Initial experience in target peroral endoscopic submucosal myotomy combined with septotomy for epiphrenic diverticulum.

The epiphrenic esophageal diverticulum is a rare non-malignant condition that is commonly associated with motility disorders. It would normally be treated surgically, but with the advancement of endoscopy techniques, peroral endoscopic myotomy with septotomy (D-POEM) has shown its benefits in coping with the symptoms. We present a case of a 71-year-old woman with increasing symptoms of dysphagia, weight loss and imaging data showing a large epiphrenic diverticulum.

Primary immunodeficiency screening in an infant with cytomegalovirus disease reveals HIV infection.

Cytomegalovirus is widely spread worldwide, and it is not uncommon for it to complicate the congenital human immunodeficiency virus (HIV) disease as an acquired or congenital coinfection. However, the association of the two infections is not common amongst infants with primary immune deficiencies.We describe a case of a 6-month-old infant with acquired cytomegalovirus and HIV infections, diagnosed in the course of the patient's clinical and laboratory workup for a presumed primary immunodeficiency.

Extrahepatic Portal Vein Thrombosis in Childhood: Risk Factors, Clinical Manifestations, and Management.

Objective: Extrahepatic portal vein thrombosis (EHPVT) is a common cause of portal hypertension in children. The aim of the present study was to identify the clinical manifestations and the risk factors for development of EHPVT in pediatric patients.

Subjects And Methods: This was a single-center retrospective cohort study.

Intrapancreatic accessory spleen in child.

Background: Intrapancreatic accessory spleen is a congenital abnormality with duplicated splenic tissue located in ectopic sites.

Case: We report a case of 10-year-old male patient with an infrequent finding of intrapancreatic mass. The examination of complete blood count, biochemistry, tumor markers were within the normal reference ranges.

Gastric trichobezoar in the absence of psychosocial stressors: a report of two cases.

Abstract.

Posttraumatic Parinaud's syndrome as a contrecoup injury in a case of closed head trauma.

The purpose of the study was to present a rare case of post-traumatic Parinaud's syndrome with a history of closed head injury. The clinical characteristics, examination, and management are presented in a 12-year-old boy who was a victim of physical violence at the hands of a young boy who punched him in his chin with his fists, with associated paralysis of the upward gaze of the left eyeball, and convergence nystagmus with pupillary involvement. CT examination indicated posttraumatic lesions in the dorsal midbrain and in the cavity of third ventricle, suggestive of acute hemorrhages.

Gallbladder polyp in children - a rare finding during ultrasound examination.

Gallbladder polyps are a relatively rare finding in children. The increased use of high-resolution ultrasound in childhood allows to detect gallbladder lesions in young patients. A precise diagnosis can be established using different imaging series.

Clinical Laboratory Tests in Some Acute Exogenous Poisonings.

Background: There is no specific toxicological screening of clinical laboratory parameters in clinical toxicology when it comes to acute exogenous poisoning.

Aim: To determine routine clinical laboratory parameters and indicators for assessment of vital functions in patients with acute intoxications.

Materials And Methods: One hundred and fifty-three patients were included in the present study.

Endoscopic diagnosis of intramural hematoma in the colon sigmoideum in a child with high titer inhibitory hemophilia A.

Lower gastrointestinal bleeding is a rare condition in childhood pathology. The incidence of this disorder in the general population of Bulgarian children is unknown. We report a case of a 7-year-old child with diagnosed hemophilia A and high titer of factor VIII inhibitor; the patient was admitted into the Department of Pediatrics and Medical Genetics for rectorrhagia after falling onto his buttocks while playing.

Cystic fibrosis and celiac disease--multifaceted and similar.

Celiac disease and cystic fibrosis share a number of clinical manifestations. The comorbidity rate of these diseases is low: 1:200000. We present a case of a child aged 1 year and 5 months, born to a mixed-marriage parents, with concomitant cystic fibrosis and celiac disease manifesting initially with chronic diarrhea.

Ventilator-associated pneumonias in children (II)--prophylaxis and treatment.

Ventilator-associated pneumonia (VAP) is the second most common nosocomial infection among children treated in intensive care units. The risk factors for developing this condition are generated by the patient's bedside conditions, the equipment used and the specific treatment administered to the child. Prophylaxis of VAP should necessarily include all measures that have been proven to be efficient in this respect such as rigorous hygiene control of hands and protective clothing of attending staff, changing breathing circuits of ventilators only if they malfunction or if they are visibly contaminated, preference of orotracheal intubation (instead of nasotracheal intubation) and use of endotracheal tubes with dorsal lumens to allow respiratory secretions to drain, and introduction of a uniform approach to patient care and staff training.

Ventilator-associated pneumonias in children (I)--diagnostic criteria, etiology and pathogenesis.

Ventilator-associated pneumonias have been estimated to be the second most common nosocomial infections among children treated in intensive care units. They occur in mechanically ventilated patients through intubation tube or tracheostomy, the inflammation usually involving the lung parenchyma. The ventilator-associated pneumonia is associated with a longer antibiotic treatment, greater duration of mechanical ventilation (MV) and higher mortality rates in children.