Pub Date : 2021-04-29DOI: 10.31031/rpn.2021.05.000617
D. Hanine, B. Rouijel, L. Aqqaoui, H. Oubejja, H. Zerhouni, M. Erraji, F. Ettayebi
Trichobezoar is defined by the presence of an intragastric foreign body formed by hair or textile fibers. It is a rare condition that usually occurs in adolescents with mental health problems. The clinical symptoms are very varied and the diagnosis is often suspected on radiology and endoscopy, but sometimes certain complications such as peritonitis can be revealing. The treatment associates surgical and psychological care. We report the observation of a 14-year-old girl hospitalized with acute generalized peritonitis, clinical and radiological investigations concluded in a Trichobezoar complicated by gastric perforation. The treatment was surgical with pre and post-operative resuscitation. The evolution was favorable thereafter with a child psychiatric follow-up for the young adolescent. At the end of this observation, we highlight the possible complications of Trichobezoar and their management.
{"title":"Unusual Location of a Gastric Perforation Due to a Huge Trichobezoar","authors":"D. Hanine, B. Rouijel, L. Aqqaoui, H. Oubejja, H. Zerhouni, M. Erraji, F. Ettayebi","doi":"10.31031/rpn.2021.05.000617","DOIUrl":"https://doi.org/10.31031/rpn.2021.05.000617","url":null,"abstract":"Trichobezoar is defined by the presence of an intragastric foreign body formed by hair or textile fibers. It is a rare condition that usually occurs in adolescents with mental health problems. The clinical symptoms are very varied and the diagnosis is often suspected on radiology and endoscopy, but sometimes certain complications such as peritonitis can be revealing. The treatment associates surgical and psychological care. We report the observation of a 14-year-old girl hospitalized with acute generalized peritonitis, clinical and radiological investigations concluded in a Trichobezoar complicated by gastric perforation. The treatment was surgical with pre and post-operative resuscitation. The evolution was favorable thereafter with a child psychiatric follow-up for the young adolescent. At the end of this observation, we highlight the possible complications of Trichobezoar and their management.","PeriodicalId":153075,"journal":{"name":"Research in Pediatrics & Neonatology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128414594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-29DOI: 10.31031/rpn.2021.05.000616
D. Hanine, B. Rouijel, A. ElBaoudi, Z. Aboulam, M. Kisra
We report the observation of a 5-year-old boy who consults for acute paroxysmal abdominal pain located in the right iliac fossa without other associated signs. The physical examination was completely normal. Abdominal ultrasound showed a multi-compartmentalized cystic mass, without vascular character on Doppler, without mass effect on neighboring structures; the mesenteric vessels were in the normal position. On computed tomography this mass corresponded to a mesenteric formation attached to the cecum containing several septas. The diagnosis of cystic lymphangioma or mesenteric lipoma was made. Surgical exploration confirmed the diagnosis of mesenteric lipoma attached to the ileum. Resection with anastomosis was performed. The post-operative consequences were simple. Pathological examination confirmed the lipomatous nature of the mass. At the end of this observation, we highlight this rare pathology with possible complications.
{"title":"The Mesenteric Lipoma in Children","authors":"D. Hanine, B. Rouijel, A. ElBaoudi, Z. Aboulam, M. Kisra","doi":"10.31031/rpn.2021.05.000616","DOIUrl":"https://doi.org/10.31031/rpn.2021.05.000616","url":null,"abstract":"We report the observation of a 5-year-old boy who consults for acute paroxysmal abdominal pain located in the right iliac fossa without other associated signs. The physical examination was completely normal. Abdominal ultrasound showed a multi-compartmentalized cystic mass, without vascular character on Doppler, without mass effect on neighboring structures; the mesenteric vessels were in the normal position. On computed tomography this mass corresponded to a mesenteric formation attached to the cecum containing several septas. The diagnosis of cystic lymphangioma or mesenteric lipoma was made. Surgical exploration confirmed the diagnosis of mesenteric lipoma attached to the ileum. Resection with anastomosis was performed. The post-operative consequences were simple. Pathological examination confirmed the lipomatous nature of the mass. At the end of this observation, we highlight this rare pathology with possible complications.","PeriodicalId":153075,"journal":{"name":"Research in Pediatrics & Neonatology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128638549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-29DOI: 10.31031/rpn.2021.05.000618
D. Hanine, B. Rouijel, A. E. Baoudi, M. Kisra
Adrenocortical Carcinoma (ACC) are rare tumors that have a bimodal distribution, the first peak is in children less than five years and the second around the fifth decade [1]. Although most adult ACC are non-functional, in the pediatric age group, nearly 95% are functional [2]. Virilization is the most common abnormality and Cushing’s syndrome and hyperaldosteronism are less frequent [3]. We begin the review with a clinical case of a 16-month-old infant, and then we will discuss this very rare pathology as well as its management.
