Human and Doll's Hair in a Gastric Trichobezoar, Endoscopic Retrieval Hazards.

Trichobezoars are masses of ingested hair, usually the individual's own hair, that accumulate in the gastrointestinal tract, most commonly in the stomach. When extending into the small intestine, this is termed "Rapunzel syndrome." Removal has traditionally been by laparotomy; however, successful endoscopic removal has also been described.

Development of a gastroschisis core outcome set.

Objective: Outcome reporting heterogeneity impedes identification of gold standard treatments for children born with gastroschisis. Use of core outcome sets (COSs) in research reduces outcome reporting heterogeneity and ensures that studies are relevant to patients. The aim of this study was to develop a gastroschisis COS.

Management of large primary spontaneous pneumothorax in children: radiological guidance, surgical intervention and proposed guideline.

Purpose: Primary spontaneous pneumothorax (PSP) is managed in accordance with the adult British Thoracic Society (BTS) guidelines due to lack of paediatric evidence and consensus. We aim to highlight the differences and provide a best practice surgical management strategy for PSP based on experience of two major paediatric surgical centres.

Methods: Retrospective review of PSP management and outcomes from two UK Tertiary Paediatric hospitals between 2004 and 2015.

Bariatric surgery in severely obese adolescents: a single-centre experience.

Background: Increasing numbers of severely obese young people undergo bariatric surgery in the USA with reports of substantial weight loss after 1 year. National Institute for Clinical Excellence 2006 suggests considering surgery for young people in 'exceptional circumstances'. We present six patients operated upon 2004-2012 at our centre in the UK.

Reduction of intussusception: defining a better index of successful non-operative treatment.

The reported non-operative reduction rate for intussusception is usually the proportion of attempted non-operative (radiological) reductions that succeed, which we term the "selective reduction rate." This value shows wide variation that may result from selection bias that is difficult to quantify because data regarding primary operative treatment are frequently lacking. The proportion of patients with late clinical presentation or pathological lead points can also distort the apparent efficacy of non-operative treatment.

Idiopathic small bowel diaphragm disease identified by laparoscopic-assisted double-balloon enteroscopy in a child: an integrated successful definitive therapeutic method.

In adults, small bowel diaphragm disease is a rare complication of small bowel enteropathy secondary to the use of nonsteroidal antiinflammatory drugs. The main clinical manifestations are gastrointestinal bleeding and subacute obstruction, and management can be challenging. We present a case of a 5-year-old girl with small bowel diaphragm disease.

20 mm lithium button battery causing an oesophageal perforation in a toddler: lessons in diagnosis and treatment.

Swallowed button batteries (BB) which remain lodged in the oesophagus are at risk of serious complications, particularly in young children. The authors report a 3-year-old child, who rapidly developed an oesophageal perforation, following the ingestion of a 20-mm lithium BB which was initially mistaken for a coin. A thoracotomy and T-tube management of the perforation led to a positive outcome.

Foreskin preputioplasty and intralesional triamcinolone: a valid alternative to circumcision for balanitis xerotica obliterans.

Background: We previously reported our short-term experience of foreskin preputioplasty as an alternative to circumcision for the treatment of foreskin balanitis xerotica obliterans (BXO). In this study, we aimed to compare this technique with circumcision over a longer period.

Methods: Between 2002 and 2007, boys requiring surgery for BXO were offered either foreskin preputioplasty or primary circumcision.

Hypertrophic pyloric stenosis: predicting the resolution of biochemical abnormalities.

Purpose: Hypertrophic pyloric stenosis (HPS) is a common condition of infancy, often presenting with marked biochemical derangement, requiring correction. Previous studies have looked at the relationship between serum electrolytes and acid-base balance in HPS but not at the relationship between the degree of biochemical derangement and time taken to resolve the biochemical abnormality.

Methods: Retrospective analysis was performed on all 151 infants undergoing pyloromyotomy over a 3 year period.

Cystoscopy assisted transvesical biopsy of prostatic rhabdomyosarcoma.

The treatment of prostatic rhabdomyosarcoma (RMS) depends on tumour stratification based on site and histology. An increasing range of cytogenetic, molecular, and immunohistochemistry studies are required. This is difficult to achieve using standard cystoscopic biopsies alone.

Intraoperative colonic lavage in infants using a Replogle tube.

On-table colonic lavage for preparing obstructed bowel prior to anastomosis or stoma formation is now routine in adults, but it is seldom used in paediatric practice. We describe a simple technique for intraoperative colonic lavage using inexpensive medical devices that are also readily available and disposable, a Replogle tube, a fine-bore sucker, and a 20-ml syringe. We have used this technique in infants with intestinal obstruction due to anorectal malformations, intestinal atresias, and post-NEC strictures, to good effect.

Precocious puberty secondary to massive ovarian oedema in a 6-month-old girl.

A 6-month-old girl was referred with breast and pubic hair development. Investigations excluded an adrenal or central cause for her precocity. Ovarian ultrasound scans showed bilaterally enlarged ovaries with both solid and cystic changes.