La Pediatria medica e chirurgica : Medical and surgical pediatrics
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Acute disseminated encephalomyelitis (ADEM) is a rare acute inflammatory demyelinating disorder of central nervous system characterized by multifocal white matter involvement. Children and young adults are more commonly affected. The onset of ADEM usually follows a viral infection or immunization after a mean period of 7-14 days. ⋯ We report a case of a 2-year-old girl with sudden onset of neurological symptoms (irritability, drowsiness, hemiparesis, ataxia, strabismus) after an upper respiratory tract infection. MRI showed the presence of multiple high signal areas in the brain and in the spinal cord. High doses of methylprednisolone (10 mg/Kg) i.v. determined a rapid and persistent improvement of neurological signs and symptoms.
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Midgut malrotation with volvulus is a life-threatening surgical emergency. Because the consequences of malrotation associated with midgut volvulus may be catastrophic, prompt diagnosis and treatment are required to prevent mortality and short-gut syndrome. ⋯ Imaging techniques (Rx, US) of the upper gastrointestinal tract must be very accurate in order to diagnose volvulus but frequently they fail to identify this illness. If any doubt exists, refer with pediatric surgical support for consultation.