{"title":"Adrenal Cortex Carcinoma: One of the Rarest Retroperitoneal Tumors in children","authors":"D. Hanine, B. Rouijel, A. E. Baoudi, M. Kisra","doi":"10.31031/rpn.2021.05.000618","DOIUrl":"https://doi.org/10.31031/rpn.2021.05.000618","url":null,"abstract":"Adrenocortical Carcinoma (ACC) are rare tumors that have a bimodal distribution, the first peak is in children less than five years and the second around the fifth decade [1]. Although most adult ACC are non-functional, in the pediatric age group, nearly 95% are functional [2]. Virilization is the most common abnormality and Cushing’s syndrome and hyperaldosteronism are less frequent [3]. We begin the review with a clinical case of a 16-month-old infant, and then we will discuss this very rare pathology as well as its management.","PeriodicalId":153075,"journal":{"name":"Research in Pediatrics & Neonatology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134610189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-26DOI: 10.31031/rpn.2021.05.000615
L. Sundararajan, Heera Tharanendran, R. Babu
A six-year-old boy with kidney matrix stones in solitary kidney is presented. Kidney matrix stones present in adults with atypical calcification on X-ray and CT, in the setting of recurrent urinary tract infections and instrumentation. These stones are not amenable to ESWL due to low calcium content. Complete stone clearance and prompt treatment of UTI are essential.
{"title":"Kidney Matrix Stone in a Solitary Kidney","authors":"L. Sundararajan, Heera Tharanendran, R. Babu","doi":"10.31031/rpn.2021.05.000615","DOIUrl":"https://doi.org/10.31031/rpn.2021.05.000615","url":null,"abstract":"A six-year-old boy with kidney matrix stones in solitary kidney is presented. Kidney matrix stones present in adults with atypical calcification on X-ray and CT, in the setting of recurrent urinary tract infections and instrumentation. These stones are not amenable to ESWL due to low calcium content. Complete stone clearance and prompt treatment of UTI are essential.","PeriodicalId":153075,"journal":{"name":"Research in Pediatrics & Neonatology","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132211112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-24DOI: 10.31031/rpn.2021.05.000613
S. Manieri, M. Mirauda, C. Colangelo, R. Lapolla, L. Romaniello, D. Salvatore, P. Caiazzo
Bezoar is an accumulation of organic substances in the gastrointestinal tract. This condition is extremely rare, their incidence in the pediatric population is unknown. Bezoars usually occur in females, adolescents, and children with psychiatric or neurological disorders. Trichobezoar refers to the accumulation of hair usually in the stomach and even beyond it (Rapunzel syndrome). We present the clinical case of a school-age female patient who started with neurological symptoms (headache, syncope) and then developed gastrointestinal symptoms. Only later was clarified a history of bullying at school and consequent anxious behaviors (trichotillomania and trichophagia). It’s very important a thorough medical history, especially in patients with Trichobezoar, to highlight psychological disorders that can cause trichotillomania and trichophagia.
{"title":"\"Rapunzel Syndrome: An Unusual Onset Case Report\"","authors":"S. Manieri, M. Mirauda, C. Colangelo, R. Lapolla, L. Romaniello, D. Salvatore, P. Caiazzo","doi":"10.31031/rpn.2021.05.000613","DOIUrl":"https://doi.org/10.31031/rpn.2021.05.000613","url":null,"abstract":"Bezoar is an accumulation of organic substances in the gastrointestinal tract. This condition is extremely rare, their incidence in the pediatric population is unknown. Bezoars usually occur in females, adolescents, and children with psychiatric or neurological disorders. Trichobezoar refers to the accumulation of hair usually in the stomach and even beyond it (Rapunzel syndrome). We present the clinical case of a school-age female patient who started with neurological symptoms (headache, syncope) and then developed gastrointestinal symptoms. Only later was clarified a history of bullying at school and consequent anxious behaviors (trichotillomania and trichophagia). It’s very important a thorough medical history, especially in patients with Trichobezoar, to highlight psychological disorders that can cause trichotillomania and trichophagia.","PeriodicalId":153075,"journal":{"name":"Research in Pediatrics & Neonatology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125984462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.31031/rpn.2021.05.000612
Halyna Bulak
Turner syndrome is a rare genetic disorder that occurs only in girls. It can cause problems ranging from short height to heart defects. Sometimes, the symptoms are so mild that it goes undiagnosed until a female is a teen or young adult. That’s why, early diagnosis plays a crucial role in further child’s development. A lot of health problems affecting girls with Turner syndrome can be managed with treatment. This article represents a clinical case of Turner syndrome phenotype diagnosed on its early stage.
