A Pediatric Gastric Dieulafoy Lesion: A Case Report and Literature Review.

This report presents a case of a 16-year-old male with severe upper gastrointestinal bleeding caused by a Dieulafoy lesion (DL). A DL is a rare but life-threatening condition characterized by sudden and massive bleeding from a small arterial vessel in the gastrointestinal (GI) tract. Diagnosis is often made through esophagogastroduodenoscopy (EGD), which reveals an enlarged submucosal blood vessel. The patient was successfully treated with adrenaline injection and hemoclipping during EGD. This case highlights the importance of considering a DL as a potential cause of severe upper GI bleeding in pediatric patients and emphasizes the significance of early recognition and intervention to achieve favorable outcomes. Additional investigation is required to enhance our comprehension of the occurrence, etiology, and most effective approaches to managing DLs in pediatric patients.

Carcinoma tiroideo en niños y adolescentes: estudio retrospectivo / Thyroid carcinoma in children and adolescents: A retrospective review

Objetivo Describir la presentación clínica, el estudio preoperatorio, la intervención quirúrgica y complicaciones, así como la histología, el seguimiento y la supervivencia de pacientes con carcinoma tiroideo (CT) cuya edad es inferior a los 18 años en el momento de la presentación. Material y métodos análisis retrospectivo de los datos clínicos de todos los niños y adolescentes con diagnóstico histológico de CT seguidos en el Hospital São João, Oporto, desde el 1 de enero de 2000 hasta el 31 de marzo de 2010.Resultados se identificaron veintitrés pacientes, 19 niñas y 4 niños. La mediana de la edad de presentación fue de 17,0 años con una incidencia anual de 2,3 casos/año. El síntoma principal de presentación (60,8%) fue nódulo tiroideo solitario. Tres (13%) de los pacientes presentaban factores de riesgo para CT, 2 de los 3 habían recibido irradiación cervical. El otro era un fumador. Se realizó una tiroidectomía total en 16 pacientes (69,6%), 10 pacientes necesitaron una segunda intervención quirúrgica. Cuatro (17,4%) presentaron complicaciones postoperatorias. El examen histológico reveló CT diferenciado en todos los casos, con carcinoma papilar tiroideo en el 86,9% y carcinoma folicular en los restantes. Todos los pacientes recibieron tratamiento supresor con tiroxina y 20 recibieron tratamiento con yodo radiactivo terapéutico. Durante el seguimiento (7,1 años), 7 de los 23 pacientes presentaron nuevas metástasis y necesitaron un nuevo tratamiento. Todos los pacientes están vivos en la actualidad. Conclusiones El CT es una realidad entre la población pediátrica y los exámenes clínicos de niños y adolescentes debería incluir siempre una examen rutinario del tiroides (AU)

Objective To describe clinical presentation, preoperative study, intervention, histology, surgical complications and follow-up characteristics, and survival in patients with thyroid carcinoma (TC) with less than 18 years at presentation. Material and methods retrospective analysis of clinical data of all children and adolescents followed in S. João Hospital from January 1, 2000 to March 31, 2010 with histologic diagnosis of TC.Results Twenty-three patients were identified, 19 girls, and 4 boys. Median age at presentation was 17.0 years. Annual incidence was 2.3 cases/year. The main presenting symptom was a solitary thyroid nodule (60.8%). Three (13%) patients had risk factors for TC, 2 of the 3 had previous cervical irradiation. The other was a smoker. Total thyroidectomy was performed in 16 (69.6%), and 10 patients underwent a second surgical procedure. Four (17.4%) patients had postoperative complications. Histologic examination revealed differentiated TC in all, papillary thyroid carcinoma (PTC) in 86.9%, follicular carcinoma in the remaining. All patients received thyroxine suppressive therapy and 20 underwent therapeutic radioactive iodine (131I). During follow-up (7.1 years), 7 out of the 23 patients presented new metastases and needed new treatment. All patients are currently alive. Conclusions TC is a reality in pediatric population, thyroid routine examination should take part in all clinical examination in children and adolescents(AU)

Thyroid carcinoma in children and adolescents: a retrospective review.

OBJECTIVE: To describe clinical presentation, preoperative study, intervention, histology, surgical complications and follow-up characteristics, and survival in patients with thyroid carcinoma (TC) with less than 18 years at presentation. MATERIAL AND METHODS: retrospective analysis of clinical data of all children and adolescents followed in S. João Hospital from January 1, 2000 to March 31, 2010 with histologic diagnosis of TC. RESULTS: Twenty-three patients were identified, 19 girls, and 4 boys. Median age at presentation was 17.0 years. Annual incidence was 2.3 cases/year. The main presenting symptom was a solitary thyroid nodule (60.8%). Three (13%) patients had risk factors for TC, 2 of the 3 had previous cervical irradiation. The other was a smoker. Total thyroidectomy was performed in 16 (69.6%), and 10 patients underwent a second surgical procedure. Four (17.4%) patients had postoperative complications. Histologic examination revealed differentiated TC in all, papillary thyroid carcinoma (PTC) in 86.9%, follicular carcinoma in the remaining. All patients received thyroxine suppressive therapy and 20 underwent therapeutic radioactive iodine (131I). During follow-up (7.1 years), 7 out of the 23 patients presented new metastases and needed new treatment. All patients are currently alive. CONCLUSIONS: TC is a reality in pediatric population, thyroid routine examination should take part in all clinical examination in children and adolescents.

Pulmonary artery sling: An uncommon cause of stridor.

Pulmonary artery sling is a rare congenital condition often associated with congenital tracheal stenosis. Untreated pulmonary sling carries a high morbidity and mortality, most of which is due to the airway and other associated anomalies rather than the aberrant artery itself. We report the case of an infant presenting progressive respiratory distress after a viral infection. The workup revealed a left pulmonary sling with concomitant tracheal stenosis. This anomaly was successfully corrected by slide tracheoplasty and left pulmonary artery reinsertion. Conclusion pulmonary artery sling is a rare entity with a nonspecific clinical presentation, a high degree of clinical suspicion is needed in order to obtain the correct diagnosis.