Intestinal Malrotation, Mesocolic Hernia, and Meckel Diverticulum – Differential Diagnosis of Abdominal Pain in Adults: Case Report and Literature Review

AbstractIntestinal malrotation is a congenital anomaly caused by incomplete rotation or absence of rotation of the primitive intestine along the axis of the upper mesenteric artery during embryonic development. Embryonic development and its anatomical variations were described by Dott in 1923.Intestinal malrotation is a rare condition among adults – prevalent in a mere 0.0001% to 0.19% of the population –, and it may be associated with other anatomical deformities. It can be asymptomatic or manifest with varying intensity, from obstruction to necrosis of intestinal segments. In general, this abnormality is diagnosed in the first year of life; however, symptoms may appear later in life, making diagnosis in adults difficult on account of non-specific symptoms.In the present study, we report a case of intestinal malrotation associated with chronic non-specific symptoms progressing to mesenteric angina.

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Operation procedure of sacrococcygeal fetus in fetu

Paediatrica Indonesiana ◽

10.14238/pi51.1.2011.58-60 ◽

2011 ◽

Vol 51 (1) ◽

pp. 58 ◽

Cited By ~ 1

Author(s):

Rochadi Rochadi

Keyword(s):

Adrenal Gland ◽

Abdominal Mass ◽

Rare Condition ◽

Mature Embryo ◽

First Year ◽

Fetus In Fetu ◽

Sacrococcygeal Region ◽

Parasitic Twin ◽

Operation Procedure ◽

First Year Of Life

Fetus in fetu is a condition in wich a fetiform calcified mass often presents in the abdomen of its host, a newborn. It is extremely rare condition, estimated once in 500,000 deliveries and has a 2: 1 male predominantly; with most patient presenting with an abdominal mass in the first year of life. 5,13 The term fetus in fetu is used to point out an unequal division of totipotential cells of blastocyst where the result is the inclusion of a small cellular mass in the more mature embryo. It was encapsulated, pedunculated and represents a malformed monozygotic, monochorionic, diamniotic parasitic twin. In 80% cases, fetus in fetu is located retroperitonealy but can be found in unusual location such as in oropharynx, neck, skull mediastinum, pelvis, iliac mesentery, adrenal gland, sacrococcygeal region and scrotal sac.

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ETV6: Its Role in Mouse Development and Leukaemogenesis Using Knock-Out and Knock-In Models.

Blood ◽

10.1182/blood.v110.11.461.461 ◽

2007 ◽

Vol 110 (11) ◽

pp. 461-461

Author(s):

Stephen Hart ◽

Veronique Duke ◽

Richard Pannell ◽

Terence Rabbitts ◽

Kikkeri Naresh ◽

...

Keyword(s):

Embryonic Development ◽

Peripheral Blood ◽

Fusion Gene ◽

Genetic Alterations ◽

First Year ◽

Mouse Development ◽

Knock Out ◽

Short Period ◽

First Year Of Life

Abstract Disruption of the transcription factor ETV6 (TEL) is believed to play a pivotal role in the development of many types of leukaemia. As well as there being more than 15 ETV6 fusion gene partners described to date, there are other genetic alterations of ETV6 including deletions, point mutations and disruption in the ETV6 promoter region that may contribute to the malignant phenotype. We generated two Etv6 knock-out mouse models (Met1 and Met43) to investigate the role of Etv6 in mouse embryonic development and two knock-in models carrying the t(12;21) and t(9;21) fusion genes to investigate the role of the Etv6-RUNX1 and Etv6-ABL fusion oncoproteins in leukaemogenesis. Etv6-Met1−/− was compatible with full embryonic development. However, from a total of 382 animals generated from the Etv6-Met1+/− cross only 39 were identified as homozygous suggesting some embryonic lethality. A second knock-out construct (Etv6-Met43) was generated in which the second transcription start site at AA position 43 was removed. Of the 235 offspring genotyped from the Etv6-Met43+/− cross, no homozygous animals were identified. Further investigation revealed that Etv6-Met43−/− foetuses lacked definitive haematopoiesis and died between dE10.5–11.5. These data indicate that an Etv6 transcript generated from the methionine at AA position 43 can partially rescue the Etv6-Met1−/− phenotype. No mice homozygous for the Etv6-RUNX1 were identified from the 628 offspring genotyped from the Etv6-RUNX1+/− cross. Further investigation revealed that Etv6-RUNX1−/− foetuses displayed a similar phenotype to the Etv6-Met43−/− animals and died in-utero at a similar time. Etv6-RUNX1+/− animals were fertile and remained well for the first year of life. However, after this time in a group of 91 animals it was noticed that among 41 Etv6-RUNX1+/− animals, the majority were dying from a blastic haematological tumour formation best identified in spleens, at a higher incidence than in the 51 wild-type littermates. Chimeric mice targeted with the Etv6-ABL construct remained well for a short period after birth but all subsequently sickened and died within the first year of life. Upon examination peripheral blood as well as post-mortem organs showed a homogeneous infiltration of granulocytic cells resembling a chronic myeloid proliferation. RT-PCR on RNA isolated from the peripheral blood, bone marrow and spleen of three chimeric animals showed the presence of the fusion gene. Our study demonstrates that Etv6 is essential for mouse embryonic development. The role of Etv6 in malignant transformation is complex and would appear to be dependent on the function of the partner fusion gene rather than on the common Etv6 part of the protein.

