Gastrointestinal Issues in Critically Ill Children.

Due to lack of uniform diagnostic criteria, gastrointestinal (GI) complications in critically ill occur with variable frequency, and overall incidence of such complications seems to be less in children compared to adults. Major risk factors are use of catecholamines, sedatives, and muscle relaxants in patients with shock. GI dysmotility in critically ill patients is the main reason behind abdominal distension, increased gastric residual volume, and constipation.

Congenital giant right coronary artery.

Giant coronary artery aneurysms are exceptionally uncommon with an incidence of 0.02%. The natural history and prognosis of giant coronary artery aneurysm are still not well known.

Pediatric Liver Transplantation.

Excellent outcomes over the last 3 decades have made liver transplantation the treatment of choice for many advanced liver disorders. This success also opened liver transplantation to new indications such as liver tumors and metabolic disorders. The emergence of such new indications for liver transplantation is bringing a new stream of patients along with disease-specific challenges.

Intestinal Transplant in Children.

The past decade has seen major advances in the field of transplantation; it is the treatment of choice for many with intestinal failure. One-year mortality from pediatric intestinal transplantation has significantly declined, from 30% to 10% to 15% nationally, mainly due to a multidisciplinary approach in transplant centers. Pediatric age carries special considerations along the spectrum of care that continue to cause challenges but also offers growth opportunities.

Remission of Refractory Celiac Disease With Infliximab in a Pediatric Patient.

Refractory celiac disease (RCD) is a rare but life-threatening complication of celiac disease (CD), and only 1 pediatric case has been reported. We report a case of a 14-year-old girl with CD presenting with persistent symptoms and positive tissue celiac-specific antibodies despite a gluten-free diet. Push enteroscopy showed jejunal scalloping and partial villous atrophy on histology.