scholarly journals Malrotation presenting beyond infancy: a clinical study

2018 ◽  
Vol 5 (10) ◽  
pp. 3288
Author(s):  
Anil Balraj T. ◽  
S. Srinivas ◽  
K. Ramesh Reddy ◽  
Manisha Reddy G. ◽  
Anusiri Inugala
Keyword(s):  
Congenital Anomaly ◽  
Pediatric Surgery ◽  
Clinical Presentation ◽  
Neonatal Period ◽  
Bowel Ischemia ◽  
Poor General Condition ◽  
Younger Patients ◽  
Small Intestinal ◽  
High Index Of Suspicion ◽  
And Child Health

Background: Intestinal malrotation is a congenital anomaly that results from abnormal or incomplete rotation and fixation of midgut during embryonic development. This study was done at Niloufer Hospital and Institute for Women and Child Health, Hyderabad with an aim of evaluating the clinical presentation, diagnosis, management and outcome of malrotation presenting beyond 1 year of lifeMethods: Overall 50 cases of malrotation presented to the department of pediatric surgery over a period of 2 year (April 2015 to April 2017). 12 patients of these 50 (12/50) whose age was above 1 year i.e. who were beyond infancy were studied in this studyResults: Out of the 12 patients, 6 were female and 6 were male. Age of patients ranged from 15 months to 13 years. Younger patients below 2 years commonly presented with typical symptoms of bilious vomiting and patients above 2 years of age presented with more varied and vague symptoms. 1/12 of patients presented with a poor general condition and succumbed during the course of treatmentConclusion: Small intestinal obstruction due to malrotation is relatively common in neonatal period. Malrotation beyond infancy is an uncommon diagnosis. Malrotation in grown up children usually is not suspected due to varied symptoms. High index of suspicion is needed as early intervention and treatment in the form of Ladds procedure can prevent any catastrophic events like volvulus and bowel ischemia.

scholarly journals Neonatal small bowel obstruction due to malrotation: a clinical study

2017 ◽  
Vol 4 (8) ◽  
pp. 2727 ◽  
Author(s):  
Srinivas S. ◽  
Reddy K. R. ◽  
Balraj T. A. ◽  
Gangadhar A.
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Pediatric Surgery ◽  
Clinical Presentation ◽  
Midgut Volvulus ◽  
Fatal Complication ◽  
Small Intestinal ◽  
High Index Of Suspicion

Background:This study was done at Niloufer hospital and institute of child health, Hyderabad with an aim of evaluating the clinical presentation, diagnostic evaluation, management and outcome of malrotation of intestines in the neonates.Methods: Cases of neonatal small intestinal obstruction due to malrotation presenting to the Department of Pediatric Surgery, Niloufer hospital over a period of two years were evaluated.Results: A total of 38 newborns presented to our department with intestinal obstruction due to malrotation. 3/38 patients presented with extensive gangrene of midgut. 4/38 patients died during the course of treatment.Conclusions: Malrotation is a relatively common cause of neonatal small bowel obstruction. A high index of suspicion is needed in neonates presenting with bilious vomiting. Early laparotomy prevents fatal complication of extensive gangrene due to midgut volvulus. 

scholarly journals Clinical and Imaging Features of a Congenital Midline Cervical Cleft in a Neonate: A Rare Anomaly

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Rachelle Goldfisher ◽  
Pritish Bawa ◽  
Zachary Ibrahim ◽  
John Amodio
Keyword(s):  
Congenital Anomaly ◽  
Pediatric Surgery ◽  
Clinical Presentation ◽  
Imaging Features ◽  
Rare Congenital Anomaly ◽  
Rare Anomaly ◽  
Work Up ◽  
Midline Cervical Cleft

Congenital midline cervical cleft (CMCC) is a rare congenital anomaly. CMCC and its complications and treatment have been well described in ENT, dermatology, and pediatric surgery literature. However, to our knowledge, the imaging work-up has not been reported in the literature thus far. We present a case of CMCC in a neonate with description of clinical presentation and imaging features.

Small Intestinal Tumors

2016 ◽  
Vol 1 (1) ◽  
pp. 9-12
Author(s):  
SM Sharma
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Early Detection ◽  
Clinical Presentation ◽  
Malignant Tumors ◽  
Morbidity And Mortality ◽  
Intestinal Tumors ◽  
Benign Lesions ◽  
Younger Patients ◽  
Small Intestinal

ABSTRACT Small intestinal tumors are rare despite small gut being a long structure with extensive mucosal surface. The clinical presentation is vague and the existence of tumor is detected after specific investigations. Small gut can be benign or may be malignant. Malignant tumors present with abdominal pain, weight loss, anemia, obstructive features, abdominal lump, diarrhea, intussusception and even fever depending upon the type of lesion. Malignancy occurs generally in elderly group above 60 years; however, younger patients too may be affected. Benign lesions may remain asymptomatic for long till these cause complications like intussusception or obstruction. Early detection and appropriate intervention can avoid morbidity and mortality. How to cite this article Sharma SM. Small Intestinal Tumors. Int J Adv Integ Med Sci 2016;1(1):9-12.

