Introduction. The biggest difficulties of pulmonary sequestration treatment appear when they are combined with other congenital malformations. Materials and methods. This article describes a rare case of combination of infradiaphragmatic extralobar sequestration of the lung and duplication cyst of the gaster. The antenatal ultrasound investigation at 21 week of gestation visualized a retroperitoneal mass that had a cystic-solid structure and a vessel that departed directly from the aorta. CT-scan that was performed after the birth, confirmed an existence of infradiaphragmatic cystic mass that had a vessel that departed directly from the aorta. We couldnt exclude the neoplastic process because of structure and topography of mass. Tumor markers were without pathology. Surgical treatment was performed: laparotomy and removal of the cyst and extrapulmonary sequestration. The histological investigation confirmed a pulmonary sequestrum and duplication cyst of the gaster. Conclusion. A nowadays method of visualization allows to find congenital malformation in earliest stages of gestation. The tradition surgical treatment and also minimal invasive surgical treatment are the main option of cure such congenital malformations. Also literature review of rare clinical forms of pulmonary sequestration presented in this article.
Pancreatic tumors are very rare problem in children that mostly in literature presented just with case reports. Solid-pseudopapillary tumors of the pancreas are a little part, just about 1–2%, from all nonendocrine tumors of the pancreas. About 90% of all patients with this tumor are female teenagers and young women. Solid-pseudopapillary tumors of the pancreas are innocent, and mostly all of them are incidental findings. However, we can see clinical findings if patient has big size of such tumor, which compress nearest anatomical structures. In this article we present a case of incidental finding of solid- pseudopapillary tumor of body and tale of the pancreas in 11 years old girl, who was treated with distal resection of pancreas.
Background. Inguinal hernias in children are a common problem. They occur in 520 cases of 1000 newborns, with the prevalence in males of about 10 times. Therefore, they present a very important problem in pediatric surgery. Materials and methods. This prospective study was performed from 2019 to 2020 and included 30 patients with diagnosed inguinal hernias. Video-assisted percutaneous hernia sac ligation was performed in all patients. Results. The mean operating time was 10.3 2.7 min in patients with unilateral inguinal hernias and 14.7 1.6 min in patients with the bilateral variant. No complications or recurrences were observed during the six-month follow-up period. In one case, an additional 3 mm port setting was performed in an eight-month-old child. The main reason for doing this was the fibrous transformation of the parietal peritoneum because of the existence of incarcerations in the anamnesis. Conclusion. This technique garners all the advantages of a minimally invasive surgical treatment of inguinal hernias using the Tuohy needle. However, the conductor application allows us to create the same approach using a Touhy needle. This means that we can perform an isolated hernia sac ligation without getting under the preperitoneal tissue ligature, parts of the internal oblique and transverse muscles, aponeurosis of the external oblique muscle, and subcutaneous fat. This presented video-assisted percutaneous hernia sac ligation method seems like a potential minimally invasive way to treat inguinal hernias in children.
Introduction. In the majority of cases, acute abdominal pathology in premature newborns masks as necrotizing enterocolitis and, if there are no signs of intestinal perforation, conservative therapy is prescribed. The article discusses rare forms of acute surgical pathology in premature newborns.Clinical observations. In the first clinical case, a premature baby had an initial air leak syndrome (pneumothorax and pneumoperitoneum). The Meckel’s diverticulitis with perforation without peritonitis was found during surgery. In the second case, a newborn child with body weight 1160 grams on the 21st day of his life developed ileoileal intussusception. In the third case, a newborn child had the duodenal membrane which was excised on the 5th day of life. On the 11th postoperative day, a picture of perforated hollow organ in the abdominal cavity developed. Destructive appendicitis was found intra-operatively. All patients clinically recovered.Conclusion. Ultrasound examination, as an early diagnostic option, can help to suspect a surgical pathology at an early stage. The described clinical cases are rare in pediatric surgeon’s practice but they require a cautious approach from both narrow clinical specialists and diagnostic specialists.
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