Tumour-like inflammatory abdominal conditions in children.

The presence of a tumour, poor general condition, features of anaemia, increased erythrocyte sedimentation rates and imaging suggesting malignancy were the common features in 4 different tumour-like abdominal conditions that are extremely rare in childhood. These conditions included: extensive retroperitoneal tumour with rib involvement that turned out to be an inflammatory lesion caused by Actinomyces in a 12-year-old girl; multi-loculated tumour of the mesentery/ovary caused by mesenteric lymphadenopathy in the course of a Salmonella enteritidis infection in a 2.5-year-old girl; tumour of the VII - VIII hepatic segments that turned out to be the focus of granuloma in the course of lambliasis in a 5.5-year-old boy with a history of purulent neck lymphadenopathy and a final suspicion of immunocompromise; and a multi-loculated tumour of the small pelvis and inguinal area that turned out to be an abscess of the iliopsoas muscle in a 16-year-old boy. Apart from the imaging, the lesions required cytological examination of the material harvested by fine-needle biopsies (liver tumour) or histopathological investigations (retroperitoneal tumour, mesenteric/ovarian tumour, liver tumour and--on second surgery--the pelvic tumour) and/or bacteriological examination (all cases), serological examination (liver tumour and mesenteric/ovarian tumour), protozoal investigation (liver tumour), and measurement of AFP levels (mesenteric/ovarian tumour). Surgical treatment (retroperitoneal tumour, mesenteric/ovarian tumour and tumour of the small pelvis) and guided antibiotic therapy (all cases including 15 weeks of antibiotics in the first case) allowed complete recovery in 3 patients (actinomycosis, mesenteric lymphadenopathy, abscess of the iliopsoas muscle). Antibiotic and antiprotozoal therapy cured the granulomatous hepatitis; however this patient tended to develop severe right-sided pleural/pulmonary changes (the child was referred for further diagnosis with suspicion of immunocompromise).

Necrotising enterocolitis (NEC)--methods of treatment and outcome: a comparative analysis of Scottish (Glasgow) and Polish (Western Pomerania) cases.

AIM OF THE WORK: The aim of the work was to compare methods of treatment and outcome in newborns with necrotising enterocolitis (NEC) in two regional centres. METHODS: Medical files of 125 newborns with NEC, treated from 1990 to 1995 in two centres--Royal Hospital for Sick Children, Glasgow, Scotland, and Western Pomerania, Poland have been analysed retrospectively. The following criteria have been studied: birth weight, gestational age, sex, risk factors, initial NEC symptoms, time of onset of the disease, x-ray findings, NEC staging, treatment protocols, outcome and complications. RESULTS: The overall mortality was 32.8%; 34.4% in Glasgow vs. 31.3% in Pomorze. Higher incidence of NEC in the group of full-term babies was observed: 31.2%. Drainage under local anaesthesia was performed in 27 Scottish newborns; none of the Polish babies were treated by this method. CONCLUSIONS: The overall results of different treatment protocols in both centres are similar. However, Scottish newborns tended to be younger, smaller and more severely ill. Less aggressive treatment-- i.e. peritoneal drainage can be a successful alternative for these tiny, very sick babies.