Acute myocardial infarction in the neonatal period

2002 ◽  
Vol 12 (4) ◽  
pp. 411-413 ◽  
Author(s):  
S. Jothi Murugan ◽  
James Gnanapragasam ◽  
Joseph Vettukattil
Keyword(s):  
Myocardial Infarction ◽  
Left Coronary Artery ◽  
Neonatal Period ◽  
Acute Onset ◽  
Cardiac Centre ◽  
Electrocardiographic Changes ◽  
Echocardiographic Assessment ◽  
High Index Of Suspicion ◽  
Treatable Condition ◽  
Fatal Myocardial Infarction

AbstractWe describe two neonates presenting with myocardial infarction, due to two different aetiologies of this extremely rare but potentially treatable condition, and discuss the management. One neonate had myocardial infarction complicating enteroviral myocarditis and recovered completely. The second had fatal myocardial infarction due to thrombosis of the left coronary artery. Although rare, the attending paediatrician should have a high index of suspicion when evaluating a neonate with acute onset of collapse. Electrocardiographic changes are diagnostic, but further echocardiographic assessment and prompt management at a tertiary cardiac centre are advised.

CONGENITAL SUCRASE-ISOMALTASE DEFICIENCY

PEDIATRICS ◽  
1972 ◽  
Vol 49 (6) ◽  
pp. 847-853
Author(s):  
I. Antonowicz ◽  
J. D. Lloyd-Still ◽  
K. T. Khaw ◽  
H. Shwachman
Keyword(s):  
Growth And Development ◽  
Clinical Presentation ◽  
Quantitative Estimation ◽  
Failure To Thrive ◽  
Normal Growth ◽  
Significant Rise ◽  
Small Intestinal Mucosa ◽  
Severe Diarrhea ◽  
Young Infants ◽  
Small Intestinal

Observations over a period of 6 years are reported on 10 children in whom the diagnosis of congenital sucrase isomaltase deficiency (SID) was confirmed by quantitative estimation of disaccharidase activity of the small intestinal mucosa. Repeat biopsies were performed on eight of the ten patients and showed no evidence that sucrase isomaltase activity is acquired. Sucrose tolerance tests (2 gm/kg) showed no significant rise in blood glucose in the seven patients in whom they were performed. This condition may appear in young infants with severe diarrhea resulting in a malabsorption syndrome and failure to thrive. It may also be manifest in a milder clinical presentation with bothersome diarrhea in spite of normal growth and development in the older infant or young child. The diagnosis in this latter group can be difficult, and is frequently missed.

scholarly journals Abdominal Tuberculosis

2017 ◽  
Vol 28 (1) ◽  
pp. 39-45
Author(s):  
Md Ismail ◽  
Golam Azam
Keyword(s):  
Clinical Presentation ◽  
Imaging Study ◽  
Abdominal Tuberculosis ◽  
Clinical Feature ◽  
Ascending Colon ◽  
Diagnostic Dilemma ◽  
Mdr Tb ◽  
Colon And Rectum ◽  
Frequent Site ◽  
High Index Of Suspicion

Abdominal tuberculosis constitute up to 12% of extrapulmonary TB and is sixth frequent site of extrapulmonary involvement. The most common sites of involvement is the ileocaecalregion. Other site of involvement in descending order are ascending colon jejunum, appendix, duodenum, stomach, esophagus, sigmoid colon and rectum. Abdominal TB has diagnostic dilemma due to its diverse and non-specific clinical presentation and has no single most specific, sensitive diagnostic test. A high index of suspicion, common and rare clinical feature, adequate imaging study, endoscopy, enteroscopy, laparoscopy, laparotomy, biopsy with histopathology, Mycobacterial isolation, Quantiferon-TB Gold, GeneXpert Assay, MULTIPLEX PCR and clinical response to anti TB therapy are considered for early diagnosis to reduce morbidity and mortality. Six month antiTB regime is effective as nine or 12month therapy. MDR TB and frequent interruption of therapy should considered in nonresponder to standard therapy. Surgery is required for minority cases that developed complications not responding to medical therpy.Medicine Today 2016 Vol.28(1): 39-45

Recently Recognized Cases of Ophthalmofilariasis in Hungary

2009 ◽  
Vol 19 (4) ◽  
pp. 675-678 ◽  
Author(s):  
Eszter Fodor ◽  
Éva Fok ◽  
Erika Maka ◽  
Olga Lukáts ◽  
Jeanette Tóth*
Keyword(s):  
Clinical Presentation ◽  
High Index ◽  
Dirofilaria Repens ◽  
The Other ◽  
Slit Lamp ◽  
The Past ◽  
Red Eye ◽  
High Index Of Suspicion ◽  
Slit Lamp Biomicroscopy

