Browsing by Author "Mir E."
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Item Primary Duhamel-Martin operations in neonates and infants(2001) Mir E.; Karaca I.; Günsar C.; Sencan A.; Fesçekoǧlu O.Background: With advances in neonatal anesthetic and surgical care, a safe, one stage, definitive procedure has been possible in Hirschsprung's disease. Since 1996, we have performed this type of operation in the neonatal and early infancy period. We aimed to review our data to state the feasibility of this operation in these age groups. Methods: At Dr Behçet Uz Children's Hospital, we treated 10 patients with a single stage Duhamel-Martin operation between 1996 and 2000. Of the 10 patients, seven were boys. Six patients were diagnosed in the first week of the neonatal period. We evaluated these 10 patients by means of age, sex, age at diagnoses, operational age, diagnostic tools, properties of operation, complications and results. Results: The patients were all full-term delivery and had a mean birthweight of 3 kg. The presenting clinical features were abdominal distention (100%), constipation (100%) and vomiting (70%). One patient was a Down syndrome patient, while another patient showed familial Hirschsprung's disease. Contrast enemas gave positive results in eight patients. Definitive diagnoses were performed with rectal biopsy specimens. The extension of the disease was rectosigmoid in nine patients and descending colon in one patient. Five patients were in the newborn period at the time of the operation, while the oldest one was 7 months old. In the postoperative period, two children were treated because of early abdominal eventration and evisceration of the wound. Postoperative enterocolitis occurred in two patients. These 10 patients have been followed-up for a period of 3 years, and spontaneous defecation and weight gain was observed in all of the patients. Conclusions: Our study confirmed the published data that this operation could be performed as an easy and safe procedure in the neonatal and early infancy period.Item Pyloric atresia associated with multiple intestinal atresias and pylorocholedochal fistula(W.B. Saunders, 2002) Sencan A.; Mir E.; Karaca I.; Gunsar C.; Sencan A.; Topcu K.Although congenital pyloric atresia commonly occurs in isolation, it has rarely been reported in association with other alimentary tract atresias. This is a report of a newborn with congenital pyloric atresia associated with duodenal atresia, jejunal atresia, apple-peel ileal atresia, and pylorocholedochal fistula. Preoperative diagnosis was duodenal atresia because of bilious vomiting, and erect radiogram showed double bubble sign. The presented case is the first report of such an association. Copyright 2002, Elsevier Science (USA). All rights reserved.Item Isolated esophageal atresia with spontaneous recanalization: Case report(W.B. Saunders, 2002) Gunsar C.; Sencan A.; Karaca I.; Mir E.Isolated esophageal atresia is characterized by a long segment between the 2 esophageal pouches. The authors describe a case of pure esophageal atresia that showed spontaneous recanalization in the waiting period for primary esophageal anastomosis. Regurgitation of gastrostomy formula surprisingly was seen in her mouth. The patency of the esophagus was confirmed with thoracic computed tomography (CT) and an esophagogram. A strictured area in the proximal upper third of the esophagus was managed with baloon dilatation. She was discharged in normal condition, feeding by mouth, and with a normal esophagogram. This interesting event led us to speculate about a different type of pure esophageal atresia with the feasibility of the ends recanalizing after some events such as inflammation. This could be the subtype 115 of type 2 in Kluth's atlas of esophageal atresia in which they described 2 blind esophageal ends and a cyst occupying the intervening space. Another speculation about this subject is the presence of double membranes associated with esophageal atresia with a normal outer appearance of the esophagus as was first described by A. F. van Loosbroek. Copyright 2002, Elsevier Science (USA). All rights reserved.Item Does ileal reverse segment in rats with short bowel syndrome change intestinal morphology?