Complications of Percutaneous and Surgical Gastrostomy Placements in Children: a Single-Centre Series.

Unlabelled: Gastrostomy placement is a standard procedure for children requiring enteral feeding for more than 3-6 weeks. Various techniques have been described (percutaneous endoscopic, laparoscopy, and laparotomy), and many complications have been reported. In our center, gastrostomy placement is performed either percutaneously by pediatric gastroenterologists, by laparoscopy/laparotomy by the visceral surgery team, or jointly, that is laparoscopic-assisted percutaneous endoscopic gastrostomy.

Digestive involvement in a severe form of Snyder-Robinson syndrome: Possible expansion of the phenotype.

Snyder-Robinson syndrome (OMIM #309583) is a rare X-linked condition, caused by mutation in the SMS gene (MIM *300105), characterized by a wide spectrum of clinical signs including developmental delay, epilepsy, asthenic habitus, dysmorphism, osteopenia, and renal or genital anomalies. Here we describe two maternal half-brothers who both presented with severe neurodevelopmental delay, seizures, hearing loss, facial dysmorphism, renal and ophthalmologic anomalies, failure to thrive and premature death. A novel p.

Pyloric Mucosal Diaphragm Associated with Hypertrophic Pyloric Stenosis: An Unusual Combination in a Male Neonate.

We describe herein the case of a 3-week-old baby with persistent nonbilious vomiting, due to a hypertrophic pyloric stenosis (HPS) associated with a congenital pyloric mucosal diaphragm. So far, an association between the two conditions has not been described. The diagnosis of a pyloric mucosal diaphragm was delayed because of its cooccurrence with HPS.

Long-Term Outcomes and Quality of Life in Patients after Soave Pull-Through Operation for Hirschsprung's Disease: An Observational Retrospective Study.

Introduction:  Patients after pull-through operation for Hirschsprung's disease (HD) are at high risk of defecation disorders. This study aimed at investigating their long-term outcomes and quality of life (QoL) in comparison with controls.

Patients And Methods:  Patients older than 5 years operated on for HD were interviewed to complete detailed questionnaires on bowel function.

Laparoscopic Repair for Perforated Peptic Ulcer in Children.

 A perforated peptic ulcer (PPU) is a rare but major complication of gastroduodenal peptic ulcer disease. Literature is scarce on this subject in the pediatric population and most articles describe a surgical treatment by laparotomy. We aim to review all our cases of pediatric PPU treated over the past 16 years and compare these to literature to deduce potential benefits and disadvantages regarding laparoscopic treatment of PPU in children.

Characteristics and management of congenital esophageal stenosis: findings from a multicenter study.

Background: Congenital esophageal stenosis (CES) is a rare condition frequently associated with esophageal atresia (EA). There are limited data from small series about the presentation, treatment, and outcomes of CES.

Methods: Medical records of all patients with CES included in the French Network on Esophageal Malformations and Congenital Diseases were reviewed retrospectively with regard to diagnosis, treatment, and outcome.

Thoracoscopic thoracic duct sealing with LigaSure in two children with refractory postoperative chylothorax.

Purpose: Chylothorax is an uncommon complication of cardiac surgery. We report two cases of the thoracoscopic management of persistent postoperative chylothorax by thoracic duct thermofusion and section with the LigaSure device.

Materials And Methods: A 6-year-old boy and a 3-year-old girl developed persistent chylothorax following an aortic coarctation repair and a Fontan procedure, respectively.

Laparoscopic partial splenectomy using radiofrequency ablation for nonparasitic splenic cysts in two children.

Nonparasitic splenic cysts are uncommon lesions, for which partial splenectomy offers a definitive treatment while preserving splenic function. We report the use of radiofrequency energy for laparoscopic partial splenectomy to treat two children with nonparasitic splenic cysts by creating a 1-cm thick coagulated parenchyma resection plane, allowing bloodless splenic transection. This approach spares the need for blood transfusions, reduces hospital stay, and offers great promise for partial splenectomy in children.

The evaluation by magnetic resonance imaging of hepatic periportal fibrosis in infants with neonatal cholestasis: preliminary report.

Purpose: The aim of this study was to evaluate the potential role of magnetic resonance (MR) imaging cholangiography for the assessment of periportal fibrosis associated with neonatal cholestasis.

Methods: The authors have compared the findings on MR imaging cholangiography and on pathology in 10 infants evaluated because of neonatal cholestasis. The series included 3 patients with biliary atresia (BA), 3 patients with choledocal cyst, 2 with a neonatal hepatitis, and 2 with an inspissated bile syndrome.

