Adolescent varicocele: the role of laparoscopic ligation and colour doppler ultrasonography

The objective of this study was to report the results of laparoscopic varicocelectomy and the role of color Doppler ultrasonography [CDU] in adolescent varicocele. Twenty-two laparoscopic varicocelectomies and CDU were performed for 18 patients. In the postoperative follow up period, symptoms disappeared in 17 patients, three patients had pneumoscrotum, one patient had vaginal hydrocele and one patient had recurrent varicocele. Ultrasonography showed the testicular growth in 15 patients within 12 months of surgery. CDU was an easy, effective and noninvasive modality for the pre and postoperative assessment of these patients

Non-operative treatment for blunt liver trauma in children: a successful, safe, cost effective protocol

In this study, a protocol for managing hepatic trauma in hemodynamically stable children was proposed where specific criteria for pediatric ICU admission were applied and ultrasonography replaced CT scan for following up the process of hepatic healing. The study was carried out on 51 children with blunt hepatic trauma. Initial CT scan was done to 49 patients and identified the hepatic injuries and their grade in all patients. Intraperitoneal fluid was found in 26 of these patients. CT scan at discharge confined the ultrasound findings in 47 discharge patients. Four patients died, one due to grade VI liver injuries and the other three due to severe associated head injuries. Although the pediatric ICU was the standard location for initial nonoperative management of children with blunt hepatic injuries, yet a successful, safe and cost effective treatment could be achieved for properly selected hemodynamically stable patients. Ultrasonography was an effective alternative to CT for following up the healing process of these liver injuries

Pyloric and antral webs in infants and children: underestimated entity?

The true incidence of pyloric and antral webs in infancy and childhood is debatable. Some authors claim to be rare, others present it as a condition occurring in epidemic form. Form 1992 through 1994, 10 patients with pyloric and antral webs were managed at Ain Shams University Hospitals. There were 5 girls and 5 boys with ages ranging firm 5 days to 5 years. The main presenting symptom was repeated non-bilious vomiting, Upper gastrointestinal barium study confirmed the presence of gastric outlet obstruction in all cases but typical signs of pyloric and antral webs were identified in only 6 patients. All patients underwent incision of the web and pyloroplasty with eventual recovery postoperatively. The finding of these 10 patients within this period suggests that the condition is not as rare as previously thought. Though some authors believe the value of conservative management on the assumption that the condition is self limiting, in all our patients treatment was basically surgical due to severity and persistence of symptoms that failed to respond to conservative management