(2002) Şencan A.; Akçora B.; Mir E.; Şencan A.; Günar C.; Arslan O.; Özer E.Background: The primary goal of surgical therapy for short bowel syndrome is to increase intestinal absorptive capacity. Many surgical procedures have been described for this purpose. One of these is ileal reverse-segment procedure. This procedure after massive small-bowel resection is an alternative way to treat short bowel syndrome, but how it affects intestinal morphology in short bowel syndrome has not been investigated. The aim of this study is to investigate macroscopic and microscopic effects of reverse-segment procedure on the short bowel. Methods: Twenty rats underwent resection of 80% of the small bowel. The rats were separated into two groups (n = 10). In the first group (reverse group), a reverse segment was formed by twisting a 2-cm ileal segment 180°, without damaging its vascularity. In the second group (control group), a 2-cm ileal segment was resected, preserving its mesentery, and end-to-end anastomosis was performed to maintain the intestinal passage. The segment was not twisted 180°. The 2-cm proximal (jejunal) and distal (ileal) segments of the resected bowel were reserved for histologic investigation. Two months later, the rats were killed and the jejunal and ileal segments were evaluated morphologically. Results: In the reverse group, body weight and total intestinal length significantly increased (14% more than in the control group). The diameter of both proximal (jejunal) and distal (ileal) segments in the reverse group also increased 53.8% and 22.8%, respectively (P < 0.05). Histologically, crypt depth and villus height of the ileal segment in the reverse group increased 15.2% and 18.2% more than in the control group (P < 0.05). No histologic change was observed at the jejunal level except for intestinal muscle thickness. Conclusions: Ileal reverse-segment procedure in rats with short bowel syndrome 1) does not cause intestinal obstruction, 2) increases total bowel length and body weight, 3) increases the diameter of both jejunal and ileal segments, and 4) increases villus height and crypt depth only at the ileal level. For this reason, reverse-segment procedure positively affects intestinal adaptation. ©2002 Lippincott Williams & Wilkins, Inc.Item Congenital midline cervical cleft: A rare embryo pathogenic disorder(2002) Genç A.; Taneli C.; Arslan O.A.; Daǧlar Z.; Mir E.Congenital midline cervical cleft (CMCC) is a rare disorder of the ventral neck. The cleft consists of an epithelium-covered, longitudinal central depression with a protuberance at the cervical end. The adjacent skin is tethered by scar tissue forming a depression, which ends in a blind sinus at the caudal end. Although a variety of embryological mechanisms are proposed, its etiology is obscure. Up to the present time, fewer than 50 cases have been reported in the English literature. CMCC can be seen in association with several midline anomalies related to the branchial arches, including median cleft of the lower lip and mandible, and hypoplasia or absence of other midline neck structures. We present a 36-day-old boy with CMCC to illustrate its clinical presentation and the result at 24 months postoperatively. © Springer-Verlag 2002.Item Effects of amnio-allantoic fluid exchange on bowel contractility in chick embryos with gastroschisis(W.B. Saunders, 2002) Şencan A.; Gümüştekin M.; Gelal A.; Arslan O.; Özer E.; Mir E.Background/Purpose: Intestinal damage in patients with gastroschisis is characterized by bowel wall thickening, intestinal dilatation, mesenteric shortening, and a fibrous peel. The prevention of intestinal damage in gastroschisis by amnio-allantoic fluid (AAF) exchange has been reported using histologic and macroscopic evaluation of intestines, but the effects of this treatment on bowel contractility have not been investigated. The current study was performed to determine the effect of AAF exchange on the intestinal contractility in chick embryos with gastroschisis. Methods: Thirteen-day-old fertilized chick eggs were used. Gastroschisis was created through amnio-allantoic cavity. There were 3 study groups: control group, gastroschisis-only group, and gastroschisis-plus-exchange group. The bowels were evaluated by an in vitro muscle strip technique, and the response was expressed as a percentage of the maximum acetylcholine evoked contraction (Emax) in each tissue obtained. Additionally, parasympathetic ganglion cells per 10 plexus at the intestinal wall were counted. Differences between groups were analyzed by analysis of variance (ANOVA) followed by Tukey-Kramer. Probabilities of less than 5% were considered significant. Results: The intestines were thickened and covered by fibrous peel in the gastroschisis-only group when compared with the control group and the gastroschisis exchange group morphologically. There was a statistically significant decrease in contractility in the gastroschisis-only group compared with the control group (P < .05). It exerted 42.03 ± 46.73% contraction of control group's Emax. This decrease in contractility was significantly reversed in the exchange group (P < .05; Emax value of gastroschisis plus exchange group was 71.45 ± 23.54% of control group's Emax). Although the number of ganglia per 10 plexus was 76.7 ± 4.3 in the control group, it was measured 28% less in the gastroschisis-only group (P < .05). There was no significant difference between the ganglion numbers of control and exchange groups. Conclusions: Prenatal AAF exchange treatment prevents decreased bowel contractility in