External hemorrhoids in children

Hemorrhoids in children are not common. The most common cause of hemorrhoids in the young children is portal hypertension. A 3 year old boy with history of hematemsis and external hemorrhoids is being reported. Patient had associated varices for which he was put on proparnolol

Evaluation of lab tests and correlation with hospital stay, transfusion and ICU care in paediatric trauma patients

The aim of this study was evaluation of lab tests and their correlation with hospital stay, transfusion and ICU care in pediatric trauma patients. Analytical study. Department of pediatric surgery at Imam Khomeini Hospital, Ahwaz, Iran from 2002 to 2006. All pediatric trauma patients, under 15 years of age admitted to the department during the study period were included. Their file record was put on a specially designed proforma noting age, gender, lab tests like complete blood count, serum electrolytes, urea, blood sugar, urine analysis etc. The data collected was analyzed by X[2] test via SPSS. A total of 86 patients were admitted during the study period. Among these 53 were boys. Abnormal tests were white blood cell / hemoglobin [68.6%, 23%] Na[+]/ K[+]/BS [7%, 15.1%, 60.5] and U/A 31.4%. Most of patients did not require blood transfusion, ICU care and surgery. The results for lab tests in trauma were similar to the results of studies in other countries. Leucocytes and hyperglycemia are important findings. Other laboratory results like anemia, hematuria and change of Na[+] and K[+] levels are of little value in the management of injured children

Peutz-Jeghers syndrome in a girl with chronic abdominal pain

It is a report of a seven years old girl with Peutz-Jeghers syndrome. Mode of presentation, various investigations, pattern of family history and management aspect are reported

Esophageal foreign bodies in children

Foreign bodies occasionally become lodged in the esophagus because of the object's size or shape, narrowing of the esophagus lumen, or anatomic abnormalities. The objective was to review our experience with esophageal foreign bodies removal in Ahawaz Imam Khomeini Hospital, Ahwaz, Iran. A retrospective review was completed of the 240 charts of patients admitted with the final diagnosis of esophageal foreign body during 10 years [March 20, 1993 - March 21, 2002]. Sex, age, diagnosis on admission, estimated duration and site of impaction, type and number of foreign body removed and complication were recorded. One hundred fifty six boys and 84 girls aged of 3 months and 14 years were admitted with the diagnosis of esophageal foreign body. Sixty- five percent of patients were four years or less in age, 2.9% had a history of esophageal anomalies requiring operation. The duration of impaction in 85.4% was less than 24 hours. Management consisted of rigid endoscopic removal in 238 patients and open surgical removal in two patients. Postcricoid area was the commonest site of impaction, and more than half [131 cases] of the foreign bodies were coins. Complications were noted in 10%. Foreign bodies of the esophagus are common in young children and are likely to occur whenever a child puts an inedible object in the mouth. A foreign body is removed more safely with a rigid esophagoscope and under general anesthesia

Rhabdomyosarcoma of the larynx

Rhabdomyosarcoma of the larynx is a very unusual neoplasm and delays in diagnosis are common because the presenting symptoms are often mistaken for inflammatory or benign laryngeal disease, therefore a high index of suspicion is necessary to make diagnosis. We report a 13 years old girl with diagnosis of laryngeal Rhabdomyosarcoma. The optimum treatment of head and neck rhabdomyosarcoma has not been defined. Therapeutic modalities include an aggressive surgery without major morbidity. Radiotherapy and chemotherapy is also preferred for the treatment of rhabdomyosarcoma

Vacterl association with sternal cleft

We present a case with Vacterl association. Our patient had imperforated anus associated with cardiac lesion and sternal cleft. Sternal cleft has not been reported before in the literature as a skeletal anomaly with Vacterl association

study of esophageal strictures after surgical repair of esophageal atresia

The aim of this study was to find out the prevalence of esophageal stricture [ES] following surgical repair of esophageal atresia. This retrospective study was carried out in two referral hospital [Bahrami and Children Medical Centre] from April 1999 till March 2000. Data was collected from patient's file and follow up clinics. Seventy four patients with esophageal atresia were operated during this period. Twenty one patients who died and two patients with long gap esophageal atresia were excluded from the study. Hence fifty one patients were included in this study. End to end anastomosis was done in 45 and end to side anastomosis in 6 patients. Forty five patients had extrapleural thoracotomy while 6 patients had intrapleural thoracotomy. Single layer and double layer anastomosis were done in 36 and 25 patients respectively. Vicryl was used for repair in 47 babies and silk in 4 patients. Standard post operative care was provided to all patients. Of 51 patients who survived 28 [54.8%] were male 23 [45.2%] female. Anastomotic leak was seen in 10 [19.6%] babies. 26 patients [M=16, F=10] developed ES. 22 [43.1%] patients had radiologically proven gastro-esophageal reflux. Incidence of stricture formation was significantly higher in babies who developed anastomosis leak after repair [p<0.05]. GER and leakage from the anastomosis site were significantly higher in the group A. The risk of stricture formation is a potential threat for up to a year in patients without G.E.R and up to 18 months in patients with GE Reflux. Leakage of anastomosis and GE Reflux play a major role in post operative strictures after esophageal atresia repair so treatment and prevention of these complications are very important