No abstract

Primary lymphangiomas or lymphangiomatous polyps of the palatine tonsil are rare benign lesions that are described infrequently in the literature. The majority of the published cases concern adults. We report a case of a lymphangiomatous lesion of the right palatine tonsil of a 9-year-old boy. Our clinical suspicion was confirmed by the histological examination after tonsillectomy and the diagnosis of primary lymphangioma of the tonsil was made. In this case we discuss the clinical and histopathological features of this lesion and present a short review of the current literature.

Because of the rare occurrence of sialoblastoma, there is no evidence-based treatment of choice. The treatment should be individualized, taking into consideration the patient's age, the high locoregional recurrence rate, the local aggressive characteristics, and the potential metastatic activity of this rare tumor. A close follow-up of the patient is strongly recommended.

Bacterial perianal dermatitis is a childhood disorder, most commonly caused by the beta-hemolytic group A strep tococcus. Despite being well-recognized in the literature, this condition is often not recognized by healthcare practitioners, leading to a delay in the proper diagnosis and treatment. An 8-year-old boy presented with a three-week history o f perianal itching, constipation and blood-streaked stools. Clinical examination revealed a bright red, sharply demarcated rash that ex tended approximately 3 cm circumferentially around the anus. Positive cultures for Enterococcus faecalis from the perianal area and the stools confirmed the diagnosis of perianal dermatitis caused by an uncommon microorganism. Therapy with systematic oral cefuroxime and topical mupirocin cream led to a resolution of the symptoms and the itchy rash by day 4. 2 weeks after the onset of symptoms in the patient, his 10-year-old brother developed perianal itching and mucous discharge. Stool cultures again identified E. faecalis and the same treatment methods were applied, resulting in rapid resolution o f the symptoms. Perianal dermatitis should be included in the differential diagnosis when a child aged from 6 months to 10 years old complains of perianal symptomatology. The differential diagnosis is wide and includes candidiasis, psoriasis, inflammatory bowel disease, diaper dermatitis, parasite infections and sexual abuse. The diagnosis is confirmed with culture swabs o f the affected area and treatment should be guided based on the culture and antibiotic sensitivity testing.

Post-tonsillectomy hemorrhage is one of the most common complications of tonsillectomy. The rate varies with different methods. We retrospectively analyzed patients who underwent tonsillectomy in a period of two years. Two surgical methods, cold dissection and microscopically assisted bipolar tonsillectomy, were compared. 1007 patients were included in the study. Postoperative hemorrhage occurred in 116 patients (11.5 %). By the cold dissection method, postoperative bleeding was noted in 86 patients (10.9 %), while by the microscopic bipolar method in 30 patients (13.9 %). A surgical hemostasis was required in 47 patients (5.9 %) and 17 patients (7.9 %), respectively. Concerning the time of occurrence of the first postoperative bleeding episode, we found that it occurred mainly on day 6 by the cold dissection technique (median = 6, mean = 5.84, SD = 3.30), whereas by the bipolar technique the first episode occurred on day 5 (median = 5, mean = 5.27, SD = 2.85). However, a statistical analysis did not show a significant difference. In conclusion, our study did not show a significant difference concerning the prevalence or the postoperative day of occurrence of the first bleeding episode after tonsillectomy when comparing the two methods, but recommendations concerning the duration of the in-hospital stay could be made. Each institution should perform its own individualized statistics concerning the occurrence of postoperative bleeding and should use a standardized documentation protocol. Level of evidence 3b.