scholarly journals Analysis of the risk of ovarian torsion in 49 consecutive pediatric patients treated at a single institution

2019 ◽  
Vol 2 (2) ◽  
pp. e000009
Author(s):  
Koshiro Sugita ◽  
Takafumi Kawano ◽  
Mukai Motoi ◽  
Toshihiro Muraji ◽  
Shun Onishi ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
White Cell Count ◽  
Ovarian Torsion ◽  
Imaging Findings ◽  
Single Institution ◽  
Exact Test ◽  
Cystic Masses ◽  
Ovarian Masses

PurposeAn early diagnosis of ovarian torsion is sometimes difficult due to variable clinical symptoms and non-specific imaging findings. We retrospectively reviewed patients with pediatric ovarian masses manifesting torsion.MethodsFifty-eight ovarian masses (55 episodes) in 49 non-neonatal patients treated from April 1984 to March 2017 were retrospectively analyzed. The Mann-Whitney U test and Fisher’s exact test were used for the statistical analysis.ResultsThe median age of these 55 episodes was 10.5 years old (range 1.0–23.0). Thirty-three patients presented with abdominal pain. Forty-five tumors and 13 cystic masses were resected and diagnosed pathologically (50 benign and 8 malignant). Torsion was identified in 15 cases (25.9%) at operation. The torsion masses were all benign, and 8 ovaries (53.3%) were successfully preserved. Comparing the torsion cases with the non-torsion cases, only the white cell count was significantly higher in the torsion cases (p=0.0133) and in the patients presented with abdominal pain (p=0.0068). The duration of abdominal pain was significantly shorter in ovary preserved cases than in oophorectomy cases.ConclusionThe white blood cell may be a helpful indicator of the presence of torsion as well as the need for surgery.

scholarly journals Idiopathic Sclerosing Encapsulating Peritonitis in a Patient with Atypical Symptoms and Imaging Findings

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Joseph Wetherell ◽  
Katherine Woolley ◽  
Rishi Chadha ◽  
Julia Kostka ◽  
Edin Adilovic ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Respiratory Distress ◽  
Clinical Symptoms ◽  
Failure To Thrive ◽  
Rare Condition ◽  
Imaging Findings ◽  
Atypical Symptoms ◽  
Sclerosing Encapsulating Peritonitis ◽  
Encapsulating Peritonitis

Sclerosing encapsulating peritonitis is a rare condition caused by a fibrotic membrane covering the small bowel which may lead to abdominal pain or obstruction. The cause may be primary and idiopathic or secondary to several diseases, treatments, and/or medications. The condition typically presents with bowel obstruction, and only one previous case has described ascites as the presenting sign. Sclerosing encapsulating peritonitis is typically diagnosed intraoperatively. We present a case of a patient who presented with atypical clinical symptoms including respiratory distress, recurrent abdominal ascites, and failure to thrive who was diagnosed nonoperatively.

Surgical tactic in treatment of ovarian masses in adolescents

2015 ◽  
Vol 6 (1) ◽  
pp. 81-86
Author(s):  
Svetlana Alekseevna Leontyeva ◽  
Elena Aleksandrovna Ulrikh ◽  
Nadezda Anatolyevna Kokhreidze
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Ovarian Tumor ◽  
Acute Abdominal Pain ◽  
Malignant Tumors ◽  
Ovarian Torsion ◽  
Reproductive Status ◽  
Gonadotropin Stimulation ◽  
Ovarian Masses ◽  
Status Of Women

Ovarian lesions in children are most frequently diagnosed in pubertal period. That could be associated with increased gonadotropin stimulation in this period. Most of the andexal masses in adolescents are benign. Malignant tumors of the ovary account less than 2 % in girls. Every girl with ovarian tumor and acute abdominal pain requires urgent differential diagnostic intervention and/or surgical treatment. The proportion of ovarian torsion is 2-3 % of all cases of abdominal pain in girls. This condition is an emergent gynecological pathology. One of the main aim of surgical treatment in young is to preserve fertility. Different surgery tactics in cases of ovarian masses in adolescents are reviewed in the article. The reproductive status of women underwent treatment for ovarian masses in childhood requires further investigations.

Comparison of doxorubicin cardiotoxicity in pediatric patients when given with dexrazoxane versus a continuous infusion

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9044-9044
Author(s):  
C. E. Herzog ◽  
W. Huh ◽  
N. Jaffe ◽  
J. Durand
Keyword(s):  
Continuous Infusion ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Test Results ◽  
Exact Test ◽  
Routine Monitoring ◽  
Number Of Patients ◽  
Significant Difference ◽  
Pediatric Service ◽  
Electrolyte Abnormalities

9044 Background: Despite the effectiveness of doxorubicin (D) in sarcomas, its use is limited by cardiotoxicity. Both delivery by continuous infusion (CI) and use of the cardioprotectant dexrazoxane (Z) have been used to reduce cardiotoxicity. Since 1998 patients with Ewing’s sarcoma seen at MDACC have been treated with a total of 540 mg/m2 D given with Z (ZD). During this period patients with osteosarcoma have been treated with 360–540 mg/m2 D given as a 48-hour infusion (CID). Methods: To compare the cardiotoxicity of ZD versus CID, we did a retrospective review of patients seen on the pediatric service at MDACC since 1998. Patients included needed to have had 1) planned therapy of at least 360 mg/m2 D, given either as ZD or CID; 2) measurement of ejection fraction (EF) prior to any D; and 3) routine monitoring of cardiotoxicity with EF. Patients were recorded as having cardiotoxicity for any EF<50% or clinical symptoms. Groups were compared by 2-sided t-test and Fisher’s Exact test. Results: A total of 64 patients were treated with ZD or DCI, 52 of which are evaluable. Comparison of ZD to CID showed no significant difference in age or male:female ratio. Total D dose was higher in ZD. Cardiotoxicity was higher in DCI as determined by number of patients with cardiotoxicity and EF on worst Echo. Conclusions: Despite the higher total dose of D, patients treated with ZD had less cardiotoxicity. Whether this is due to giving a cardioprotectant or other factors, such as, higher degree of electrolyte abnormalities or greater degree of anemia in patients treated with CID needs to be investigated. [Table: see text] No significant financial relationships to disclose.

