ABSTRACT
PURPOSE: The objective of this study was to clarify the presentation, associated preceding illness, pathologic organisms, treatment and outcome of deep neck abscess in children according to age and location. METHODS: We retrospectively reviewed the in-patient charts of children treated at our hospital for deep neck abscess. Thirty-five such patients were identified as having been treated from March 1990 to December 2005. RESULTS: A total of 35 were enrolled in our study: 25 boys and 10 girls. Their ages ranged from 11 months to 15 years. Presenting symptoms included mass, fever, irritability, trismus and dysphagia. The most commonly known associated preceding illness was viral upper respiratory infection (53%). The most common site of infection was the submandibular space (37%). Bacteria was identified in 16 patients. The most common pathogen was Staphylococcus aureus. Thirteen (37%) children recovered from the infection with conservative treatment and twenty-four (68%) children received surgical drainage. The duration of hospitalization was longer in the group who underwent surgery than in the group who were managed with conservative treatment. No complication occurred. CONCLUSION: Unexplained torticollis, trismus or irritability in children were suggestive of deep neck abscess. Our results demonstrate that deep neck abscesses in children is respond well to conservative treatment if diagnosed early.
Subject(s)
Child , Female , Humans , Abscess , Bacteria , Deglutition Disorders , Drainage , Fever , Hospitalization , Neck , Pediatrics , Retrospective Studies , Staphylococcus aureus , Torticollis , TrismusABSTRACT
PURPOSE: Acute renal failure (ARF) is an important complication of rhabdomyolysis. The purpose of this study was to identify the major causes of rhabdomyolysis in children and to identify the factors associated with the developmet of ARF. METHODS: A retrospective chart review between January 1997 to June 2005 was conducted of 60 patients with a diagnosis of rhabdomyolysis. Rhabdomyolysis was defined by an elevation of serum creatine phosphokinase (CK) greater than 1,000 IU/L with a MM fraction more than 95% or serum myoglobin>300 mg/dL or positive urine myoglobin. Patients were excluded if they had evidence of myocardial ischemia, or cerebrovascular insufficiency. RESULTS: Sixty patients (37 males, 23 females) were enrolled, with the median age of 4.25 year. The most common causes of rhabdomyolysis were repiratory tract infection (9), seizure (7), hypoxia or asphyxia (6). Fifteen patients (25.0%) developed ARF and ten of them (66.0%) died. The initial serum creatinine, uric acid, potassium, pH and peak serum creatinine, initial systolic blood pressure, and mental status were statistically correlated with the development of ARF. The peak serum CK was associated with mortality of rhabdomyolysis. CONCLUSION: Acute renal failure was significant complication of rhabdomyolysis in children. Several clinical and laboratory factors were statistically associated with the development of ARF and death.
Subject(s)
Child , Humans , Male , Acute Kidney Injury , Hypoxia , Asphyxia , Blood Pressure , Cerebrovascular Disorders , Creatine Kinase , Creatinine , Diagnosis , Hydrogen-Ion Concentration , Mortality , Myocardial Ischemia , Myoglobin , Potassium , Retrospective Studies , Rhabdomyolysis , Seizures , Uric AcidABSTRACT
Foreign body ingestion is common in children. About 80% of ingested foreign bodies spontaneously pass through gastrointestinal tract. The management of an ingested magnet depends on its size, the same as for other foreign bodies. However, it has been reported that magnetic foreign body ingestion can lead to gastrointestinal fistula. We report here on the case of a 13-month-old boy who ingested two magnet bars that attracted to each other, and they were holding the gastric mucosa. A simple abdomen X-ray revealed that the location of two magnet bars was not changed according to the patient's positional change. The magnet bars were removed with an alligator forcep under gastroduodenal endoscopy.
Subject(s)
Child , Humans , Infant , Male , Abdomen , Alligators and Crocodiles , Eating , Endoscopy , Fistula , Foreign Bodies , Gastric Mucosa , Gastrointestinal Tract , Surgical InstrumentsABSTRACT
We report a boy with acute pancreatitis without abdominal pain accompanied by hepatic hematoma and massive ascites due to unperceived trauma. The case was difficult to diagnose with image study and the level of amylase. Strong suspicion of pancreatic injury based on mechanism of injury and clinical evaluation would be required to avoid a delay in diagnosis.