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Suprapatellar bursitis in a newborn

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic644 ◽

2021 ◽

Vol 10 (2) ◽

pp. 199-202

Author(s):

IIya O. Erenkov ◽

Ivan S. Denisov ◽

Svetlana A. Zarubina

Keyword(s):

Knee Joint ◽

Blood Test ◽

White Cell Count ◽

Treatment Strategies ◽

Rare Condition ◽

Well Being ◽

Patient Treatment ◽

First Year ◽

First Year Of Life

Introduction. One of the most frequent pathologies in childhood is bursitis of the knee joint. Such conditions may occur in infectious pathologies, traumatic disorders, overuse syndromes, and other various pathologies. Diagnostic and treatment strategies depend on the cause of bursitis development. Particular attention should be paid to bursitis cases in newborns since the frequency of such pathologies is casuistic and clinical guidelines for treating patients in this age group are absent. Materials and methods. A 26-day-old newborn arrived for consultation with complaints of knee joint pain and movement restrictions for four days. From five to 21 days of life, she has had in-patient treatment at another clinic because of pneumonia and a urinary tract infection. Intravenous and intramuscular injections of antibacterial drugs were prescribed for two weeks. The condition of the newborn was satisfactory upon consultation in our clinic. Her physical examination showed swelling and muscle tightness on the distal part of the thigh. The range of motion of the shinbone was restricted. Her blood test showed that her white cell count was unchanged. According to an X-ray examination of the knee, no pathology was detected. According to the US-examination, exudative suprapatellar bursitis was detected. The nonsteroidal anti-inflammatory drug, Nimesulid, was prescribed for seven days. Results. Daily remote monitoring of the patient's well-being during treatment was performed. Movement restrictions reduced the swelling on day 3 of treatment. A follow-up blood test on day 4 of treatment showed no pathology. According to the follow-up US-examination after six days of drug therapy, no signs of bursitis were detected. Conclusion. Inflammation of the suprapatellar bursa is a rare condition in newborns. In isolated cases of bursitis in children during the first year of life, a bacterial presence was noted, with the predominance of staphylococcal and streptococcal floras. However, in our opinion, there is a possibility of developing aseptic forms of bursitis in infants. In these cases, it may be prudent to refrain from prescribing courses of antibiotic therapy.

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PECULIARITIES OF COVID-19 IN CHILDREN OF DIFFERENT AGE GROUPS

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2020-99-6-141-147 ◽

2020 ◽

Vol 99 (6) ◽

pp. 141-147

Author(s):

E.I. Krasnova ◽

◽

G.S. Karpovich ◽

T.V. Komissarova ◽

I.I. Izvekova ◽

...

Keyword(s):

Clinical Picture ◽

Pediatric Patients ◽

Clinical Symptoms ◽

Clinical Course ◽

Age Groups ◽

Epidemiological Data ◽

First Year ◽

High Incidence ◽

First Year Of Life ◽

Specific Symptoms

Materials and methods: a pilot open observational prospective study of 218 pediatric patients with laboratory-verified COVID-19 diagnosis was performed. The main epidemiological data were analyzed, including the age structure, as well as the features of the clinical course of this disease. The development of COVID-19 pneumonia was recorded in 11,5% of cases (25 patients), while more often pneumonia was recorded in children of the first year of life, as well as over 12 years of age (23,5% and 20% of cases, respectively) than in children of other age groups (p<0,05). CT-1 stage was recorded in 13 patients (52% of cases), CT-2 stage in 10 patients (40% of cases), CT-3 stage in 2 patients (8% of cases). The leading clinical symptoms of COVID-19 in children were: hyperemia of the mucous membranes of the pharynx – 100% of cases (218 patients); increased body temperature – 95,9% of cases (209 patients), while the average figures were 37,6 (36,6; 38,2)0 С; cough – 19,7% of cases (43 patients, of which 21 with pneumonia); diarrhea – 17,9% of cases (39 patients); vomiting – 6,4% of cases (14 patients); change in the auscultatory picture – 3,7% of cases (8 patients with pneumonia). In infants with COVID-19, diarrhea was more often recorded in comparison with patients in the age group over 13 years old (35% and 4% of cases, respectively; p=0,001). The development of cough was less often recorded in children of the first year of life, in Compared with patients over 13 years of age (9% and 40% of cases, respectively; p=0,004), the same trend was observed in COVID-19 pneumonia (25% and 89% of cases, respectively, p=0,02). Thus, the clinical picture of COVID-19 in pediatric patients is characterized by non-specific symptoms. There is a definite trend towards more frequent development of COVID-19 pneumonia in patients in the first year of life, as well as in puberty. Infants with COVID-19 pneumonia are characterized by a high incidence of atypical course of the disease, while adolescents are more likely to show a manifest clinical picture of COVID-19.

