Management of esophageal perforation secondary to caustic esophageal injury in children.

Purpose: To review our management of esophageal perforation in children with caustic esophageal injury.

Method: We reviewed the medical records of 22 children treated for esophageal perforations that occurred secondary to caustic esophageal injury.

Results: There were 18 boys and 4 girls (mean age, 5 years; range, 2-12 years).

The missing hazelnut.

This report describes a case of esophageal perforation caused by a hazelnut which became stuck in the upper esophagus but was not detected. We outline the pitfalls in diagnosis, complications and treatment in the pediatric population.

Do patch procedures prevent complications of the Mathieu technique?

Purpose: The effects of V-incision sutured (MAVIS) and dartos patch reinforcement techniques in reducing side effects and complications of the Mathieu procedure and improving the appearance of the meatus are evaluated.

Materials And Methods: A total of 74 patients with distal shaft hypospadias without chordee or with minimal chordee were operated on by a single surgeon using Mathieu's technique. While only the classic Mathieu repair was performed in group 1, MAVIS and dorsal dartos patch reinforcement was included with the procedure in group 2.

Neonatal gastric perforation: review of 23 years' experience.

Purpose: To review our experience of treating 13 neonates with gastric perforation (GP) over the past 23 years.

Methods: The records of all 13 patients were reviewed, noting gender, weight, gestational age, age at admission, associated anomalies, site of perforation, type of operation, and clinical outcome.

Results: There were 11 boys and 2 girls, with a mean body weight of 2 375 g, including 4 (45%) preterm infants.

Hepatobiliary mucinous cystadenoma in a child.

The authors present a 4-year-old boy who had a large mucin-hypersecreting hepatobiliary cystadenoma. The tumor caused a hepato-colo-cutaneous fistula, which produced a large amount of external fluid loss. Total excision and the repair of the fistula could be possible after shrinkage of the tumor with the use of selective embolization of the feeding artery by interventional radiology.

Intestinal rotation anomalies in childhood: review of 22 years' experience.

Purpose: We review our experience of treating intestinal rotation anomalies in infants and children in the 22-year period between 1978 and 2000.

Methods: The type of operation performed, postoperative complications, and mortality were compared in three age groups. Group 1 consisted of neonates <1 month old, Group 2 consisted of infants aged <1 year old, and Group 3 consisted of children aged >1 year old.

Management of portal hypertension in children: a retrospective study with long-term follow-up.

Objectives: Data regarding the management of the portal hypertensive haemorrhage in the paediatric patients have yielded conflicting results. The purpose of this study was to evaluate the efficacy of beta-blocker (propranolol) alone, sclerotherapy alone and beta-blocker + sclerotherapy combination in the management of portal hypertension in the paediatric population.

Methods: Medical information was retrieved from the records of 62 children with portal hypertension who were under treatment during at least two years of follow-up period.

Pyloric atresia: 15-year review from a single institution.

Background: Pyloric atresia (PA) is a rare pathology. Calder presented the first pyloric atresia case in 1749 and Touroff, Sussman, Meltz, and their colleagues presented the first successful operation in 1940. PA has 3 types of anatomic variations: (1) type A, pyloric membrane or web; (2) type B, the pyloric channel is a solid cord; and (3) type C, in which there is a gap between the stomach and duodenum.

Nonsurgical diagnosis and management of an inflammatory pseudotumor of the spleen in a child.

Primary splenic tumors in children are rare and usually benign. We report the case of a 7-year-old boy with a splenic mass that initially resembled an infectious process. Histopathologic examination of a specimen obtained using sonographically guided Tru-cut needle biopsy, performed after angiography, revealed an inflammatory pseudotumor of the spleen, an extremely rare benign lesion.

Arterial carbon dioxide markedly increases during diagnostic laparoscopy in portal hypertensive children.

Unlabelled: Several factors are responsible for hypercarbia during laparoscopic procedures. This study was undertaken because we observed a sudden increase in PaCO(2) in children with portal hypertension (PHT), which was unusual in healthy children undergoing laparoscopic procedures. Fifty-seven children underwent laparoscopic procedures under general anesthesia and were mechanically ventilated.

Esophageal variceal bleeding secondary to portal hypertension: endoscopic sclerotherapy as the first-step treatment.

Background: Variceal bleeding from the esophagus is an important cause of mortality and morbidity in children with portal hypertension (PHT).

Patients And Methods: A series of 69 PHT cases (41 intrahepatic, 28 extrahepatic) have been evaluated in our department since 1990. According to the Child-Pugh classification, 49 cases were in class A, 16 cases were in class B, and 4 cases were in class C at admission.