Esophageal replacement surgery is performed in children with either congenital long gap esophageal atresia or acquired esophageal damages such as caustic injury of the esophagus. although the left colon because of less variation in blood supply and suitable diameter in comparison with right colon is the better choice. A secured pedicled colon is mandatory for reducing the sever complications, such as leak and necrosis. Ileocolic conduit is an alternative method of colon interposition which has anti reflux effect and therefore with less complications related to gastroesophageal reflux. When we have a short segment esophageal stricture due to corrosive esophagitis or other causes of esophageal strictures which is refractory to repeated dilatations, it is advisable to perform colon patch esophagoplasty. Gastric transposition can produce a good way for gastrointestinal continuity with a perfect weight gain and oral feeding, therefor it can be a safe choice for esophageal replacement in children. Partial gastric pull-up is an alternative operation for esophageal replacement in children and infants with long gap esophageal atresia. Gastric conduit replacement is another alternative technique for esophageal replacement, in which a gastric tube is created in the abdomen and it is pulled to via thoracic cavity to the neck and is committed by cervical anastomosis. Antral patch esophagoplasty is used for benign and limited esophageal stricture due to gastroesophageal reflux. Usefulness of pedicled jejunum was under optimal results because of technical problems and high rate of necrosis and mortality for decades. Sternocleidomastoid myocutaneous esophagoplasty is a scarce method which is reported by some surgeons for limited cervical esophageal stricture repair. Free microvascular transfer of the reverse ileo-colon flap with ileocaecal valve valvuloplasty is used for reconstruction of a pharyngoesophageal defect, and Patch esophagoplasty by using of degradable bioscaffolds of extracellular matrix have shown good results in preclinical and clinical outcomes to prevent stenosis after endoscopic mucosectomy. We will explain the advantages and disadvantages of these different surgical methods in this review article.
Foreign body ingestion may do not have any sign and symptoms and cause no complication [1]. In some cases, it can cause gastrointestinal bleeding, perforation or obstruction [1]. Many of foreign bodies can pass through gastrointestinal tract without any signs, symptoms and complications [2]. Foreign body is more common in male population and male to female ratio is reported nearly 1.5/1 in some investigations [3]. In this case presentation we will explain signs and symptoms of a 6-year-old boy who had swallowed a telescopic antenna when it was closed and it produced abdominal pain after opening in gastrointestinal tract due to peristaltic movement. Abdominal pain had been introduced in forward bending position. At the time of operation, we found a metal telescopic antenna in the duodenum which was removed by duodenotomy.
Objective: This study was conducted to evaluate and compare the results of ultrasound and clinical examination in the diagnosis of inguinal hernia in children and also to evaluate the benefits and complications of ultrasound in these children. Study Design: This study, was performed by a cross-sectional method in Children's Medical Center Hospital during 2013-2014 years and follow up was done until July 2020 with the help of a questionnaire from 70 children who had been referred due to unilateral inguinal hernia symptoms. All 70 children underwent Ultrasonographic evaluation and the results of the ultrasound were compared with the initial clinical examination and then with surgery and follow up. Results: In 95.7% of cases, uni or bilateral inguinal hernia was correctly diagnosed by ultrasound. Ultrasound revealed 13.4% of cases were bilateral and 86.6% were unilateral, all of which were confirmed by surgery. In 17.1% of cases, although they were referred with the chief complaint and clinical examination of unilateral inguinal hernia, Bilateral diagnosis was made for them during the ultrasound, and during the surgery, 75% of them were confirmed to have bilateral inguinal hernia. Conclusion: Ultrasound is effective in diagnosing the opposite side of the hernia in cases with unilateral hernia.
Background: Meckel's diverticulum is the most common anomaly of the intestine. It is usually asymptomatic but could also be symptomatic with complications such as bleeding, intestinal obstruction, and inflammation. This study was performed to assess the frequency of various presentations of the patients who underwent surgery with the diagnosis of Meckel's diverticulum in Children's Medical Center, Tehran, Iran from March 2005 to March 2011. Material and Methods: Since this study is a case series report (retrospective descriptive study) and the purpose is assessing the various presentation of Meckel’s` diverticulum, we express the frequency and percent frequency of each presentation. The data collection tool was a five-part survey form. The first part was related to demographic data, the second part was related to clinical data, the third part was related to diagnostic data, the fourth part was related to treatment data and the fifth part was related to histological data. Data were analysed using SPSS statistical program. Result: We found 49 patients in this period (71% male 29% female). The mean age was 3.5 years (1 month to 9 years). The male to female ratio was 2.5. The most common clinical symptoms were abdominal pain (63%). forty-three percent of patients had single symptoms and the others had combined symptoms such as abdominal pain and hematochezia. Only 8 patients with lower gastrointestinal bleeding had a Technetium scan and all of them were positive. Associated findings during surgery included appendicitis and invagination. Our sonographic imaging findings were nonspecific. In the pathologic report, 6 patients had gangrene in specimens and 2 perforations. The lining was of gastric type in 24 specimens pancreatic in 3 and mixed in 2 specimens. None of those with the gastric type of mucosa showed Helicobacter pylori infection. Conclusion: Regarding our findings, clinical findings of Meckel's diverticulum in our study were rather the same as in the literature. Pathologic examination of specimens revealed that most diverticula were lined by gastric type of mucosa. None of those with the gastric type of mucosa showed Helicobacter pylori infection.
Objective: This study was conducted for the practical use of biopsy in the diagnosis of chronic lung disease and the guidance of risks and benefits. Design of Study: We studied 64 children with chronic lung disease who underwent open lung biopsy in 5 years at the Children's Medical Center . Results: Biopsy results were diagnostic in 57 cases (89.1%) and non-diagnostic in 7 cases (10.9%). The biopsy determined the type of mass in all cases where a possible diagnosis of lung mass or thoracic wall was made. In 37 cases (57.8%) the diagnosis was changed and the exact diagnosis was determined. The main side effects (including pneumothorax, hemothorax, pyothorax, and pleural effusion) were 50% (32 cases), the most common of which were pneumothorax and pleural effusion, with a total of more than 87% of these major complications. 22 patients (34.4%) required intubation. 24 patients (37.5%) were admitted to the ICU after surgery. The death occurred in only one case, who was a 3-month-old boy with a disorder of INR and suffering from acute respiratory distress syndrome. There was no mortality that could be directly related to surgery. Conclusion: Open lung biopsy is a gold standard for the histological diagnosis of chronic pulmonary disease in children and plays an important role in the treatment of children with chronic pulmonary diseases. However, serious and common side effects of this method should be considered
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