The hidden mortality in surgically treated necrotizing enterocolitis: fungal sepsis.

From 1979 to 1986, 82 infants underwent surgical treatment for necrotizing enterocolitis (NEC), with 36 deaths. The records of 30 of the 36 infants who died were available for review. Fungal colonization and sepsis, the sites of infection, and timing of diagnosis and therapy were determined.

Peritoneal drainage for necrotizing enterocolitis.

This study evaluates the role of primary peritoneal drainage (PPD) in the management of neonatal necrotizing enterocolitis (NEC). Of 169 patients with definite NEC, 92 (55%) underwent operation: primary laparotomy, 41 patients (45%); and PPD, 51 patients (55%). Seventeen (33%) of the PPD infants had subsequent laparotomy within seven days.

Neonatal abdominal calcification: is it always meconium peritonitis?

Intraluminal meconium calcifications are a rare cause of neonatal abdominal calcifications and can easily be misinterpreted as meconium peritonitis. We report three patients with anorectal anomalies, rectourethral fistula, and intraluminal calcified meconium. Intestinal stasis and mixing of urine and meconium may be predisposing factors for the calcification of meconium.

Reconstruction of penile agenesis by a posterior sagittal approach.

Penile agenesis is a rare condition requiring gender reassignment and staged perineal reconstruction. This report describes two children reconstructed by taking advantage of the posterior sagittal approach. This approach allows a precise anatomic dissection, construction of a neovagina and accurate positioning of all perineal orifices.

Pyloroduodenal duplication cyst.

Pyloroduodenal duplication cysts are an extremely rare congenital anomaly, whose clinical signs and symptoms often mimic those of hypertrophic pyloric stenosis. This radiographic analysis revealed configurational changes consistent with a large extrinsic mass rather than muscular hypertrophy, thus leading to the correct preoperative diagnosis.