; Ikizoglu, Nilay Bas; Gokdemir, Yasemin; Eralp, Ela Erdem; Kiyan, Gursu; Yilmazbayhan, Dilek; Karadag, BulentIdiopathic pleuroparenchymal fibroelastosis (IPPFE) is a rare disorder recently included in rare idiopathic interstitial pneumonias according to the updated American Thoracic Society/European Respiratory Society classification. IPPFE is characterized by pleural and subpleural parenchymal fibrosis causing volume loss predominantly in the upper lung lobes. Age of onset is variable, IPPFE mainly occurs in third and fourth decades. We present a 16 year old patient with a 2-year history of exertional dyspnea, nonproductive cough and weight loss. On physical examination, auscultation revealed diminished breath sounds on the upper lobes. Chest radiograph showed apical pleural thickening and volume loss. Computerized tomographic scan (CT) of chest revealed ground glass densities and tubular bronchiectasis predominantly in upper lobes bilaterally, with interlobular septal thickening of the pleura and enlarged mediastinal lymph nodes. Thoracoscopic lung biopsy was performed and histological evaluation showed subpleural fibrosis and elastic staining demonstrated fragmented elastic fiber deposition in the subpleural area and adjacent pulmonary parenchyma suggesting IPPFE. To our knowledge this is the first case in childhood. Therefore, pediatricians should be aware of this disease for the diagnosis and appropriate management.Publication Metadata only Diaphragmatic paralysis after pediatric heart surgery: Usefulness of non-invasive ventilation(ELSEVIER IRELAND LTD, 2010) KARADAĞ, BÜLENT TANER; Oktem, Sedat; Cakir, Erkan; Uyan, Zeynep Seda; Karadag, Bulent; Hamutcu, Refika Ersu; Kiyan, Gursu; Akalin, Figen; Karakoc, Fazilet; Dagli, ElifDiaphragmatic paralysis after cardiac surgery is an important complication especially in infants. We report a child who developed diaphragmatic paralysis, atelectasis, bronchomalasia and respiratory failure following cardiac surgery. Ventilatory support alleviated respiratory distress in this child. This report illustrates the usefulness of invasive and non-invasive ventilatory support for a pediatric patient with diaphragmatic paralysis. (C) 2010 Elsevier Ireland Ltd. All rights reserved.