ABSTRACT
Introduction: Intussusception is the commonest cause of bowel obstruction in infancy and childhood. Early diagnosis and management is essential to reduce morbidity and mortality. The objective was to To review the diagnostic criteria of intussusception in infants and children to increase awareness of attending personnel for effective management decrease the rate of operative treatment and complications. Materials and Methods: The data collected of all 38 patients admitted in Kanti Childrens Hospital between 2008 September to 2009 September were studied prospectively. Each patient was evaluated in regard to age at presentation, sex, signs and symptoms, diagnostic method, treatment (operative, non-operative). Results: During study period of one year there were a total of 20 (52%) males and 18 (48%) females of age 3 months to 6 years. Pain abdomen was seen in 25(66%), vomiting 16(42%), diarrhea 15(40%), blood mixed with stool 10(26%). These symptoms were seen in different combination. X-ray erect abdomen was done in 15 and ultrasound in all 38 cases. Ten out of 15 (66.6%) patients with early presentation and diagnosis had successful barium enema reduction.10 (66.6%) had successful reduction and admitted to our hospital. 28(74%) patients were undergone laparatomy. Among 28 (74%) patents that had lapartotomy, manual reduction was successful in 18 and 10 required bowel resection and anastomosis. Conclusion: The awareness of early features of intussusception is important for early referral to tertiary centers for successful non-operative barium reduction and reduce the need of laparotomies in children.
ABSTRACT
Necrotizing enterocolitis (NEC) is a leading cause of morbidity and mortality among premature infants. Although the pathogenesis of NEC remains unclear, recent researches revealed several associated factors of the immature intestine, with an emphasis of delayed maturation of motor and digestive function, impairment of regulation of vascular flow and intestinal barrier function, and defective immune defense. Many clinical trials have investigated the preventive role of possible disease-modification factors, but only breast feeding and antenatal steroid were proven to decrease the incidence of NEC in meta- analyses. Recent multicenter studies demonstrated a promising outcome of probiotics supplementation in the prevention of NEC, which emphasized the role of abnormal bacterial colonization in the pathogenesis of NEC. Studies on optimal choice for surgically indicated infants with NEC (laparatomy versus primary peritoneal drainage) still remain inconclusive. As NEC is a disease with a multifactorial etiology, combinations of current evidence in practice are required to reduce the incidence of NEC.
Subject(s)
Humans , Infant , Infant, Newborn , Breast Feeding , Colon , Enterocolitis, Necrotizing , Incidence , Infant, Premature , Intestines , ProbioticsABSTRACT
Context: Trichobezoars (TB) are bezoars formed by ingested hair. TB are more common among girls and young women. The findings include a hard, mobile and painless abdominal mass in the epigastrium, anorexia, nausea and vomiting, weight loss and reports of thichophagia. Image abdominal studies can confirm the diagnosis. The treatment is based on the complete TB remotion.Case report: M.O.M., 16 years old, female, single, student, born and living in São Paulo. She reported anorexia, abdominal discomfort, halitosis and mild colicky abdominal pain associated with a lump three years ago. On examination: huge, non-tender, mobile, painful, palpable mass in the upper abdomen (13cm) without inflammatory sign. Plain films of abdomen: diffuse radiopaque mass in upper abdomen without gastric bubble. Abdominal ultrasound and computadorized tomography show enlarged stomach filled by heterogeneous material. Endoscopy demonstrates the stomach completely filled with black hair. Once the diagnosis was made, surgical treatment was indicated.
Subject(s)
Humans , Female , Adolescent , Bezoars/diagnosis , Bezoars/pathology , Bezoars/therapy , Bezoars , Stomach Diseases/diagnosis , Stomach Diseases/therapy , GastroscopyABSTRACT
0 05).Conclusion Rountine use of the nasogastric tube is not needed for the elective abominal surgery.