RESUMO
Background: Congenital diaphragmatic hernia [CDH] is considered as one of the most common congenital anomalies. As a result, significant literatures have been done to assess the different management procedures and outcomes of each. Assessment of these literatures will support in providing better outcomes for the patients
Objective: Aim of the study: Assessment of different management plans of CDH, and the outcomes related. In addition to providing scientific references for analyzing all the clinical studies in this field
Methods: PubMed database was used for articles selection. We included all relevant articles to our review with the following topics: Congenital Diaphragmatic Hernia, Management, Outcomes, Morbidity, and Mortality. We excluded other articles which are not related to this field. The data were extracted according to specific form to be reviewed by group members to assess the different procedures, and the outcomes
Conclusion: Congenital Diaphragmatic Hernia has high complexity regarding its management. Prenatal screening is important because early diagnosis is helpful either in family education about the condition and its prognosis or in the decision regarding prenatal intervention. Smoking and alcohol intake are modifiable risk factors of CDH and their complications like prematurity, which is associated with high incidence of morbidity and mortality. Resolution and improvement of pulmonary hypertension either with or without treatment in the first 2-3 weeks was a major indicator of good prognosis of the case. Minimally invasive techniques showed lower rate of complications than open surgeries either prenatally like FETO or postnatally like thoracoscopic CDH repair. In addition, Hernia repair after decannulation from ECMO showed lower bleeding complications than repair on ECMO
RESUMO
Background: Acute intestinal obstruction occurs when there is an interruption in the forward flow of intestinal contents. This interruption can occur at any point along the length of the gastrointestinal tract, and clinical symptoms often vary based on the level of obstruction. Intestinal obstruction in children can occur as a result of various causes such as, intussusception, adhesive small bowel obstruction, malrotation, and Hirschsprung's disease. In this review paper we will go through the literatures that have been investigated to assess the various management measures and its outcomes
Objective: In this review we aimed at assessing of different management plans of gastrointestinal obstruction in different conditions like Intussusception, Congenital Duodenal Obstruction and Adhesive Small Bowel Obstruction [ASBO], and the outcomes related. Moreover, providing a reference paper analyzing all the clinical studies in this field
Methods: PubMed database was used for articles selection, and the following keys used in the Mesh ["Intestinal Obstruction/diet therapy"[Mesh] OR "Intestinal Obstruction/drug effects"[Mesh] OR "Intestinal Obstruction/ drug therapy"[Mesh] OR "Intestinal Obstruction/surgery"[Mesh] OR "Intestinal Obstruction/ therapy"[Mesh]]
Results: Intussusception should be treated with hydrostatic reduction [HR] even with more than one try because this method was associated with high success rate. After successful HR, patient can be discharged from ED if there were no suspected complications. Surgical treatment is indicated mostly in cases of complications. Manual reduction was associated with significantly better post-operative outcomes and lesser time to recovery. It is advised not to maintain high threshold for resection in order to avoid post-operative recurrence or perforation. The use of Gastrografin in treating children with adhesive small bowel obstruction when the conservative management fails is safe. However, half of the patients will need surgical management after all
Conclusion: The laparoscopic approach in the management of congenital duodenal obstruction can be performed in neonates safely. It showed similar outcomes to the open approach despite the presence of high conversion rate