gastroschisis. Gastroschisis does not affect intestinal ganglia morphology, but the number of ganglion cells decreases. AAF exchange prevents these functional and morphologic adverse effects of disease. By these findings the expectancy of a better clinical result in gastroschisis with intrauterine pretreatment by amniotic fluid exchange increases. Copyright 2002, Elsevier Science (USA). All rights reserved.Item Histopathological evaluation of the urethra after the Snodgrass operation: An experimental study in rabbits(2002) Genç A.; Taneli C.; Günşar C.; Türkdoǧan P.; Yilmaz O.; Arslan O.A.; Mir E.Objective: To investigate the histopathological outcome of the incised urethral plate after tubularized incised-plate urethroplasty (the Snodgrass procedure to repair hypospadias) in a hypospadiac rabbit model, as it can produce meatal and neourethral strictures, and healing with scarring. Materials and methods: The study comprised 10 male New Zealand White rabbits (2.2-2.4 kg); under general anaesthesia the ventral urethra was completely excised 1 cm from the meatus proximally and a model of hypospadias formed. A full-thickness incision was then made in the distal dorsal urethra and the two sides of the incision marked by Indian ink tattooing. After placing a feeding tube (5 F) as a urethral catheter, both urethral wings were sutured ventrally by a 7/0 polydioxanone running suture, and the penile skin approximated by 5/0 chromic catgut. At 21 days and 3 months after surgery the penises were harvested. assessed histopathologically, and compared with those from control untreated rabbits of the same age and weight. Results: In the study group the incised area of the dorsal urethra was re-epithelialized; the regional tissue and vascularity were normal. Conclusion: In this rabbit model the dorsal urethral incisions healed with no scar tissue: only the ventral suture lines had minimal fibrosis and inflammatory reaction.Item Meckel's diverticulum: Incidence and complications in childhood; [Meckel divertikülü: Siklik ve çocukluk çaǧindaki komplikasyonlar](2003) Günşar C.; Ceylan H.; Munis N.; Karaca I.; Mir E.Aim: Meckel's diverticulum is the most commonly seen congenital anomaly of the gastrointestinal system. Many complications related with this diverticulum could be seen in childhood. The aim of this study is to investigate the incidence of Meckel's diverticulum in our population and to evaluate the features of the complications originating from it. Method: The data about 1685 patients who underwent laparotomy in İzmir Behcet Uz Children's Hospital between 1990-1996 were investigated. The patients with Meckel's diverticula were classified as symptomatic or asymptomatic. The parameters evaluated were age, sex, clinical presentation, associated anomalies, type of complications related with Meckel's diverticulum, ectopic mucosa, surgical treatment and complications. Results: 25 patients were classified as asymptomatic whereas 35 were classified as symptomatic in a group of 60 patients with Meckel's diverticulitis. The average age was 4.7 years. The incidence was calculated as 1.51 %. The male female ratio (m/f) was 2.5/l and 2.6/l for symptomatic and for asymptomatic patients respectively. Intestinal obstruction (18 cases) was the most common clinical finding presented with vomiting and abdominal pain which were the primary symptoms. Fifteen diverticulum in the asymptomatic group, and all of them in the symptomatic group were excised. The ratio of ectopic mucosa was found as 16 % for the asymptomatic, and 51 % for the symptomatic cases. Symptomatic group had a 16 % complication rate. Conclusion: Meckel's diverticulum is a congenital structure, which is frequently encountered with the clinical presentation of intestinal obstruction in childhood causing life-threatening complications it should be investigated in the laparotomies performed for acute abdomen and where appendices were found innocent.Item MURCS association and rectovestibular fistula: Case report of a patient treated with one-stage posterior sagittal anorectoplasty and sigmoid loop vaginoplasty(W.B. Saunders, 2003) Günşar C.; Genç A.; Şencan A.; Daǧlar Z.; Alparslan O.; Mir E.MURCS association is rare, first described by Duncan in 1979, including nonrandom association of Mullerian duct aplasia or hypoplasia (MU), renal agenesis or ectopy (R), and cervicothoracic somite dysplasia. A 5-year-old girl was admitted to the clinic with a complaint of anteriorly located anus. Physical and radiologic examination of the patient found MURCS association with anorectal malformation (ARM) of rectovestibular-type fistula. She had multiple vertebral anomalies, left renal agenesis, vaginal and uterine agenesia, with a normal female 46,XX karyotype. Posterior sagittal anorectoplasty (PSARP) and sigmoid loop vaginal reconstruction was performed as a one-stage operation for the treatment of vaginal agenesis and ARM, There were no complications in the postoperative period. This combined one-stage operation can be used easily in the treatment of some components of the MURCS association such as vaginal agenesis and ARM as an associated anomaly. Copyright 2003, Elsevier Science (USA). All rights reserved.Item Urethral meatal dilatation using topical EMLA cream for anaesthesia [3](Blackwell Publishing Ltd., 2003) Genç A.; Tekin I.; Taneli F.; Arslan O.A.; Taneli C.; Mir E.