1,721,248 research outputs found
Ernia Jatale, Stenosi ipertrofica del piloro, Anomalie del dotto onfalo mesenterico. Duplicazioni intestinali
No full text
Ernia iatale.Stenosi ipertrofica del piloro. Anomalie del dotto onfalo mesenterico. Duplicazioni intestinali.
No full textPrima edizion
Abdominal wall defects:prenatal diagnosis, newborn management, and long-term outcomes
No full textOmphaloceleandgastroschisisrepresentthemostfrequentcongenitalabdominalwalldefectsa
pediatricsurgeoniscalledtotreat.Therehasbeenanincreasedreportedincidenceinthepast10years
mainlyduetothediffuseuseofprenatalultrasound.Theearlydetectionofthesemalformations,and
relatedassociatedanomalies,allowsamultidisciplinarycounselingandplanningofdeliveryinacenter
equippedwithhigh-riskpregnancyassistance,pediatricsurgery,andneonatology.Atpresenttimes,
closureofdefects,eveninmultiplestages,isalwayspossibleaswellasmanagementofmostofcardiac-,
urinary-,andgastrointestinal-associatedmalformations.Theprogress,hereindiscussed,inthecareof
newborns withabdominalwalldefectsassuresmostofthemsurviveandreachadulthood.Someaspects
of transitionofmedicalcarewillalsobeconsidered,includingfertilityandcosmesi
ENDOABDOMINAL FOREIGN BODY IN AN INFANT: A CASE REPORT
No full textA 40 days old newborn male was brought to the Emergency Paediatric Department by his parents at 8:00 a.m. suffering from abdominal distension, acute constipation and persistently crying. He is the first born of the couple, breast-fed and otherwise healthy. Up till the previous afternoon, the baby was perfectly normal and had evacuated regularly after the mid-day meal. In the hours that followed, he complained of lack of appetite, vomiting, fever and had recurrent crisis of crying that, during the night, became interminable. On medical examination the child appeared in general good health, but looked to be suffering greatly. The abdomen was tense and painful. Abdominal examination showed a hard and movable mass at lower quadrants. Ultrasound study and X-ray investigation confirmed the presence of a mass localised at sigma level and digital examination revealed an empty rectum and a mass could be palpated, with difficulty, as a high “faecaloma”. The anus was gaping and bleeding.
A first therapeutical approach was an attempt to remove the “faecal impaction” with rectal washing for some days. This treatment proved to be unsuccessful. On the fifth day we decided to remove the faecal mass by sedation in operating room. By the rectal approach some pieces of the mass were removed and they were discovered to be fragments of a vegetable. A laparatomy proved necessary to remove a big carrot (13 cm length and 3 cm width) within the sigma, split into two fragments.
The parents, informed immediately, expressed surprise and incredulity and confirmed that only they and some close relatives look care of the baby at all times.
The impossibility to attribute the finding of this inner foreign body to an accidental event left us no choice, but to report the case immediately to a magistrate
La plastica antireflusso nel paziente pediatrico neuroleso”.
No full textTo evaluate results of Nissen fundoplication in a neurologically impaired children population versus normal, considering symptoms improvement, general conditions, parents satisfaction, facility to assist the patient
Inflammatory markers for acute appendicitis in children: are they helpful?
No full textBACKGROUND/PURPOSE: Diagnosis of acute appendicitis in children remains challenging, and the role of blood tests in the decision-making process is still unclear. We prospectively evaluated if routine inflammatory markers could contribute to exclude the presence of acute appendicitis in children.
METHODS: Preoperative white blood cell count (WBCC) and C-reactive protein (CRP) were prospectively tested in children undergoing surgery for suspected appendicitis. Surgery was indicated on the basis of clinical findings and/or ultrasound scan, but WBCC and CRP values were ignored during the decision-making process. Sensitivity of individual markers and their combinations were assessed.
RESULTS: One hundred children (55 males) with a mean age of 9.34 years (SD, 3.54 years) had pathologically confirmed diagnosis of appendicitis. A perforated appendix was found in 23% of cases. Elevated WBCC alone had a sensitivity of 0.6 (confidence interval [CI], 0.506-0.694). Sensitivity of elevated CRP alone was 0.86 (CI, 0.926-0.793). Elevation of either WBCC or CRP or both had a sensitivity of 0.98 (CI, 1.0-0.953).
CONCLUSIONS: White blood cell count or CRP values alone do not appear to provide any useful additional information to the surgeon. However, the sensitivity of the 2 combined tests is extremely high, and normal values of both WBCC and CRP are very unlikely in pathologically confirmed appendicitis
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