A shortage of small pediatric organ donors has led to the development of reduced size liver transplantation in children. However, the discrepancy between donor and recipient weight can limit the use of this procedure despite transplantation of the left lobe only. Monosegmental liver transplantation using segment III only was recently described. We report here the case of an 11 month old, 6.9 kg boy who received another monosegmental graft (segment II) from a 78 kg donor on an urgent basis. Because of the lack of parenchymal landmarks between segments II and III, sterile methylene blue solution was injected into the portal vein of segment III: parenchyma of this segment colored immediately and was resected accordingly. Three and a half years later, the growth, development, and nutrition of this child were normal. This procedure seems to be helpful when the left lobe of the graft is obviously too large.
We present a case of volvulus without malrotation in a twin fetus where serial antenatal US assisted in the diagnosis and ensured prompt postnatal surgical treatment. When a fetal subumbilical intestinal mass is seen, changing its echogenicity from complex to cystic, and associated with progressive proximal small-bowel obstruction and/or bowel perforation, small-bowel volvulus should be included in the differential diagnosis.
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