scholarly journals Clinical and imaging findings of walled-off pancreatic necrosis misdiagnosed as an intra-abdominal neoplasia in a Schnauzer dog: A case report

2021 ◽  
Vol 66 (No. 1) ◽  
pp. 32-39
Author(s):  
J Kim ◽  
J Ko ◽  
H Yoon ◽  
H Kim ◽  
J Hwang ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Report ◽  
Soft Tissue ◽  
Pancreatic Necrosis ◽  
Abdominal Mass ◽  
Imaging Findings ◽  
Diagnostic Modality ◽  
Surgical Exploration ◽  
Cystic Masses

A 10-year-old Schnauzer presented with a 1-month history of vomiting, anorexia, and abdominal pain, and a recently detected intra-abdominal mass. The round, soft-tissue opacity masses identified on the radiography in the left mid-abdomen were confirmed as multifocal, cystic masses via ultrasonography. The necrotic masses mimicked an intra-abdominal neoplasia on the initial imaging examinations. The computed tomography (CT) clearly showed encapsulated masses with a necrotic fluid arising from the left limb of the pancreas and extending to the peripancreatic, paracolic, and perigastric regions. Based on the multimodal imaging, surgical exploration, and histopathology, the mass was diagnosed as a walled-off pancreatic necrosis (WOPN). CT is an effective diagnostic modality for diagnosing acute pancreatitis in WOPN.

scholarly journals REPETITIVE OVARIAN TORSION AS WARNING SIGN OF SEROUS AND MUCINOUS CYSTADENOMA IN CHILDREN - REPORT OF TWO CASES

2020 ◽  
Vol XXIII (91-92) ◽  
pp. 35-38
Author(s):  
Usiwoma Okeroghene Ataikiru ◽  
◽  
Emil Radu Iacob ◽  
Călin Marius Popoiu ◽  
Rodica Heredea ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pediatric Patients ◽  
Iliac Fossa ◽  
Mucinous Cystadenoma ◽  
Cyst Formation ◽  
Serous Cystadenoma ◽  
Ovarian Torsion ◽  
Warning Signs ◽  
Warning Sign ◽  
Late Adolescent

Cystadenomas are surface epithelial-stromal tumors. Although they are the most common type of ovarian tumor, seen mostly from late adolescent age, yet, they remain difficult to accurately diagnose clinically due to their diverse presentations similar to other diseases like functional cyst and appendicitis. We report the cases of two pediatric patients. The first one aged seventeen years and six months old with serous cystadenoma and the second patient aged seventeen years and three months old with mucinous cystadenoma, presenting with abdominal pain in the level of the right iliac fossa and abdominal pain in the inferior part of the abdomen respectively aiming to reveal some warning signs and particularities in diagnosis and management of female pediatric patients with ovarian cystadenomas. Conclusion: Recurrent ovarian torsion or recurrent cyst formation is a warning sign of mucinous cystadenoma and serous cystadenoma tumor requiring further investigations and treatment.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

scholarly journals Non-Celiac Gluten Sensitivity: A Challenging Diagnosis in Children with Abdominal Pain

2018 ◽  
Vol 73 (Suppl. 4) ◽  
pp. 39-46 ◽  
Author(s):  
Frank M. Ruemmele
Keyword(s):  
Abdominal Pain ◽  
Celiac Disease ◽  
Clinical Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Clear Cut ◽  
Clinical Presentations ◽  
New Findings ◽  
Three Phase ◽  
Gi Symptoms

Several disorders related to the ingestion of gluten are well recognized despite overlapping clinical presentations: celiac disease, an autoimmune enteropathy triggered by gluten ingestions in susceptible individuals, allergy to wheat, and more recently non-celiac gluten sensitivity (NCGS). While celiac disease and wheat allergy are well-known disorders with a clear-cut diagnosis based on clinical tests and biological parameters, NCGS is a more difficult diagnosis, especially in children with functional gastrointestinal (GI) complaints. NCGS is considered a syndrome of intestinal but also extraintestinal symptoms occurring within hours, but sometimes even after several days of gluten ingestion. In children, the leading symptoms of NCGS are abdominal pain and diarrhea, while extraintestinal symptoms are rare, in contrast to adult patients. No precise diagnostic test nor specific biomarkers exist, except a rather cumbersome three-phase gluten-exposure, gluten-free diet, followed by a blinded placebo-controlled gluten challenge with crossover to provoke symptoms elicited by gluten in a reproducible manner that disappear on gluten-free alimentation. Recent data indicate that the peptide part of wheat proteins is not necessarily the sole trigger of clinical symptoms. Mono- or oligosaccharides, such as fructan and other constituents of wheat, were able to provoke GI symptoms in clinical trials. These new findings indicate that the term gluten sensitivity is probably too restrictive. The incidence of NCGS was reported in the range of 1–10% in the general population and to increase steadily; however, most data are based on patients’ self-reported gluten intolerance or avoidance without a medically confirmed diagnosis. Treatment consists of gluten avoidance for at least several weeks or months. Patients with NCGS require regular reassessment for gluten tolerance allowing with time the reintroduction of increasing amounts of gluten.

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