[Primary peritonitis in the newborn: a recently recognised disease]. / Peritonite primitiva in neonati. Una entità nosologica recentemente riconosciuta.

BACKGROUND DATA: Neonatal primary peritonitis (or autonomic bacterial peritonitis) is a diffuse peritoneal inflammation without any obvious visceral cause. It is a disease rarely described during the neonatal period. OBJECTIVE: The aim of the current study was to make the surgical community aware of it, in an attempt to help a prompt diagnose and to avoid any unnecessary surgery in patients admitted in Neonatal Intensive Care Unit (NICU). MATERIALS AND METHODS: It concerns the description of 7 cases of newborns affected by primary peritonitis during their hospitalization in the NICU, underlining their signs and symptoms along with all additional paraclinical tests and the final outcome. RESULTS: Primary peritonitis was identified in 7 neonates (5 females and 2 males). Despite the severity of their symptoms (e.g., abdominal sensibility, a long standing ileus etc.) none of them had sustained any surgery and the mortality was nil. CONCLUSIONS: Neonatal primary peritonitis should always be taken into account in such circumstances. The final outcome, despite the initial clinical severity, is favorable with the appropriate conservative therapy

Paraesophageal hernia in childhood.

AIM OF THE STUDY: Paraesophageal hernia is a particularly rare condition in childhood. Sometimes it is possible to have an asymptomatic course and to be discovered incidentally. Anyway there are no more than 20 reported cases of which only two are well studied and documented to be real paraesophageal hernias. CASE REPORT: Patients were all over 4 years old except for our little patient which was 18 months old, the only infant reported with this condition. On the contrary it is the most common postoperative complication of Nissen fundoplication, which is the most commonly performed, surgical technique for the correction of gastroesophageal reflux in children. CONCLUSIONS: The Authors believe that the presentation of this case with all its special characteristics will improve knowledge about this rare entity and add information about its treatment and surgical correction that are use full for all doctors that care children.