Pediatric ovarian sliding inguinal hernia, is surgical repair urgent?

OBJECTIVES: To find if repairing sliding inguinal hernias containing the ovary should be carried out urgently or not. METHODS: A retrospective chart review carried out at King Abdulaziz Medical City, Riyadh, Saudi Arabia from 2015-2022. All cases with an ovarian inguinal hernia in females aged 0-14 years were reviewed after obtaining approval from the Institutional Review Board. RESULTS: Female children with inguinal hernia patients were 191. A total of 28 cases were sliding inguinal hernias involving the ovary. All were repaired electively except for 4 cases that had an initial presentation of an incarcerated ovary at age less than 90 days which required urgent reduction and repair. CONCLUSION: Based on our review, ovarian sliding hernias in female patients can be repaired electively, although newborns are at a higher risk of complications from sliding inguinal hernias.

Case Series and Review of Literature of Malignant Adrenocortical Neoplasms: Experience of Two Tertiary Centers in Saudi Arabia.

Pediatric malignant adrenocortical neoplasms are among the rarest tumors encountered by pediatric surgeons and oncologists. In Saudi Arabia, only case reports exist due to the rarity of the condition. In this case series, we present five cases of malignant adrenocortical neoplasm and their clinical outcomes from two tertiary centers in Riyadh, Saudi Arabia, from 2012 to 2021. Patients ranged in age from one to eight years. We report the cases of three female and two male patients. All cases presented with hormonally active tumors. In two cases where tumors were excised with negative margins, only surgery and close follow-up were performed. In three cases, neoadjuvant and/or adjuvant therapy was required. In conclusion, for malignant adrenocortical neoplasms, the timing of diagnosis played a vital role in outcomes. Best outcome can be achieved with complete surgical excision as malignant adrenocortical neoplasms show a poor response to other treatment modalities.

Patterns of pediatric thoracic penetrating injuries: A single-trauma-center experience in Riyadh, Saudi Arabia.

OBJECTIVES: To review the patterns and outcomes of pediatric thoracic penetrating injuries in a level one trauma center. METHODS: Retrospective chart review of pediatric patients who presented to the King Abdulaziz Medical City Emergency Department (KAMC-ED), Riyadh, Saudi Arabia with thoracic penetrating injury from 2001 to 2016. RESULTS: Eighty-nine patients had a penetrating injury to the thorax were identified. The mean age was 15.5 ± 3.6 years. The mean length of hospital stay was 3.87 ± 5 days. The most common cause was stabbing followed by gunshot. Isolated injury to the thorax was seen in 58 patients. The most common injuries sustained were pneumothorax and hemothorax. In the ED, tube thoracostomy was required in 65 patients, endotracheal intubation in 12, blood transfusion in 14, massive blood transfusion in one, pericardiocentesis in one, and ED thoracotomy in 2. Only 15 patients required surgical intervention. The overall mortality rate was 3.4%. Death was mainly caused by associated injuries to the heart, aorta and/or inferior vena cava. CONCLUSION: Thoracic injuries represent 25% of the overall penetrating traumas in pediatric age group. Most sustained injuries can be safely managed non-operatively, with a favorable outcome. Prompt resuscitation and intervention are required to identify and manage life-threatening injuries.

Clinicopathological features of resected pediatric congenital lung and mediastinal lesions: A single institution experience.

OBJECTIVES: To evaluate resected congenital lung and mediastinal lesions among children and their characteristics in a single tertiary hospital. METHODS: A retrospective chart review analysis of all patients under 14 years of age who underwent congenital lung and mediastinal lesion resection in a single tertiary center from June 1997 to June 2018 was performed. RESULTS: In total, 108 cases of resected lung and mediastinal lesions were performed from June 1997 to June 2018. Congenital lung and mediastinal lesions were found in 52 (48%) cases. Overall, 23 cases were males (44%) and 29 (56%) were females. The most common histopathology was congenital lobar emphysema. CONCLUSION: This study provides a 21-year review of the clinical and histopathological features of resected congenital lung and mediastinal lesions in a single center. Congenital lung and mediastinal lesions represented 48% of all resected lesions.