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    Plasma D-lactic acid level: A useful marker to distinguish perforated from acute simple appendicitis
    (Elsevier (Singapore) Pte Ltd, 2004) Demircan M.; Cetin S.; Uguralp S.; Sezgin N.; Karaman A.; Gozukara E.M.
    Early diagnosis of perforated appendicitis is important for reducing morbidity rates. The aim of this study was to determine the value and utility of plasma D-lactic acid levels in identifying the type of appendicitis. In this clinical study, plasma D-lactic acid levels were assessed in 44 consecutive paediatric patients (23 with acute appendicitis, 21 with perforated appendicitis) before laparotomy. D-lactic acid levels were determined by an enzymatic spectrophotometric technique using a D-lactic acid dehydrogenase kit. Patients with perforated appendicitis had higher D-lactic acid levels (3.970 ±0.687 mg/dL) than patients in the control group (0.478 ± 0.149 mg/dL) and patients with acute appendicitis (1.409 ±0.324 mg/dL; p < 0.05). For a plasma D-lactic acid level greater than 2.5 mg/dL, the sensitivity and specificity of the D-lactic acid assay were 96% and 87%, respectively. The positive predictive value was 87%, the negative predictive value was 96%, and the diagnostic value was 91%. These results suggest that the measurement of plasma D-lactic acid levels may be a useful adjunct to clinical and radiological findings in distinguishing perforated from acute non-perforated appendicitis in children.
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    Subcutaneous fat necrosis mimicking a malignant mass associated with the left internal oblique and the sartorius muscles in a 3 months old boy: Differential diagnosis
    (Turkiye Klinikleri, 2009) Si?irci A.; Karaman A.; Başsüllü N.; Çelik T.
    Subcutaneous fat necrosis (SCFN) is a rare, self-limited and benign disorder that develops after birth. A 3-month-old-boy presented with a semi-mobile mass under the skin without erythema on the left inguinal area. Ultrasound (US) revealed a mass within the subcutaneous fat layer over the left internal oblique and the sartorius muscles with heterogenous echogenicity. Computed tomography (CT) showed that the mass had a smooth border with partially spicular extensions to the subcutaneous fat. The presumptive diagnosis was rhabdomyosarcoma. Surgical exploration and excision biopsy were performed. The pathological examination revealed SCFN. Copyright © 2009 by Türkiye Klinikleri.