ABSTRACT
INTRODUCTION: Malignant neurogenic tumors /MNT/ are the third by frequency malignancies in children with mainly localization in the retroperitoneal space and posterior mediastinum. THE AIM: of this study is to compare the clinical presentation and the treatment results by young children with retroperitoneal and mediastinal MNT. CLINICAL MATERIAL: For a period of 12 years (1993 -2004) 52 children aged fron 1 month to 3 years were admitted at the Department of Pediatric surgery-University Hospital "N.I.Pirogov", Sofia. The findings of different diagnostic methods are reviewed. Age and sex of the children, the frequency of location, maturity and stage of the tumor, type of operations and survival rate are compared. RESULTS: The MNT in young children encounter more common in the retroperitoneal space and are diagnosed in advanced clinical stage due to late clinical presentation. Most of them have an unfavorable histological variant and affect predominantly the adrenal glands. The mediastinal MNT are mainly manifested in the first age of life with good prognosis. The total survival up to 2004 year is 59,6 %.
Subject(s)
Mediastinal Neoplasms , Neuroblastoma , Retroperitoneal Neoplasms , Child, Preschool , Disease-Free Survival , Female , Humans , Infant , Male , Mediastinal Neoplasms/diagnosis , Mediastinal Neoplasms/mortality , Mediastinal Neoplasms/surgery , Neoplasm Staging , Neuroblastoma/diagnosis , Neuroblastoma/mortality , Neuroblastoma/surgery , Retroperitoneal Neoplasms/diagnosis , Retroperitoneal Neoplasms/mortality , Retroperitoneal Neoplasms/surgeryABSTRACT
Postoperative intussusception is a rare but serious complication which occurs usually during the early postoperative period with intermittent, but progressing intestinal obstruction with characteristic appearance of mucus-bloody stools. Two children with postoperative intussusception have been observed among 381 children who have had abdominal operations during the last three years (1985-1987) (0.5 per cent). Various postoperative complications developed in 45 children (11.8 per cent), in 2 of them (4.4 per cent) the complication being intussusception. Both children were operated for tumors. In one (1 1/2 years old) the postoperative intussusception was not diagnosed until it was re-operated; the child died. In the second child (3 months old) the postoperative intussusception was diagnosed by clinical and X-ray examination; the ileocolic portion of the intussusception was reduced by pneumocoloscopy, while the ileo-ileal required re-operation with manual reduction. The infant survived. Early diagnosis of this rare postoperative complication, especially when mucus-bloody stools appear and pneumocoloscopy is performed, is feasible. Appropriate treatment will help for a favourable outcome.