[No abstract available]Item Blunt renal injuries in Turkish children: A review of 205 cases(2003) Ceylan H.; Gunsar C.; Etensel B.; Sencan A.; Karaca I.; Mir E.A retrospective analysis of the medical records of 205 children with renal injuries secondary to blunt abdominal trauma is used to make recommendations regarding the initial diagnostic and therapeutic approaches in this type of patient. It was found that the absence of hematuria on initial urinalysis does not exclude a serious renal injury. Thus, following blunt abdominal trauma, all children should undergo imaging procedures to exclude renal injury, whether they have hematuria or not. Ultrasound is a good initial screening procedure in all patients. Computed tomography is recommended for the definitive evaluation of suspected major renal injuries. Since even major renal injuries may heal without surgical intervention, conservative management is the recommended initial treatment of choice. Surgery is reserved for those children who are hemodynamically unstable and those that develop complications.Item Foreign body extraction with endoscopy assisted tracheotomy: Case report; [Endoskopi yardimiyla trakeotomi ile yabanci cisim çikarilmasi: Olgu sunumu](2003) Günşar C.; Genç A.; Şencan A.; Taneli C.; Mir E.The authors present a rare case of foreign body aspiration treated with a recently defined technique. Endoscopy assisted tracheotomy was used for the removal of a broken plastic pen top from a child and the surgical methods used in the treatment of tracheobronchial foreign body aspiration are discussed.Item Does sucralfate prevent apoptosis occurring in the ischemia/reperfusion-induced intestinal injury?(2003) Şencan A.; Yilmaz Ö.; Özer E.; Günşar C.; Genç K.; Ulukuş Ç.; Taneli C.; Mir E.Background/Purpose: We have shown in a previous study that sucralfate is beneficial in the prophylaxis and treatment of hypoxia/reoxygenation-induced intestinal injury. The aim of this study is to investigate whether sucralfate has any effect on the prevention of apoptosis in the ischemia/reperfusion (I/R)-induced intestinal injury. Methods: Rats were randomized into three groups. Group 1 and 2 were subjected to I/R. Group 1 (treatment group) received sucralfate while group 2 (treatment control group) did not. Group 3 served as a normal control group (sham group). The terminal ileum was harvested for histopathologic investigation by light microscopy. The presence of apoptotic enterocytes (DNA fragmentation in cell nuclei) was detected by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end-labeling (TUNEL) reaction. Results: In treatment control group, 3 of 7 rats had severe inflammation. None of the sucralfate-treated rats showed severe inflammation, 6 of them only showed mild inflammatory changes (p < 0.05). The apoptotic percentage was found to be 37.1 ± 9.4 in the sucralfate-treated group (group 1), whereas it was 45.4 ± 3.9 in the untreated group (group 2) (p < 0.05). The sham group had a completely normal intestinal architecture. Conclusions: The present study shows that 1) the experimental model of I/R-induced intestinal injury induces enterocyte apoptosis; 2) sucralfate decreases enterocyte apoptosis in the experimental model of I/R-induced intestinal injury which may play a key role in the pathophysiological events leading to failure of the intrinsic gut barrier defense mechanisms.Item Does high-pressure carbon dioxide insufflation facilitate mucosal dissection in transanal endorectal pull-through? A rabbit model(2003) Genç A.; Taneli C.; Türkdoǧan P.; Yilmaz Ö.; Arslan O.A.; Mir E.The aim of the present study was to investigate whether high-pressure carbon dioxide insufflation facilitates mucosal dissection in the transanal endorectal pull-through (TEPT) operation performed in Hirschsprung's disease in a rabbit model. In the study, ten New Zealand rabbits were used. In six of the rabbits, CO2 under 50 mmHg pressure was insufflated into the submucosal area through a 25-gauge scalp needle inserted 0.3 cm over the dentate line. Two of the rabbits were taken for histopathological examination. In four rabbits, the TEPT operation was performed and in another four the operation was performed without CO2 insufflation. Histopathological examination in the CO2-insufflated group of rabbits showed that at transversal incisions mucosa was seen to be separated circumferentially from submucosa by high pressure CO2 and at longitudinal incision the