European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
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In children, strokes occur with a frequency of 2 to 13 per 100,000. Risk factors include hematological, embolic and anatomical anomalies. But often the exact cause of strokes in pediatric patients remains unclear. ⋯ Follow-up clinical controls showed a favorable course. Today, at the age of 14 months, almost no neurological deficits are evident. To the best of our knowledge, no description of vascular cerebral complications combined with esophageal atresia can be found in the literature.
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Today, haemodynamically stable children with blunt liver trauma are treated conservatively and can be discharged from hospital within one week. We report on a 14-year-old boy with a blunt hepatic trauma grade III, who showed a pseudoaneurysm with active bleeding into the abdominal cavity after mobilisation on day 9. Supraselective angiography of the right hepatic artery was performed and 2 titanium coils and gelatine sponge particles were placed for embolisation. In view of this complication, we suggest carrying out colour Doppler sonographic imaging to rule out pseudoaneurysm in children with blunt hepatic trauma before they are discharged from hospital.
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Case Reports
Laparoscopic sleeve gastrectomy achieves substantial weight loss in an adolescent girl with morbid obesity.
The European guidelines for bariatric surgery clearly define criteria for operating children with morbid obesity. However the appropriate technique for this age-group has not been identified yet. So far gastric banding and Roux-Y bypass represent the standards, but they demand life-long tolerance of either an artificial device or significant malabsorption. Although laparoscopic sleeve gastrectomy (LSG) demands neither, it has not been advocated for this age-group as a stand-alone technique. We report the outcome and the rationale for this approach in a 16-year-old girl with morbid obesity. ⋯ LSG is a safe and effective option for bariatric surgery in obese adolescents. It can be offered as a stand-alone restrictive operation and could be extended to a malabsorptive procedure at any time. However longer follow-up is required before universally recommending this procedure.
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The aim of this study was to investigate latent manganese toxicity in patients with biliary atresia and to use this tool to predict the prognosis of biliary atresia patients after Kasai's portoenterostomy. ⋯ Although the study size is small, it shows that there is a risk of latent manganese toxicity in patients with biliary atresia who have undergone Kasai's portoenterostomy. Whole blood manganese assay in conjunction with brain MRI can be used to serially monitor these patients for early detection of these complications. This tool can be used for prognosis after Kasai's portoenterostomy and can also be extremely useful in selecting patients who will need a liver transplant on a priority basis.
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We report our experience in the postnatal management of congenital diaphragmatic hernia (CDH) after fetal endoluminal balloon tracheal occlusion (FETO). ⋯ CDH patients with a poor prognosis undergoing FETO had postnatal outcomes similar to non-prenatally studied cases and good prognosis cases.