Journal of pediatric surgery
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Cecal bascule is a rare type of intestinal obstruction that occurs when a mobile cecum folds upward and obstructs the ascending colon. Most often occurring in the elderly, we present the first reported case of cecal bascule in a child. ⋯ Cecal bascule should be considered in the differential diagnosis of children with early postoperative bowel obstruction, especially in the developmentally delayed status-post laparoscopic surgery. For the pediatric patient with cecal bascule, we recommend operative management with either cecopexy or resection.
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The surgical treatment for patients with progressive familial intrahepatic cholestasis (PFIC) is either liver transplantation (LTX) or partial external biliary diversion (PEBD). Both procedures achieve a good short-term outcome. However, the treatment strategy for these children remains controversial because the long-term outcome after PEBD is unknown. The aim of our study was to assess the long-term outcome and complications after PEBD in our institution. ⋯ Clinical improvement with normalization of serum bile acids within 1 year was associated with an excellent long-term outcome in patients with PEBD. The presence of liver cirrhosis at the time of PEBD indicated an unfavorable outcome. Thus, we recommend primary LTX only in PFIC patients with liver cirrhosis.
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Aneurysms are rare in children. Causes include congenital, traumatic, inflammatory, and infectious etiologies. When and how to best surgically treat arterial aneurysms in a child remain unclear. We present the case of a 3-month-old child with an aneurysm of the left common iliac artery, which was first detected on abdominal ultrasound and was successfully repaired with a cadaveric vein graft.