separation was seen to be complete along the anal canal. It was noted that mucosal dissection was rapid, non-bloody and without induced mucosal tears or perforation; however, in the non-insufflated group the operation was time-consuming, bloody and more difficult to perform and needed meticulous care. In the present study, it was seen that submucosal high pressure CO2 insufflation in rabbits facilitates mucosal dissection in the TEPT operation and is easy to perform, time-saving and highly economical.Item The association of jejunal atresia and cystic lymphangioma in the same location(W.B. Saunders, 2003) Şencan A.; Akçora B.; Mir E.Cystic lymphangiomas, which are localized on the mesentery of the intestine, are rarely seen. The presence of intestinal atresia together with cystic lymphangioma in the same location has never been described before. In this study, a premature girl weighing 2,630 g who had jejunal atresia, cystic lymphangioma localized in the mesentery of the distal atretic jejunal segment, and multiple rib anomalies is presented. The association of jejunal atresia and cystic lymphangioma may be coincidental, or jejunal atresia may be caused by an intrauterine vascular compression of volvuled cystic lymphangioma. Such an association is being reported for the first time in the literature. © 2003 Elsevier Inc. All rights reserved.Item The effect of circumcision status on periurethral and glanular bacterial flora(2004) Günşar C.; Kurutepe S.; Alparslan O.; Yilmaz Ö.; Daǧlar Z.; Şencan A.; Genç A.; Taneli C.; Mir E.Introduction: Circumcision is a historical operation which is still performed for different purposes. The aim of this study is to investigate the changes in periurethral and glanular sulcus flora due to circumcision to determine the role of circumcision on urinary tract infections (UTIs). Patients and Methods: Fifty patients who were circumcised for social-religious reasons between January 2000 and January 2001 were evaluated in this prospective study. Two swabs were taken from the periurethral and glanular sulcus regions both just before circumcision and 4 weeks after, and the bacteria cultured were recorded. Results: We isolated pathogenic bacteria in the periurethral region of 32 (64%) patients (enterococci in 14 cases; Escherichia coli in 12 cases) before circumcision, and this number decreased to 5 (10%) after circumcision. Similarly, pathogenic bacteria were cultured from the glanular sulcus swabs of 33 (68%) patients (enterococci in 14 cases; E. coli in 10 cases), as well as coagulase-negative staphylococci in another 15 patients before circumcision. Following circumcision, we detected pathogenic bacteria in the glanular cultures of only 4 cases, whereas 40 children had non-pathogenic skin flora. Only 1 of 5 children with history of UTIs (n = 1) and retractable phimosis (n = 4) had periurethral pathogenic bacteria (Proteus spp.) in the post-circumcision period. The differences between pre- and post-circumcision values of the pathogenic bacterial colonizations were statistically significant in both groups sampled (p < 0.05). Conclusion: Non-circumcised patients have similar pathogenic bacterial colonizations in the periurethral and the inner preputial regions, although they have no phimosis. The origin of periurethral flora should be the deeper preputial regions. The flora greatly changed with skin commensals after circumcision. Circumcision might be beneficial from this point of view. Copyright © 2004 S. Karger AG, Basel.Item Testis-fixation in prepubertal rats: Fibrin glue versus transparenchymal sutures reduces testicular damage(2004) Şencan A.; Genç A.; Günşar C.; Daǧlar Z.; Yilmaz Ö.; Ulukuş Ç.; Özer E.; Taneli C.; Mir E.Experimental studies have shown that different suture materials used in testis fixation cause some degree of inflammation in the testis. This study was planned to compare the histological changes that were caused by fibrin glue which is a tissue sealant and by silk and polypropylene for transparenchymal testis fixation. 28 prepubertal rats were divided into 4 groups. Testis was fixed to the tunica vaginalis by fibrin glue in group 1, by silk in group 2 and by polypropylene in group 3. Group 4 was planned as a control. Testicular inflammation and seminiferous tubular diameter were evaluated for histological changes. The least inflammation was observed in the fibrin glue group, while the most inflammation occurred in the silk group. Seminiferous tubular diameter was 241.55 ± 45.90 in the fibrin glue group, 151.90 ± 8.34 in the silk group and 161.36 ± 9.96 in the polypropylene group. In conclusion, fibrin glue, when used for testis fixation, causes less inflammation and less destruction of seminiferous tubular diameter compared with silk and polypropylene.Item Modification of meatal advancement and glanuloplasty for correction of distal hypospadias(2004) Taneli C.; Genç A.; Günsar C.; Sencan A.; Arslan