Background: Surgical procedure in colorectal cases have a high morbidity rate; in pediatric population, surgical site infection occurs in more than 13% of patients undergoing elective colorectal surgery. Bowel preparation is believed to decrease infection rate by removing feces from colorectal. This procedure has been routinely performed despite the lack of clear evidence and the invasive nature of the procedure. In pediatric population, the evidence is scarce with varying qualities, thus this study aims to evaluate the effect of bowel preparation on pediatric population. Methods: We conducted a comprehensive literature review from PubMed and cross-referencing articles. Six full-text studies presenting bowel preparation in pediatric colorectal surgeries were included in the analysis. Results: Majority of studies we analyzed showed no association between bowel preparation and surgical site infections. They also showed the lack of correlation between the procedure and post-operative complication. Discussion: Bowel preparation was quickly adapted by surgeons due to its theoretical effect, but current evidence showed no clear benefit in doing so. In pediatric cases, the evidence is scarce and variable, and with the risk associated, surgeons should consider carefully before conducting bowel preparation in pediatric patients.  Conclusion: Bowel preparation does not significantly decrease post-operative morbidities, such as anastomosis leakage, intrabdominal infection, and surgical wound infection.

Introduction: Congenital prepubic sinus (CPS) is a rare congenital abnormality in the urinary tract in the form of remnant ducts that extend from skin openings near the pubic symphysis to various areas. Due to its anatomical and pathological variation, the clinical manifestation of this condition has a wide spectrum. This paper shows one of the youngest reported cases of CPS that was successfully treated with surgery. This paper aims to elucidate and provide the current literature review in order to increase awareness towards CPS diagnosis in general practitioners, pediatricians, and surgeons. Case report: Here we present a 2-months-old female baby with a CPS that presented a purulent discharge and recurrent abscess from an opening since birth. Prior to surgery, the patient had visited multiple health care provider until a definitive diagnosis of CPS could be established, which was followed by the administration of topical antibiotic prior to surgery. The condition was diagnosed through abdominal CT imaging and treated with a simple surgical technique aided with methylene blue dye. Conclusion: Clinicians should consider the differential diagnosis of congenital anomaly such as CPS in a patient presenting with purulent discharge or erythema from accessory meatus in the pubic region.

Background: Biliary atresia (BA) is the leading indication for liver transplantation in pediatric patients. Delayed diagnosis of BA in Indonesia causes the primary living donor liver transplantation (LDLT) rate to be higher than the other transplant centers worldwide. This study aimed to assess the primary LDLT outcome in BA patients in Cipto Mangunkusumo Hospital (CMH) and the associated influencing factors. Methods: This is a retrospective cohort study of pediatric BA patients who underwent primary LDLT from 2010 to 2019 in CMH. Morbidity and mortality were analyzed for preoperative and intraoperative prognostic factors. Results: 31 primary LDLT subjects were included in this study. The majority were males with a median age of 14 months and a mean PELD score of 17.09. Complications occurred in 96.7% of subjects with infection (90.3%) as the most common complication. Relaparotomy was performed in 54.8% of subjects. The median length of stay was 41 days. One-year post-transplantation mortality was 9.3%. There were statistically significant correlations found between nutritional status and infection incidence (p = 0.003). Conclusions: Infection is the most common complication in primary LDLT patients in CMH with nutritional status serving as the influencing factor. Despite the complication rate, the one-year mortality rate is comparable to other transplantation centers worldwide. The incidence of relaparotomy and infectious complications are still major problems in newer, resource limited centers, and further, larger sample research is needed to investigate other influencing factors affecting primary LDLT outcome.