Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
-
Case Reports
[Spontaneous pneumomediastinum in an adolescent: an underestimated cause of chest pain].
A case of mediastinal emphysema occurring without etiologic factor except a Valsalva's manoeuvre a few hours before admission in a 15-year-old boy is reported. Symptoms were cervical and chest pain with moderate dysphagia. Diagnosis was confirmed by palpating subcutaneous air in the neck region and mediastinal air on a chest roentgenogram. A CT scan was performed to exclude a concurrent pneumothorax. The patient recovered with bed rest. ⋯ Spontaneous pneumomediastinum results from nontraumatic, mediastinal air leakage without underlying lung disease. It should be considered in the differential diagnosis of chest pain, especially in healthy adolescents and young adults; it is certainly underdiagnosed in this population.
-
Button batteries are easily swallowed by children and may produce severe digestive injuries through two different mechanisms: electrochemical burns when in contact with the digestive mucosa, release of caustic substances when fragmented. Esophageal lesions are especially dangerous, as they can lead to perforation, fistula or secondary stenosis. The risk of mercury intoxication is less worrying since the assimilated fraction of the metal is unlikely to produce clinical effect. ⋯ Any battery lodged in the esophagus must be urgently removed by endoscopy. Other locations do not need any removal attempt unless complications: nonetheless a follow-up is necessary to confirm the spontaneous elimination of the battery. Manufacturers, physicians and parents share responsibility for preventing such accidents.
-
The subdural hematoma detected in utero is unusual but probably under-diagnosed and has a bad prognostic. ⋯ A subdural hematoma detected in utero may have a good prognostic. Prenatal MRI is useful for the check-up. However, medical and ethical problems remain in these cases.
-
We report our experience of the utilization of the 50% oxygen-nitrous oxide mixture (nitrous oxide 50%) in our general pediatric ward after one year of use. ⋯ Nitrous oxide (50%) can be used successfully in a general pediatric ward. Other studies are necessary to define the best conditions.
-
In recent years, close collaborations have been established between pediatric cardiology, medical and molecular genetics, fetal cardiology and pediatric radiology. As a consequence, several congenital heart defects and syndromes including cardiovascular malformations have been related to microdeletions such as 22q11 in Di George syndrome and 7q in Williams syndrome. ⋯ We are at the dawn of a new era of the development of preventive cardiovascular medicine starting from childhood thanks to new techniques of echo-tracking. Finally, three-dimensional reconstruction of heart defects by using ultrasound, X-ray or MRI have dramatically improved the diagnosis and the therapeutic strategies of cardiac diseases.