[Acute abdomen in children: a continuous challenge. Two cases report: Meckel's diverticulum with small bowel volvolus and internal herniation related to epiploic appendagitis mimicking acute appendicitis]. / Addome acuto in età pediatrica: una sfida continua. Due casi clinici: volvolo intestinale su residue del dotto onfalo mesenterico e strangolamento ileale su appendice epiploica cecale.

Acute abdomen is a continuous clinical challenge in pediatric age. The aim of our study is to describe two pediatric rare cases: the first case is a small bowel volvolus related to Meckel's diverticulum confused with an intestinal intussusception; the second an internal herniation related to epiploic appendagitis with intestinal obstruction mimic acute appendicitis in two years old children. We review the current literature.

[Treatment of gastrointestinal bleeding in neonates: a case report]. / Scelta terapeutica nelle emorragie intestinali pediatriche: un controverso caso neonatale.

Gastrointestinal bleeding in infants and children is an uncommon and potentially serious problem, but fortunately is usually limited and most cases resolve with close medical attention. The therapeutic criteria is often difficult particularly in neonates. In this work we examine the case of a neonate with serious gastrointestinal bleeding and the delayed treatment for diagnostic difficulties.

Iatrogenic traumas by nasogastric tube in very premature infants: our cases and literature review.

OBJECTIVE: The nasogastric tube is the chosen nutritional technique in premature infants. However, it is not without complications. The aim of this study is to compare our experience in iatrogenic complications caused by nasogastric tube (especially in very low birth weight infants) to a review of the most recent literature. METHODS: From january to december of 2008, in the Department of Neonatal Pathology at the Hospital of Treviso, 118 premature patients were treated. 110 of them had a body weight less than 1,500gr: serious complications caused by nasogastric tube occurred in two of these very low birth weight infants. The first case relates an injury of the esophagus, while the second case is about a perforation of the posterior wall of the stomach, left lobe of the liver and the spleen hilus. RESULTS: The surgical treatment was limited to the second case ending in splenectomy and repair of the posterior gastric wall and liver lobe. DISCUSSION AND CONCLUSIONS: Among all the iatrogenic injuries described in the literature, this last case is the most serious. It is important to verify always the position of the gastric tube and to doubt for a dislocation in any case of deviation of the tube from the normal course. In those cases in which a patient suddenly goes from a full well-being to a critical state without a precise contingent cause it is imperative to check the nasogastric tube place. In addition those cases have guided us to change our habits for managing these critical patients: we are then oriented toward the usage of silastic gastric probes, which are softer, less dangerous for ulcer damages, and long term replaceable, thus reducing the possibility of a iatrogenic injury.

[Foreign body ingestion: a common problem in paediatric age]. / L'ingestione di corpi estranei in età pediatrica: una costante realtà.

Foreign body (F.B.) ingestion occurs very frequently in paediatric age. The kind of ingested foreign bodies depends on the patient's age. Children between 1 and 3 years of age mostly swallow coins, toy parts, stones and small batteries; instead, older children typically ingest boluses of meat. The aim of this study is to review our case histories according to the latest literature, focusing on some events that needed a therapeutic emergency treatment.

Carotid artery approach as an alternative to femoral access for balloon dilation of aortic valve stenosis in neonates and infants.

PURPOSE: to evaluate the efficacy of a right common carotid artery cutdown as alternative access in neonates and small infants requiring a balloon dilation of aortic valve stenosis. In infants, the femoral approach is limited by difficulties in advancing the catheter across the valve and by the risk of femoral artery injuries. METHODS: from January 1997 to July 2000, 16 infants at our department underwent balloon dilation through a carotid artery cutdown. Infant weight ranged from 2670 to 6450 g; mean weight 3967 g, and age ranged from 1 to 157 days, mean age 42,8 days. Fifteen of 16 infants had aortic valve stenosis; the remaining infant presented with a aortic coartation relapse. RESULTS: In 15 infants an adequate dilation of the valve was obtained with no complications. In only one infant an arterial intimal disconnection was caused by inadequate choice of surgical instruments. At the end of the procedure, the carotid arteries were reconstructed with interrupted 7-0 prolene stitches. There were no neurological sequaelae observed. All infants were followed-up and examined by echocolordoppler ultrasound: all carotid arteries were open with no significant stenosis. CONCLUSION: Our experience confirms that the carotid access proposed in 1973 by Azzolina et al is a valid and safe alternative to the usual percutaneous femoral access. In particular it could be useful in neonates and infants were the size of femoral vessels could facilitate important and dangerous complications.