Abscessing Infection by Streptococcus mitis Mimicking Metastatic Lesions in a 5-Year-Old Girl With Nephroblastoma: A Case Report.

Streptococcus mitis is a common pathogen causing infections in oncological patients. However, cases of abscesses caused by Streptococcus mitis in oncological patients have not been reported so far. We report on 5-year-old child with nephroblastoma and pulmonary and hepatic metastases at diagnosis who went into complete remission undergoing chemotherapy and nephrectomy, and who developed new round lesions in liver and lungs under continuous chemotherapy suggestive of new metastases.

Etiology of Appendicitis in Children: The Role of Bacterial and Viral Pathogens.

Background: Although acute appendicitis is the most common cause for abdominal surgery in children, its etiology is still largely unknown. The aim of this study was to evaluate the role of bacterial and viral pathogens for the etiology of appendicitis in children.

Methods: Between 2000 and 2010, 277 children underwent appendectomy in our institution.

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases.

Background: Inguinal hernia repair is the most frequently performed surgical procedure in infants and children. Especially in premature infants, prevalence reaches up to 30% in coincidence with high rates of incarceration during the first year of life. These infants carry an increased risk of complications due to general anesthesia.

Postoperative outcome in premature infants with open abdomen.

Background: Premature infants treated with laparostomy in the first days of their life represent a group of complex patients with high morbidity and mortality rates. Laparostomy is a surgical treatment method in which the peritoneal cavity is opened anteriorly and deliberately left open, hence often called "open abdomen". The aim of this study was to analyze crucial factors influencing the postoperative outcome of premature infants treated this way.

Paediatric and adolescent traumatic gastrointestinal injuries: results of a European multicentre analysis.

Aim: Paediatric gastrointestinal injuries (GIIs) are rare, and the aim of this multicentre study was to evaluate their outcomes in a large cohort.

Methods: Hospital databases of 10 European paediatric surgical centres were reviewed for paediatric traumatic GIIs managed between 2000-2010.

Results: Ninety-seven patients with a median age of 9 years (0-17 years) were identified, with 72 blunt and 25 penetrating GIIs.

Recognition and management of abdominal compartment syndrome among German pediatric intensivists: results of a national survey.

Introduction: Several decades ago, the beneficial effects of goal-directed therapy, which include decompressive laparotomy (DL) and open abdomen procedures in cases of intra-abdominal hypertension (IAH) in children, were proven in the context of closures of abdominal wall defects and large-for-size organ transplantations. Different neonatologic and pediatric disease patterns are also known to be capable of increasing intra-abdominal pressure (IAP). Nevertheless, a considerable knowledge transfer regarding such risk factors has hardly taken place.

Recognition and management of abdominal compartment syndrome among German anesthetists and surgeons: a national survey.

Background: Abdominal compartment syndrome (ACS) is a life threatening condition that may affect any critically ill patient. Little is known about the recognition and management of ACS in Germany.

Methods: A questionnaire was mailed to departments of surgery and anesthesia from German hospitals with more than 450 beds.

Abdominal compartment syndrome in childhood: diagnostics, therapy and survival rate.

Purpose: The abdominal compartment syndrome (ACS) in childhood is a rare but dire disease if diagnosed delayed and treated improperly. The mortality amounts up to 60% (Beck et al. in Pediatr Crit Care Med 2:51-56, 2001).

Influence of the elasticity module of synthetic and natural polymeric tissue substitutes on the mobility of the diaphragm and healing process in a rabbit model.

Mesh implants are frequently used in congenital diaphragmatic hernia. This experimental study aimed to examine the influence of different materials on the diaphragmatic movement over time as well as their mechanical qualities after 4 months. Ultrapro®, Surgisis®, and Proceed® were implanted onto a diaphragmatic defect in growing rabbits.

Is biocompatibility affected by constant shear stress?--comparison of three commercially available meshes in a rabbit model.

Mesh implants as standard treatment for tissue defects can be adapted to patient's needs by specific bioactive coatings. The biophysical interaction with the surrounding tissue must be understood to describe the influence of coatings qualitatively and quantitatively. This study investigates the use of meshes to repair diaphragmatic defects.

Ileocecal intussusception with histomorphological features of inflammatory neuropathy in adenovirus infection.

The pathophysiological mechanisms for ileocecal intussusception in children with adenovirus infection are not well characterized. Here we demonstrate coincidence of adenovirus infection and inflammatory neuropathy of myenteric plexus in two children with ileocecal intussusception. Inflammatory neuropathy, an unspecific morphological feature which is found in peristalsis disorders, was morphologically characterized by the influx of CD3 positive lymphocytes in nervous plexus.

Experimental investigation of the elasticity of the human diaphragm.

