Hereditary multiple intestinal atresia (HMIA) is a rare form of intestinal atresia that affects the gastrointestinal tract from the pylorus to the rectum. A few cases have been reported in the literature. Here, we report the case of a three-day-old girl who was referred to our hospital as a case of upper intestinal obstruction. After initial resuscitation, the radiological examination revealed pyloric obstruction, multiple intra-abdominal calcifications, and rectal atresia making the diagnosis of HMIA most likely. Exploratory laparotomy revealed multiple intestinal atresia, the first started at the pylorus, the second was at the level of the duodenojejunal junction, and there were also multiple small bowel atresias. The colon was a cord-like structure, and there was rectal atresia. Multiple resections of the atretic intestinal segment followed by multiple anastomoses, terminal ileostomy, and the use of a trans-anastomotic tube were performed. In this study, the clinical picture, radiological findings, and management are described and compared to the findings reported in the literature.
IntroductionTesticular torsion (TT) is the most common urological emergency in children that requires immediate intervention. The prognosis of testicular torsion depends on the patient's time of presentation to the emergency department (ED), as well as on the time at which the diagnosis is established and treatment is initiated. Raising public awareness of testicular torsion, particularly among parents, plays a crucial role in preventing delay in presentation and reducing the frequency of orchiectomy. To this end, the study is designed to assess the level of awareness and knowledge of testicular torsion, as well as the response of parents to the scrotal pain of their children. MethodsA descriptive cross-sectional study was conducted among parents in the western region of Saudi Arabia. Data was collected between the 23rd of November and the 22nd of December 2022. A simple random sampling technique was implemented. The data was collected and analyzed using SPSS software (IBM Corp., Armonk, NY). ResultsA total of 394 parents participated in this study. It showed that 13.5% of parents reported having a child with a previous experience of pain in the scrotum. Of them, only 25.4% previously heard about torsion of the testicles. Only 68.8% and 76.6% correctly reported that if the child complains of pain in the scrotum during working hours or over the weekend, they will drive him to the hospital immediately. Good knowledge about TT was significantly higher among children's fathers compared to mothers (66.7% vs. 33.3%) (p≤0.05). ConclusionTesticular torsion (TT) represents significant morbidity among male patients and early identification is crucial to avoid the need for orchiectomy and all its prominent physical and psychological consequences. To improve children's well-being, we need to raise parents' awareness of TT and the potential future implications of this critical condition as it is not widely known in our community. Further studies evaluating the knowledge regarding testicular torsion among preadolescent and adolescent boys are warranted.
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