European Journal of Pediatric Surgery Reports最新文献

{"title":"Post Circumcision Intraperitoneal Rupture of the Urinary Bladder: A Rare Complication.","authors":"Sherif Abdelmaksoud, Mohammed Albishbishy, Mostafa Elayyouti, Mohamed Zohiri, Adham Elsaied","doi":"10.1055/s-0039-1700986","DOIUrl":"10.1055/s-0039-1700986","url":null,"abstract":"<p><p>Circumcision is one of the most common pediatric surgical procedures performed all over the world and especially in Arab and Islamic countries. Many complications have been documented following this maneuver. We report on a rare case of intraperitoneal bladder rupture in a 7-day-old baby who was circumcised on his second day using the guillotine method. He presented to us with gangrene of the tip of the penis and a failure to void urine associated with progressive abdominal distension. Ultrasound revealed severe ascites. Aspiration and analysis confirmed the fluid to be urine. Ascending cystourethrogram was performed revealing a perforation of the posterior bladder wall near the trigone. Exploration was performed and repair done. Postoperative course was uneventful.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"8 1","pages":"e14-e17"},"PeriodicalIF":0.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1700986","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37722629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Umbilical Endometriosis in an Adolescent Girl: Unsuspected Pathology.","authors":"Leel Nellihela,&nbsp;Mudher Al-Adnani,&nbsp;Dorothy Kufeji","doi":"10.1055/s-0039-1700987","DOIUrl":"https://doi.org/10.1055/s-0039-1700987","url":null,"abstract":"<p><p>Endometriosis affects 7 to 10% of women of reproductive age. Primary umbilical endometriosis (PUE) is even rarer with unclear pathogenesis. We report a case of PUE possibly the youngest patient reported in the literature. A 16-year-old girl of African origin presented with painful umbilical lump for 2 to 3 months duration with background history of precocious puberty, cyclical vomiting, and menorrhagia. Clinical examination showed dark-colored, tender, irreducible umbilical lump. A provisional diagnosis of incarcerated umbilical hernia was made. Abdominal X-ray showed no features of intestinal obstruction. Ultrasound scan of the abdomen showed lump containing heterogeneous echogenic material measuring 2.0 × 1.5cm within the umbilicus with no visible bowel loops or peristalsis. This was reported as consistent with an umbilical hernia with narrow neck possibly containing mesentery or intra-abdominal fat. The patient underwent urgent exploration of umbilicus under general anesthetic. At operation, a dark-colored, firm mass was excised and sent for histology. The underlying fascia and peritoneum were repaired. Histological examination confirmed the excised tissue was endometriosis. Follow-up continues in the endometriosis clinic. Umbilical endometriosis should be considered in differential diagnoses of painful umbilical lesion in adolescent girls and women of reproductive age. Complete excision and histology are highly recommended for obtaining a definitive diagnosis, to exclude malignancy and to prevent recurrence.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"8 1","pages":"e10-e13"},"PeriodicalIF":0.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1700987","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37630803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Strategy for the Conservative Management of Acquired Tracheoesophageal Fistula Due to Lithium Button Battery Ingestion.","authors":"Soichi Shibuya,&nbsp;Takahiro Azuma,&nbsp;Geoffrey J Lane,&nbsp;Manabu Okawada,&nbsp;Atsuyuki Yamataka","doi":"10.1055/s-0040-1705157","DOIUrl":"https://doi.org/10.1055/s-0040-1705157","url":null,"abstract":"<p><p>A 16-month-old boy was referred to our hospital for the management of suspected lithium button battery (LBB) ingestion. He had been previously well, but became febrile with a persistent cough resistant to oral antibiotics and dysphagia for 5 days. Radiography identified an LBB lodged in the upper esophagus. The LBB was retrieved under direct visualization with rigid laryngoscopy. He was sedated for 5 days and enteral feeding was commenced through a nasojejunal tube on the next day after procedure. On day 8 after retrieval, endoscopy and fluoroscopy identified a tracheoesophageal fistula (TEF), 6 mm in diameter. Conservative management was conducted with periodic follow-up endoscopies, which showed signs of healing in the esophagus. Following continuous antibiotics and proactive nutritional support, the TEF was found to have closed spontaneously by day 28 after the LBB removal. We present our experience of the successful nonsurgical management of acquired TEF secondary to LBB ingestion and aim to establish a protocol for managing it conservatively by reviewing the relevant literature.