Background: Traumatic diaphragmatic ruptures affect mainly the left side. In an experimental study in human corpses we examined the stretch behaviour of the left and right diaphragmatic halves.

Methods: In a total of 8 male and 8 female corpses each diaphragmatic half was divided into 4 different segments.

[Mechanical ileus in childhood--causes and surgical therapy].

Background: The present study examines the causes and surgical management in children who underwent surgery for a mechanical Ileus.

Patients: We studied all children up to the age of 18 years who had undergone a surgical intervention for a mechanical ileus between 1.1.

The Gist of literature on pediatric GIST: review of clinical presentation.

Aim/background: To provide a review of existing literature on pediatric GIST with focus on clinical presentation.

Methods: A MEDLINE search was conducted in July 2007 to give an overview on literature concerning pediatric gastrointestinal stromal tumors (GISTs) with a focus on clinical presentation, using keywords "gastrointestinal stromal tumor" and one of the following "young/boy/girl/child/children/pediatric." Two of the authors sorted the resulting abstracts by relevance for a review on clinical aspects of pediatric GIST if they were in English language, not explicitly only reporting of adults and describing clinical features of patients.

Contralateral inguinal hernia in childhood and youth: which child will develop a contralateral inguinal hernia?

This work addresses the controversial topic of the exploration of the contralateral side in the presence of a one-sided inguinal hernia in infancy. In a prospective study of 368 children with one-sided inguinal hernia, we demonstrated the consecutive development of a contralateral hernia in 22 (6%) of the children. We found that the child's age at first operation represents a risk factor for the development of a consecutive hernia.

[Medicine between humanitarianism and competition: the patients' point of view].

Background: An open medical market is supposed to be a promising tool for preserving the meagre resources of the German public health care system. The competition between humane and economic practice induces conflicts which burden physicians as well as patients. To analyse this problem by scientific means, inpatients were interviewed with the help of a standardised protocol.

[Fair allocation of reduced resources in the German health care system. The patient's view].

Background: The financial resources in the German Public Health care system are running short due to reduced budgets and demographic changes. Reform plans of the state, backers, and care providers seem to neglect patients' needs. To analyse this problem by scientific means, inpatients were interviewed as to their views concerning fair allocation.

[Current patient perceptions of the physician].

Background: The structure and organisation of German hospitals currently are undergoing radical change forced by reforms in the German public health system. Operating procedures, efficiency assays, and management programs compete with the traditional philanthropic relationship between physician and patient. To analyse this problem by scientific means, inpatients were interviewed in standardised fashion on current expectations, ideals, and experience with that relationship.

[Liver laceration following a kick in a soccer game].

Severe intraabdominal injuries in soccer are very rare. We present the case of an 18 year old soccer player who suffered from a grad IV liver laceration following a kick during a soccer game. After primary explorative laparatomy and liver packing in a hospital nearby the patient was transferred to our clinic.

Venocutaneous fistula.

This is the first description of venocutaneous fistula, a late complication of elective laparoscopic cholecystectomy that arose 18 months after the initial operation. Postoperatively, the patient twice developed an abscess in the abdominal wall at the former site of the umbilical trocar. The first abscess occurred on the 6th postoperative day; the second, after 14 months.

A case of bilateral inguinal hernia recurrence in infancy: investigations on collagen metabolism.

Background: Recurrent inguinal hernias in early infancy are rare. We report on a case of a 3-month-old male infant suffering bilateral inguinal hernia recurrence (RINGH). Due to previous observations of an altered collagen metabolism in hernia patients, a severe connective-tissue pathology in the infant was hypothesised.

[Assisted death in daily surgical practice--an interdisciplinary discussion with examples].

New laws for assisted patient death in The Netherlands and Belgium have resulted in animated discussion about the permissibility of the practice in Germany. Physicians here are being confronted more and more by patients and their relatives with the wish for assisted death. Polls confirm that the majority of this population supports active death assistance, whereas doctors reject it.

[Laparoscopic staging in abdominal tumors in children: an alternative to staging laparotomy].

Introduction: In abdominal tumors in childhood, staging laparotomy is usually an essential diagnostic tool to obtain information about the histology and the extension of the tumor, when less invasive methods do not reach to clarify the process.

Patients: In fourteen children between 3 months and 17 years a laparoscopical procedure was performed.

Material And Method: Only in patients without a clear diagnosis after noninvasive exploration were submitted to an explorative laparoscopy in order to define the histology, the extension of the illness or to locate it.

Treatment of extrahepatic bile duct disease in infancy and early childhood.

Extrahepatic bile duct disease is a rare finding in infancy and early childhood. However, there is an increasing number of patients operated at this age reported in the literature. This increase may have multifactorial reasons, e.