Purpose To report four cases of zoonotic ophthalmodirofilariasis infection caused by Dirofilaria repens in Hungary. Methods Four cases of ophthalmofilariasis have been treated at our department during the last 14 months. A subconjunctival moving worm was observed by slit lamp biomicroscopy in two cases. In one of these a living filaria was surgically removed, but the other disappeared. Red eye and migrating edema were the presenting signs in two cases. A biopsy taken from the subcutaneous masses disclosed D repens. Results Histopathologic or parasitologic examination identified a female D repens in every case. Laboratory alterations were not found. Symptoms subsided after treatment. Conclusions The clinical presentation of filariasis is not always straightforward, and a high index of suspicion is necessary in cases presenting with orbital or periorbital inflammation. During the past 10 years the identification of locally acquired infections by D repens has increased in Hungary.

Arthroscopy-Assisted Retrograde Drilling of Osteochondral Lesions of the Talar Dome

2005 ◽  
Vol 95 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Scott C. Nelson ◽  
Darryl M. Haycock
Keyword(s):  
Clinical Presentation ◽  
Osteochondral Lesion ◽  
Final Diagnosis ◽  
Osteochondral Lesions ◽  
Resonance Imaging ◽  
Talar Dome ◽  
Advanced Imaging ◽  
Retrograde Drilling ◽  
High Index Of Suspicion

Traumatic ankle conditions can lead to long-term sequelae if a pathologic process is misdiagnosed. The clinical presentation of an osteochondral lesion of the talar dome requires the clinician to have a high index of suspicion, and advanced imaging is often necessary to make the final diagnosis. Treatment should be initiated once the lesion is appropriately staged by radiologic or magnetic resonance imaging. We discuss the use of arthroscopy-assisted retrograde drilling of the medial talar dome that spares the articular cartilage within the talotibial articulation. (J Am Podiatr Med Assoc 95(1): 91–96, 2005)

scholarly journals Symptomatic Hypokalemia in a 19-Year-Old Student

2020 ◽  
Vol 63 (3) ◽  
pp. 137-140
Author(s):  
Sara Pereira ◽  
André Salgueiro ◽  
Paula Rosa ◽  
Carla Peixoto ◽  
Marta Ferreira ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Metabolic Alkalosis ◽  
Clinical Presentation ◽  
Adrenal Adenoma ◽  
Screening Tests ◽  
Common Cause ◽  
Confirmatory Tests ◽  
High Index Of Suspicion ◽  
Prompt Diagnosis

Primary hyperaldosteronism (PA) is the most common cause of secondary arterial hypertension and is frequently undiagnosed. It affects all ages but is more frequent between 20 and 60 years old. The clinical presentation is variable, and the diagnosis is based on screening and, in equivocal cases, confirmatory tests. A 19-year-old student presented with complaints of extreme fatigue, arterial hypertension, hypokalemia and metabolic alkalosis, raising a high index of suspicion for PA. Screening tests were performed and its expressiveness excluded the need of confirmatory tests. CT-scan showed a unilateral adrenal adenoma and the patient was submitted to laparoscopic adenectomy without complications. Prompt diagnosis and treatment are essential to avoid long term complications of PA.

scholarly journals Circumcision requirement in children with phimosis: immediately or elective?

2020 ◽  
Vol 7 (2) ◽  
pp. 425-428
Author(s):  
Serpil Sancar ◽  
Elif Altınay Kırlı
Keyword(s):  
Pediatric Surgery ◽  
Clinical Presentation ◽  
Genital System ◽  
Common Condition ◽  
Pathological Findings ◽  
Undescended Testicle ◽  
Male Genital System ◽  
One Year ◽  
Referring Physicians ◽  
Male Genital

Objective: Phimosis is define as unretractable prepuce and has two different clinical presentation; pathological (PaP) and physiological. Physiological phimosis (PhP) is a common condition in children that does not require treatment. In our study, we aimed to determine the actual requirement for circumcision in patients with phimosis who were recommended circumcision. Material and Methods: Children who were offered circumcision due to phimosis between July 2019 and January 2020 and applied to the pediatric surgery and pediatric urology outpatient clinic were included in the study. They were evaluated in terms of referring physicians, genital examination findings and requirement for circumcision. Results: Between the study dates, 199 patients applied for circumcision due to phimosis.  126 patients are under one year old, 73 patients are over one year old. PhP was present in 194 of the patients and PaP in 5 of them. While PaP is not detected in patients under one year of age, there are 5 patients with PaP over one year of age (2%). There was no requirement for urgent circumcision in any of the patients. Genital examination revealed incidentally undescended testicle in 3 patients and hydrocele in 12 children. Conclusion: Male genital system examination and pathological findings are not well known by physicians. We think that there is a need for detailed training for physicians regarding PhP and childhood testicle pathologies.

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