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"8 1","pages":"e18-e22"},"PeriodicalIF":0.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1705157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Surgical Technique to Repair Perineal Body Disruption Secondary to Sexual Assault.","authors":"Giulia Brisighelli,&nbsp;Marc A Levitt,&nbsp;Richard J Wood,&nbsp;Christopher J Westgarth-Taylor","doi":"10.1055/s-0039-1695048","DOIUrl":"https://doi.org/10.1055/s-0039-1695048","url":null,"abstract":"<p><p>Perineal trauma is uncommon in the pediatric population and it is estimated that 5 to 21% is secondary to sexual abuse. We aim to present a proposed surgical technique to repair perineal injuries secondary to sexual assault in female children. The technique is based on the posterior sagittal anorectoplasty (PSARP) for repairing anorectal malformations and, between 2017 and 2019, it was used to treat three girls (2 months, 2 years, and 8 years of age) with fourth-degree perineal injuries secondary to sexual assault. One of them underwent laparotomy and Hartmann's colostomy for an acute abdomen. Two underwent wound debridement and suturing and only had a stoma fashioned at 5 days and 6 weeks posttrauma, respectively. The perineal repair was performed 2, 6, and 7 weeks postinjury and done as follows: with the child prone in jack-knife position, stay-sutures are placed on the common wall between the rectum and the vagina. Using a needle tip diathermy, a transverse incision is performed below the sutures lifting the anterior rectal wall up. Stay sutures are then positioned on the posterior wall of the vaginal mucosa. The incision between the walls is deepened until the rectum and the vagina are completely separated. The deep and superficial perineal body is then reconstructed using absorbable sutures and an anterior anoplasty and an introitoplasty are performed. The stoma in each was closed 6 weeks postreconstruction. At follow-up, now 1 year or more postrepair, all patients have an excellent cosmetic outcome and are fully continent for stools.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"8 1","pages":"e27-e31"},"PeriodicalIF":0.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1695048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Dismembered Repair in Two Patients with Retrocaval Ureter.","authors":"Yuri Cavaleri,&nbsp;Giuseppe Farullo,&nbsp;Simona Gerocarni Nappo,&nbsp;Paolo Caione","doi":"10.1055/s-0040-1705156","DOIUrl":"https://doi.org/10.1055/s-0040-1705156","url":null,"abstract":"<p><p>Retrocaval ureter (RCU) or circumcaval ureter is a rare cause of congenital hydronephrosis. The surgical correction of RCU should be performed in all patients with obstruction and hydronephrosis symptoms, lumbar pain, urinary tract infections, hematuria, or urolithiasis. Traditionally, an open surgical approach was used for the treatment of RCU. Nowadays, surgical correction of these anomalies is performed using minimally invasive techniques. We report on two cases treated with our standardized laparoscopic technique using only three 5-mm trocars. The proposed approach could be considered as the first-line treatment for RCU.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"8 1","pages":"e32-e34"},"PeriodicalIF":0.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1705156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystoscopy-Guided Laparoscopic Excision of Prostatic Utricle: Report of a Case.","authors":"Ozlem Boybeyi-Turer,&nbsp;Huseyin Demirbilek,&nbsp;Tutku Soyer","doi":"10.1055/s-0040-1705155","DOIUrl":"https://doi.org/10.1055/s-0040-1705155","url":null,"abstract":"<p><p>Prostatic utricle (PU) is incomplete regression of Müllerian duct and may cause recurrent urinary tract infections (UTIs), stone formation, postvoid dribbling, and recurrent epididymitis. Although surgical excision is recommended to avoid complications, surgical access to PU has been challenging. Cystoscopy-guided laparoscopic management of PU in a 3-year-old boy is reported to discuss use of other endoscopic aids in the surgical treatment of PU. He was admitted with disordered sexual development with karyotype of 47,XYY/46,XY and has been experiencing