Successful treatment of recurrent rectal prolapse using three Thiersch sutures in children.

Many techniques are described to manage recurrent rectal prolapse in children, including repeated Thiersch stitch, phenol injections, Delorme and Altemeier procedures, and rectopexy. We describe a case of successful treatment of rectal prolapse by placing three Thiersch sutures circumferentially along the anal canal--a simple and novel modification of a well-known procedure. An 8-year-old boy with full-thickness rectal prolapse was treated with laxatives to no avail.

Spontaneous resolution of a recurrent axillary cystic hygroma following acute infection.

We report a case of spontaneous resolution of a recurrent axillary cystic hygroma in a 4-year-old boy. He presented with a 1-year history of a cystic lump in the left axilla, which intermittently changed in size. Ultrasound suggested it was a lipoma, with raised suspicions of vascular malformation.

Synthetic Cannabinoids and Their Effects on the Cardiovascular System.

Background: In the past couple of years, there has been an outbreak of synthetic cannabinoid (SC) use in major cities in the United States. Patients can present with various symptoms affecting the central nervous and cardiovascular systems. The effects of endocannabinoid on contractility and Ca(2+) signaling have been shown through both cannabinoid receptors and a direct effect on ion channels.

Extensive Necrotising Enterocolitis: Objective Evaluation of the Role of Second-Look Laparotomy in Bowel Salvage and Survival.

Aim: We investigated the role and outcome of a planned second-look laparotomy (SLL) in preserving bowel in extensive necrotizing enterocolitis (NEC).

Methods: Extensive NECs managed surgically in a tertiary centre in 2006-2009 were retrospectively studied to include patients planned for an SLL. End points were bowel salvage rate and survival outcomes.

Management of necrotising appendicitis associated with widespread necrotising enterocolitis of the small and large bowel and perforated duodenal ulcer.

A 7-year-old boy presented in septic shock secondary to appendicitis with generalised peritonitis. Following crystalloid resuscitation, he underwent surgery. Faecopurulent contamination and free air were found.

Peristeen (ⓒ) transanal irrigation system for paediatric faecal incontinence: a single centre experience.

Aim. To evaluate the efficacy of the Peristeen (Ⓒ) transanal irrigation system when treating faecal incontinence in children due to chronic idiopathic constipation. Methods.

Experience of the MACE procedure at a regional pediatric surgical unit: a 15-year retrospective review.

Introduction: The Malone antegrade continence enema (MACE) procedure is an established treatment option for children with constipation or fecal incontinence. This study retrospectively analyses the management and outcomes of children who underwent MACE procedures at a regional pediatric surgery unit.

Patients And Methods: Children who underwent a MACE procedure in our unit between 1998 and 2012 were identified.

Scrotal fixation in the management of low undescended testes.

Aims: Scrotal fixation (SF) is a known technique for the management of low undescended testes (UDT). SF assumes that most low UDT have no patent processus vaginalis (PPV) and can be managed via scrotal mobilization alone. We report our experience of the role of SF in the management of low UDT.

Oblique anastomosis in Soave endoanal pullthrough for Hirschsprung's disease--a way of reducing strictures?

The Soave endorectal pullthrough is a commonly performed procedure for the definitive management of children with Hirschsprung's disease (HD). Anastomotic stricture is a recognised complication of this procedure. There are multiple causes for these strictures, circular anastomosis being one of them.

Validity of 13C octanoic acid breath test for measurement of solid meal gastric emptying time in children.

Background/purpose: It is important to establish a physiologic range of gastric emptying (GE) in children. Gastric emptying time measured with (99)Tc-labeled solid meal (GE(Tc)) is the gold standard. Large-scale studies with GE(Tc) are ideal but not feasible because of radiation exposure.

Gastric emptying of solids in normal children--a preliminary report.

Objective: The physiological range of gastric emptying in healthy children has not previously been documented. The aim of this study was to establish the range of normal gastric emptying in children aged between 5 and 10 years with a Tc 99m-labelled solid meal acceptable to most of the children.

Methods: A list of 7 child-friendly foods was compiled.

Use of pelvic ultrasound in the diagnosis of megarectum in children with constipation.

Purpose: It has not been possible so far to differentiate slow transit constipation from functional fecal retention because the existing medical literature lacks data on rectal dimensions for healthy children or children with chronic idiopathic constipation (CIC). We, for the first time, describe the use of pelvic ultrasound (US) to achieve this.

Methods: A pelvic US was carried out on 82 children with a full or partially full bladder and with no history of bowel problems and on 95 children with CIC.

Denis Browne's thoracotomy revised.

The three main issues involved in thoracotomy technique for the repair of oesophageal atresia (OA) are: (1) prevention of chest wall deformities; (2) adequate surgical exposure; and (3) the cosmetic appearance of the skin scar. Adequate surgical exposure should be the first priority. The technique described is an endeavour to address all the above concerns, a modification of the technique described by Denis Browne that eliminates the risk of injury to the long thoracic nerve (LTN).