Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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A congenital mesenteric band is a rare cause of intestinal obstruction. We describe a case of upper gastrointestinal obstruction on a jejunal congenital band in a 2-year-old child. The challenge is to make the diagnosis in a patient with no history of previous surgery.
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Food protein-induced enterocolitis syndrome (FPIES) is a particular non-IgE-mediated food allergy, manifested by profuse and repetitive vomiting with hypotonia and lethargy in its acute form. ⋯ FPIES is a pathology that has suffered from a lack of knowledge, delaying diagnosis for many months. The progression of chronic forms to acute forms and acute forms to an IgE-mediated allergy is not rare. Doctors need more detailed knowledge: profuse and repetitive vomiting accompanied by hypotonia and/or lethargy should suggest the diagnosis of acute FPIES. To improve the management of acute FPIES, a treatment protocol is proposed here.
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Case Reports
[Hereditary neuropathy with liability to pressure palsies in childhood: Report of three cases].
Hereditary neuropathy with liability to pressure palsy (HNPP) is an autosomal dominant neuropathy. It is characterized by recurrent sensory and motor nerve palsies, usually precipitated by minor trauma or compression. Even though rare in childhood, this disorder is probably underdiagnosed given its wide spectrum of clinical symptoms. ⋯ The diagnosis of HNPP is confirmed by genetic testing, which in 90% of cases shows a 1.5-Mb deletion of chromosome 17p11.2 including the PMP22 gene. Patients are expected to make a full recovery after each relapse. However, it is very important for both the patient and his or her family to establish a diagnosis in order to prevent recurrent palsy brought on by situations involving prolonged immobilizations leading to nerve compression.
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Observational Study
[Use of high-flow nasal cannula in infants with bronchiolitis in a pediatric emergency department].
High-flow nasal cannula oxygen therapy (HFNC) is a technique for noninvasive ventilation commonly used in pediatric intensive care units for respiratory distress, particularly in acute bronchiolitis. HFNC was introduced in the pediatric emergency department of the Reims university hospital for the treatment of infants with moderate to severe acute viral bronchiolitis. This retrospective observational study aimed to investigate the use of HFNC in a pediatric emergency ward, describing the groups of infants with acute viral bronchiolitis to be treated either with conventional oxygen therapy or with HFNC therapy. ⋯ Moreover, modified Wood's score was higher and the mean PCO2 was 61.1 versus 49.9mmHg (P<0.01). Six infants treated with conventional oxygen therapy (7.9%) and six with HFNC (46.1%) were then transferred to an intensive care unit. HFNC therapy in the pediatric emergency ward seems to be an advantageous therapeutic option in the early treatment of infants with moderate to severe bronchiolitis, but further studies are needed to specify its indications and effectiveness.