recurrent UTIs. Voiding cystourethrogram (VCU) demonstrated large PU (IKOMA II). Cystoscopy was performed confirming PU and the cystoscope was left in situ to aid laparoscopic exploration after bladder was emptied. A 5-mm umbilical port and two 5-mm ports in both lower quadrants were inserted. The peritoneum was dissected behind bladder. The cystoscope in PU was used as guidance in identification and dissection of PU. The vas deferens was identified and could be secured. The neck of PU was ligated with surgiloop. PU was retrieved from umbilical port. Postoperative VCU revealed normal posterior urethra. He has been free of UTIs for the last 6 months. Laparoscopy is safe and feasible alternative in surgical management of PU, by providing good visual exposure, easy dissection in deep pelvis, and improved cosmesis. The cystoscopic guidance is an important aid in identification and dissection of PU.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"8 1","pages":"e35-e38"},"PeriodicalIF":0.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1705155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The First Reported Pediatric Case of Primary Myoepithelial Carcinoma Involving the Whole Lung: Surgical Radical Treatment and Prosthesis Implant.","authors":"Claudia Filisetti,&nbsp;Tiziana Russo,&nbsp;Andrea Pansini,&nbsp;Claudio Vella,&nbsp;Camilla Viglio,&nbsp;Giovanna Riccipetitoni","doi":"10.1055/s-0040-1713766","DOIUrl":"https://doi.org/10.1055/s-0040-1713766","url":null,"abstract":"<p><p>Primary myoepithelial carcinoma of the lung (PMC-L) arising from the bronchial glands in lower respiratory tract is exceedingly rare. Thus far, few cases in adults and only one in a pediatric patient have been recorded. To our knowledge, this is the first report of PMC-L successfully removed in a child, focusing on the importance of multidisciplinary primary surgery for the treatment of this tumor. A 7-year-old girl was admitted for persistent cough and fever; she was unresponsive to oral antibiotics. Chest radiography showed loss of volume of left lung sustained by almost total atelectasis. After routine clinical investigations, she was referred for computed tomography scan and magnetic resonance imaging that documented the presence of a mass occupying the entire left upper lobe, infiltrating the pulmonary hilum (main bronchus, pulmonary artery, superior pulmonary vein, and pericardium). After multidisciplinary evaluation, the histopathologic diagnosis of PMC-L was established using ultrasonography-guided transthoracic core needle biopsy and bronchoscopic biopsies. She was then subjected to left pneumonectomy under extracorporeal circulation and positioning of a thoracic expander filled with 200 mL of saline solution. The postoperative course was uneventful. With TREP (very Rare Tumor in Pediatric Age) consent radiotherapy was performed (61.2 Gy). At the 10-month follow-up, the patient was alive, breathing normally without any oxygen support, without recurrence of PMC-L or metastasis, and without any chest deformity. To our knowledge, this is the first case where a pediatric patient was successfully operated for PMC-L involving the whole lung. Extracorporeal circulation enabled us to perform radical primary surgery. Prosthesis implant not only maintained normal chest expansion but also allowed focused radiotherapy, thus enabling us to prevent damage to vital organs.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"8 1","pages":"e52-e55"},"PeriodicalIF":0.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1713766","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38300799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When It Doesn't Fit: Congenital Anomalies of the Choledochus.","authors":"Helena Reusens,&nbsp;Mark Davenport","doi":"10.1055/s-0039-1693998","DOIUrl":"https://doi.org/10.1055/s-0039-1693998","url":null,"abstract":"<p><p><b>Introduction</b>  Congenital choledochal malformations (CCMs) are characterized by intra- and/or extrahepatic bile duct dilatation. Five basic types (1-5) are recognized in Todani's classification and its modifications, of which types 1 and 4 typically have an associated anomalous pancreatobiliary junction and common channel (CC). We describe two cases with previously undescribed features. <b>Case Report</b>  1 Antenatal detection of a cyst at porta hepatis was made in an otherwise normal girl of Iranian parentage. She was confirmed to be a CCM (20 mm diameter), postnatally, with no evidence of obstruction. Surgical exploration was performed at 