Small-bowel perforation in very low birth weight neonates treated with high-dose dexamethasone.

Introduction: Early postnatal treatment with high doses of corticosteroids may be effective in reducing the duration of mechanical ventilation in very low birth weight infants at risk for bronchopulmonary dysplasia. However, serious side effects may occur.

Material And Methods: A retrospective study on 5 very low birth weight neonates, mean (+/- SEM): gestational age range 27.

Gastric outlet obstruction: unusual ultrasonographic findings in the pyloric and antral regions.

The authors present the cases of four infants aged 2-4 months with symptoms suggesting gastric outlet obstruction. All four had US evaluation of the antropyloric region and upper GI series. Three of them underwent endoscopic investigations and three, surgery.

Midgut malrotation, the reliability of sonographic diagnosis.

We are unaware of any other anatomical study which deals with normal variations in the relationship between the superior mesenteric artery (SMA) and the superior mesenteric vein (SMV). In our investigation in the majority of cases, the SMV lies to the right of the SMA. It has been suggested that ultrasonographic demonstration of a left sided SMV, is characteristic of midgut malrotation so a prospective study was undertaken in order to try to correlate the position of the mesenteric vessels on Ultrasound with the radiological diagnosis of midgut malrotation on upper GI series.

Post-necrotising enterocolitis pseudo-obstruction treated with Cisapride.

We report on one patient in whom segmental colic intestinal pseudo-obstruction (IPO) following the surgical treatment of a grade III necrotising enterocolitis (NEC) was responsible for a severe failure to thrive. Further intestinal resection in an already short gut was avoided by using Cisapride, a new intestinal prokinetic agent (1 mg/kg/d in 4 doses, orally), which dramatically improved the symptoms and allowed weight gain and intestinal adaptation. After 6 months, Cisapride was withdrawn.

Decrease of vasoactive intestinal peptide, methionine-enkephalin, substance P and increase of neuropeptide Y immunoreactive nerve fibres in aganglionic colon of Hirschsprung's disease.

Ganglionic and aganglionic full-thickness samples, at 4 levels of the colon of 26 infants with Hirschsprung's disease, were studied by immunohistochemistry. In the distal part of the aganglionic bowel, we observe a decrease of substance P and vasoactive intestinal peptide, an absence of methionine-enkephalin and an increase in neuropeptide Y nerve fibres. When detected, substance P and vasointestinal peptide are mainly present in abnormal bundle nerve fibres.

Proenkephalin A associated peptides in the autonomic nervous system of the human infant gastrointestinal tract.

The digestive tract of neonates and infants were examined by immunohistochemistry using specific antisera raised against proenkephalin A related peptides. Proenkephalin A, methionine-enkephalin and leucine-enkephalin are observed in nerve fibres in the smooth muscles in the myenteric and submucosal plexuses or in neuronal cell bodies of the myenteric plexus. In these structures synenkephalin has general distribution as methionine-enkephalin but not the same as leucine-enkephalin.

Falciform ligament: a cause of extrinsic antral obstruction in the neonatal period.

We are describing two cases of neonatal antral obstruction due to the presence of an abnormal falciform ligament. Abdominal palpation revealed a cord in the right hypochondrium. In one case, a barium swallow revealed a very short extrinsic compression of the antrum.

Unusual association of upper gastro-intestinal anomalies in a newborn.

We are describing one case of persistent nonbilious post-prandial vomiting in a newborn due to hypertrophic pyloric stenosis, intestinal malrotation and gastric antral diaphragm. Those three anomalies were successively diagnosed as causes of persistent upper gastrointestinal subobstruction.

[Inguinal hernia in infants and children].

Inguinal hernia is a rather common pathology encountered in children, present in 1 to 3% of full term newborns and in 3 to 5% of premature babies. Between January 1982 and January 1983, we operated upon 134 children with inguinal hernia, more than half of them were under 6 months of age. In most cases, the history of the patient would suffice to make the diagnosis, indeed, in 99 cases, the history would reveal the transient presence of an inguinal mass often absent during the examination at the clinics.

[Macrodystrophia lipomatosa. Angiographic aspects (author's transl)].

A new case of this unusual entity is reported. The patient, male aged 43 has an hypertrophy of the first and second left fingers. Radiographic examination shows bony overgrowth and marked soft tissue thickening.