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Cyst of Canal of Nuck in a 62-Year-Old Woman: Case Report of a Rare Disease

International Journal of Surgical Case Reports ◽

10.31487/j.ijscr.2020.02.03 ◽

2020 ◽

pp. 1-5

Author(s):

Livia Bressan ◽

Barbara Pozzetto ◽

Bussani Rossana ◽

Livia Bressan ◽

Marina Bortul ◽

...

Keyword(s):

Spermatic Cord ◽

Inguinal Canal ◽

Rare Condition ◽

Round Ligament ◽

First Year ◽

Female Development ◽

Prolene Mesh ◽

Case Presentation ◽

Canal Of Nuck ◽

First Year Of Life

Introduction: Cyst of Nuck in women is a rare development disorder corresponding to hydrocoele of the spermatic cord in males; it can be associated with inguinal hernia in 30-40% of cases. Only 400 cases have been described in literature and in there are no older than 50. Case Presentation: A 62-year-old presented a right aching inguinal swelling. On physical examination the mass was not reducible, without signs of incarceration or strangulation. On ultrasound the lesion was mostly hypoechoic. CT saw an over liquid lesion, confirmed on MRI as a lesion hypointense in T1 and hyperintense in T2. The patient underwent open surgery: the cyst was separated from the round ligament and excised in mass and the defect was repaired with a prolene mesh. The histopathological exam confirmed the hydrocoele (calretinin positive, mesothelial cells on the inner surface). Discussion: The canal of Nuck is a small evagination of the parietal peritoneum that accompanies the round ligament into the inguinal canal during the first year of female development and is normally obliterated in the first year of life. Failure of obliteration of Nuck canal results in a hydrocoele that could develop intraabdominal or extra – abdominal or both. Ultrasound shows a thin walled, well defined, echo free cystic structure but the perfect diagnosis is given by MRI. Therapy is surgical and it can be open or, more recently, laparoscopic, depending on the expertise of the surgeon. Conclusion: A cyst of Nuck is a rare condition but it should always be considered in differential diagnosis of cystic inguinal lumps in women. Most of the reported cases concern children and young men. To our knowledge this is the only case regarding a more than 50-year-old.

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Spontaneous Perforation of the Extrahepatic Bile Ducts in an Infant

PEDIATRICS ◽

10.1542/peds.70.4.601 ◽

1982 ◽

Vol 70 (4) ◽

pp. 601-603

Author(s):

Dan Andersson ◽

Ingemar Helin ◽

Sven-Caspar Nettelblad ◽

Clas-Göran Cederlund

Keyword(s):

Surgical Treatment ◽

Obstructive Jaundice ◽

Biliary Atresia ◽

Bile Ducts ◽

Surgical Intervention ◽

Rare Condition ◽

First Year ◽

Spontaneous Perforation ◽

Extrahepatic Bile Ducts ◽

First Year Of Life

Spontaneous perforation of the extrapepatic bile ducts, with an accumulation of bile in the peritoneal cavity, is a rare condition. Nevertheless, it is second in frequency to biliary atresia as the cause of obstructive jaundice during the first year of life.1 Although approximately 60 cases of this condition have been described in the literature, it is only occasionally listed in pediatric textbooks. Nevertheless, it is important that the condition be recognized in time to perform lifesaving surgical intervention. We therefore consider it instructive to present a patient with the classic features of this condition who was cured by surgical treatment on the 29th day of life.

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The Development of Swallowing Respiratory Coordination

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd18.1.19 ◽

2009 ◽

Vol 18 (1) ◽

pp. 19-24

Author(s):

Maggie-Lee Huckabee

Keyword(s):

Cortical Activation ◽

First Year ◽

Healthy Children ◽

Nasal Airflow ◽

Single Session ◽

Primary Finding ◽

Patterns Of Behavior ◽

Cortical Modulation ◽

First Year Of Life ◽

Swallowing Apnea

Abstract Research exists that evaluates the mechanics of swallowing respiratory coordination in healthy children and adults as well and individuals with swallowing impairment. The research program summarized in this article represents a systematic examination of swallowing respiratory coordination across the lifespan as a means of behaviorally investigating mechanisms of cortical modulation. Using time-locked recordings of submental surface electromyography, nasal airflow, and thyroid acoustics, three conditions of swallowing were evaluated in 20 adults in a single session and 10 infants in 10 sessions across the first year of life. The three swallowing conditions were selected to represent a continuum of volitional through nonvolitional swallowing control on the basis of a decreasing level of cortical activation. Our primary finding is that, across the lifespan, brainstem control strongly dictates the duration of swallowing apnea and is heavily involved in organizing the integration of swallowing and respiration, even in very early infancy. However, there is evidence that cortical modulation increases across the first 12 months of life to approximate more adult-like patterns of behavior. This modulation influences primarily conditions of volitional swallowing; sleep and naïve swallows appear to not be easily adapted by cortical regulation. Thus, it is attention, not arousal that engages cortical mechanisms.

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