12 weeks. She had an isolated cystic dilatation of the right-hepatic duct only. The left-hepatic duct and common bile duct (CBD) were normal without a CC. Histology of the resected specimen showed stratified squamous epithelium. <b>Case Report 2</b>  A preterm (31 weeks of gestation) boy of Nigerian parentage was presented. His mother was HIV + ve and he was treated with nucleoside reverse transcriptase inhibitors following birth. He had persistent cholestatic jaundice and a dilated (10 mm) bile duct from birth. Although the jaundice resolved, the dilatation persisted and increased, coming to surgery aged 2.5 years. This showed cystic dilatation confined to the common hepatic duct, and otherwise normal distal common bile duct and no CC. <b>Result</b>  Both underwent resection with the Roux-en-Y hepaticojejunostomy reconstruction to the transected right-hepatic duct alone in case 1, leaving the preserved left duct and CBD in continuity, and to the transected common hepatic duct in case 2. <b>Conclusions</b>  Neither choledochal anomaly fitted into the usual choledochal classification and case 1 appears unique in the literature.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"8 1","pages":"e86-e89"},"PeriodicalIF":0.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1693998","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38711721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal Perforation following High-Pressure Distal Colostogram.","authors":"Giulia Brisighelli,&nbsp;Liam Lorentz,&nbsp;Tanyia Pillay,&nbsp;Christopher J Westgarth-Taylor","doi":"10.1055/s-0040-1709140","DOIUrl":"https://doi.org/10.1055/s-0040-1709140","url":null,"abstract":"<p><p>In patients with anorectal malformations and a colostomy, the high-pressure distal colostogram is the technique of choice to determine the type of malformation and thus to plan the surgical repair. Perforations associated with high-pressure distal colostograms are very rare. The aim of our study was to identify pitfalls to prevent perforation secondary to high-pressure distal colostogram. The study included two male patients and was complicated with rectal perforations secondary to high-pressure distal colostogram. Both patients had an imperforate anus without a fistula. One patient had extraperitoneal rectal perforation with progressive contrast spillage into the peritoneum and demised. The other patient developed an extraperitoneal perforation and an associated necrotizing fasciitis of his perineum and scrotum, but he recovered well after debridement. Two further cases of rectal perforation have been described in the literature. Rectal perforation, although rare, is a described life-threatening complication secondary to high-pressure distal colostogram. The cause is excessive contrast pressure. Injection of contrast should be stopped once the distal end of the colon has a convex shape. Intraperitoneal perforation may cause hypovolemic/septic shock, and patients need to be appropriately resuscitated and should undergo laparotomy. Extraperitoneal perforation requires close monitoring for possible local complications, which may necessitate early debridement.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"8 1","pages":"e39-e44"},"PeriodicalIF":0.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1709140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image of the Month: High Pressure Distal Colostogram in a Patient with an Anorectal Malformation.","authors":"Anisha Apte,&nbsp;Giulia Brisighelli,&nbsp;Elise McKenna,&nbsp;Marc A Levitt","doi":"10.1055/s-0040-1721051","DOIUrl":"https://doi.org/10.1055/s-0040-1721051","url":null,"abstract":"<p><p>An adequately performed high pressure distal colostogram is crucial to plan surgery in male patients born with anorectal malformations. We present two male patients that underwent a divided sigmoid colostomy with distal mucus fistula in the neonatal period and at 6 months of age underwent a high pressure distal colostogram. In the discussion, we will give some tricks beyond the known rules: how to correctly interpret a high pressure distal colostogram, how to identify the level of a recto-urinary fistula, and how to accurately plan the surgical approach.</p>","PeriodicalId":43204,"journal":{"name":"European Journal of Pediatric Surgery Reports","volume":"8 1","pages":"e108-e111"},"PeriodicalIF":0.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1721051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38306896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}