Intestinal obstruction in neonatal period is an emergency caused by many surgical causes. An extremely rare surgical cause in this group of age is intussusception which can be easily confused with other surgical entities. In several reports, a significant number of the infants who were included in the study population were believed to have necrotizing enterocolitis (NEC). We present a rare cause of small intestine obstruction in a preterm female infant that can be easily misdiagnosed and confused preoperatively with other clinical entities particular for this period.

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Our data demonstrate differences between the two groups in preoperative symptoms and short-term postoperative complications and short-term outcome. Late-presenting cases of CDH had a greater number of chronic symptoms preoperatively, more favorable postoperative outcomes, and less recurrences and reoperations.

Ectopic nephrogenic rests in the inguinal canal are rare. Usually discovered incidentally during surgery, these rests should raise the suspicion of an early extrarenal Wilms tumor. The differential diagnosis between the two entities is not only difficult but also essential, since they imply different treatment decisions. We report a rare case of an inguinal ectopic nephrogenic rest found in a 6-month-old girl and discuss the clinicopathological implications of this condition. The patient was admitted for a routine repair of a presumed inguinal hernia; during suregry, a nodular mass was noted in the inguinal canal. Pathological diagnosis confirmed the diagnosis of an extrarenal hyperplastic nephrogenic rest. Five previous cases of ectopic nephrogenic rests originating in the inguinal canal have been reported, all of which were associated with a patent processus vaginalis. In this case, the nephrogenic rest was not associated with a congenital inguinal hernia.

INTRODUCTION: Cholecystectomy in children is not a common surgical procedure. In the past 5 years, we have performed it laparoscopically. There was no difference in insufflated pressure between 2 groups while no drainage catheter was placed. OBJECTIVE: We present a modified laparoscopic technique in children. METHODS: In a 5-year period, 54 children underwent laparoscopic cholecystectomy. Their ages ranged from 14 months to 15 years (mean: 7.6 years). Depending on the applied technique, the patients were separated into 2 groups. The first group comprised 17 patients on whom we performed the conventional 4-port technique. The second group comprised 37 patients on whom a modified technique was performed. We used 3 ports: an umbilical port for the camera, another in the subxifoid region for the dissector, and a third in the right lower quadrant for the grasping clamp and the extraction of the gallbladder. Vessel sealing electrocautery was used for ligation of the cystic artery and detachment of the gallbladder. RESULTS: Reduction of the number of ports had no effect on accessibility and duration of the procedure; however, it simplified access and handling, particularly in the smaller patients. Conversion to open cholecystectomy was performed in 1 case with major deformities of the vertebral column. The duration of hospitalization varied from 1 to 4 days (mean: 2.7 days). CONCLUSIONS: The decreased number of ports and the use of vessel sealing electrocautery make laparoscopic cholecystectomy in children easier and safe, without affecting the perioperative time.