O.A.; Daglar Z.; Mir E.Objective: The meatal advancement and glanuloplasty (MAGPI) technique is still successfully used for the repair of distal hypospadias. The technique has been modified considerably since it was first described in 1981. The primary drawbacks of the procedure are the complications of meatal regression and meatal stenosis. The aim of this study was to present a modification of MAGPI for correction of distal hypospadias. Material and Methods: Ten cases with distal hypospadias were operated on using our modified MAGPI procedure. The modification involves excision of a pull-out, tag-shaped piece of glanular tissue through the vertical incision in the meatoplasty section of the original operation. By means of this excision, burying of the meatus into the glans was eased without inducing extra mobilization of the glans wings. As less glans tissue was left at the dorsal urethra the urethral meatus could be replaced in the center of the glans and better anatomic reconstruction could be attained. Results: After 1-3 years of follow-up, all the operated cases showed functionally and cosmetically satisfactory results. The cosmetic appearance achieved with our modified technique was better than that obtained with the classical MAGPI procedure. Conclusions: Using our MAGPI modification, the urethra was localized deeper in the glans and an elliptical (slit-like), wide meatus was obtained, the cosmetic appearance of which was more acceptable than that achieved with classical MAGPI.Item The maturity of intestinal neomucosa: Integrin expression and ultrastructural aspects(2004) Günşar C.; Vatansever H.S.; Arslan O.A.; Şencan A.; Müftüoǧlu S.; Özbilgin K.; Kaymaz F.; Mir E.Background/purpose The maturity of neomucosa growing on a serosal surface for the treatment of short bowel syndrome still is questionable. The aim of this study was to evaluate the intestinal neomucosa to assess its histologic maturity. Methods A 6-cm-long isolated ileal segment (IS) was prepared in 8 Wistar albino-type rats. The IS was divided from the antimesenteric side, and 2 intestinal tubes were established, which shared a common wall and a common pedicle. After ileal biopsy sampling for the control group (CG), the IS was fashioned into a mucous fistula. Eight weeks later, all the rats were killed, and the ISs were investigated for neomucosal growth. Sections were prepared with periodic acid shift (PAS) and H & E staining for light microscopy. They also were evaluated by transmission electron microscopy. The microscopic morphology of the 2 groups was evaluated. Immunohistochemical staining was performed to show the expression of the tissue β1, α3 and α2β1 integrin subunits of both the neomucosa (NS) and control group (CG) segments. Results Sections of the NS showed a well-arranged columnar epithelial cell layer with goblet cells that were generally located superficially and with a complete basement membrane. Under the electron microscope, the sections from the NS group showed an epithelial cell layer with proper microvilli of the same height, although they were shorter than those of the CG, and tight intercellular junctions between the epithelial cells. Significant differences between the NS and CG groups were found in the measurements of villus width at base, microvillus surface, and microvillus height. The lamina propria consisted of rich collagen fibers and active fibroblasts in the NS group. In the immunohistochemical staining, although β1 integrine showed a dense distribution (+++) in the lamina propria, particularly localizing at the depth of the tunica mucosa layer, α3 integrin was observed to have a less dense immunoreactivity (++) in both groups. The expression of α2β1 integrin showed slight and dispersed (+) staining. Conclusions The NS showed histologic maturity and ultimate structural similarity with the native small bowel mucosa, which provides strong indirect evidence for the proper functioning of the neomucosa. © 2004 Elsevier Inc. All rights reserved.Item Intrascrotal paratesticular lymphangioma; [Skrotum içi testis dişi lenfanjiom](2004) Günşar C.; Şencan A.; Demir M.A.; Genç A.; Küçükoǧlu T.; Taneli C.; Mir E.We present a case of cystic scratal lymphangioma who showed three different clinical presentations in fourty days. At his first admission, he had a soft, painless, transilluminating, scrotal mass which progressed to an acute scrotum like disease after inadequate excision. Following total excision of the mass, he had a local celhditis attack on the scrotal skin. His lesions healed without any sequela. For histopathological differential diagnosis we performed some immunohisiochcmical dyeing methods in addition to the classical hematoxylene-eosine stained sections. Scrotal lymphangioma should be kepi in mind for the differential diagnosis of inguinoscrotal lesions and with adequate, surgical interventions, the recurrences could be prevented.