{"title":"Early diagnosis of Turner Syndrome Phenotype in a Newborn With Mild Symptoms and Concomitant Neonatal Jaundice","authors":"Halyna Bulak","doi":"10.31031/rpn.2021.05.000612","DOIUrl":"https://doi.org/10.31031/rpn.2021.05.000612","url":null,"abstract":"Turner syndrome is a rare genetic disorder that occurs only in girls. It can cause problems ranging from short height to heart defects. Sometimes, the symptoms are so mild that it goes undiagnosed until a female is a teen or young adult. That’s why, early diagnosis plays a crucial role in further child’s development. A lot of health problems affecting girls with Turner syndrome can be managed with treatment. This article represents a clinical case of Turner syndrome phenotype diagnosed on its early stage.","PeriodicalId":153075,"journal":{"name":"Research in Pediatrics & Neonatology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124773291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-28DOI: 10.31031/rpn.2021.05.000611
B. Fernández-Bautista
The presence of posterior urethral valves as a cause of oligoamnios is well known. Differential diagnosis should be established with other pathologies such as prune-belly syndrome, high-grade vesicoureteral reflux, bilateral obstructive megaureter, urethral atresia, obstruction of the anterior urethra, ureteroceles and less frequently the presence of an obstructed bilateral ectopic system [1]. The ectopic ureter is more frequent in girls, associated with a duplicated renoureteral system and rarely associated with bilateral obstruction of the urinary tract. We present an exceptional case of anhydramnios in a female fetus secondary to obstruction of a bilateral ectopic ureter and a duplicated left system with severe worsening of renal function.
{"title":"Prenatal Anhydramnios in a Girl: An Exceptional Case of Obstruction by Bilateral Ectopic Ureter","authors":"B. Fernández-Bautista","doi":"10.31031/rpn.2021.05.000611","DOIUrl":"https://doi.org/10.31031/rpn.2021.05.000611","url":null,"abstract":"The presence of posterior urethral valves as a cause of oligoamnios is well known. Differential diagnosis should be established with other pathologies such as prune-belly syndrome, high-grade vesicoureteral reflux, bilateral obstructive megaureter, urethral atresia, obstruction of the anterior urethra, ureteroceles and less frequently the presence of an obstructed bilateral ectopic system [1]. The ectopic ureter is more frequent in girls, associated with a duplicated renoureteral system and rarely associated with bilateral obstruction of the urinary tract. We present an exceptional case of anhydramnios in a female fetus secondary to obstruction of a bilateral ectopic ureter and a duplicated left system with severe worsening of renal function.","PeriodicalId":153075,"journal":{"name":"Research in Pediatrics & Neonatology","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117149361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-25DOI: 10.31031/RPN.2021.05.000609
Agnieszka Zubkiewicz-Kucharska
Introduction Sodium concentration in the body is controlled by osmoregulatory system, which regulate water intake and excretion. If this system fails and plasma sodium level stray outside its normal range (135-145mmol/L), the cells are exposed to hypotonic or hypertonic stress. Hyponatremia is one of the most common electrolyte imbalances, occurring in up to 20% of hospitalized patients. It is defined as a plasma sodium concentration lower than 135mmol/L, with severe hyponatremia being below 120mmol/L. The symptoms of hyponatremia vary, depending not only on the concentration of sodium, but also on the rate of lowering of natremia. Mild symptoms may include headaches, cognitive impairment, lethargy, nausea, and vomiting; however, the signs may be subtle, or it may be asymptomatic whatsoever. In severe hyponatremia consciousness disturbances, seizures, and coma are common. The most common cause of hyponatremia include vomiting and diarrhea, adrenal insufficiency, heart, liver and renal failure, syndrome of inappropriate antidiuretic hormone secretion (SIADH), cerebral salt wasting syndrome, osmotic diuresis, and hyperglycemia. One should not forget about overhydration as a potential reason of hyponatremia. Here we present a case of a child with severe hyponatremia due to fluid oversupply. A two-year-old boy was admitted to the Emergency Department after an episode of seizures lasting several minutes, with breathing disorders and loss of consciousness. Past medical history was not relevant, the psychomotor and physical development was normal (body mass 14kg = 72pc, height 91,5cm = 63pc, BMI 16,7kg/m 2 =75pc). Laboratory examination revealed a decreased natremia of 120mmol/L, which was gradually corrected with 3% sodium chloride,
{"title":"To Drown A Baby in A Water Bottle. Case of A Severe Hyponatremia Caused by Fluid Oversupply in A 2-Year-Old Child","authors":"Agnieszka Zubkiewicz-Kucharska","doi":"10.31031/RPN.2021.05.000609","DOIUrl":"https://doi.org/10.31031/RPN.2021.05.000609","url":null,"abstract":"Introduction Sodium concentration in the body is controlled by osmoregulatory system, which regulate water intake and excretion. If this system fails and plasma sodium level stray outside its normal range (135-145mmol/L), the cells are exposed to hypotonic or hypertonic stress. Hyponatremia is one of the most common electrolyte imbalances, occurring in up to 20% of hospitalized patients. It is defined as a plasma sodium concentration lower than 135mmol/L, with severe hyponatremia being below 120mmol/L. The symptoms of hyponatremia vary, depending not only on the concentration of sodium, but also on the rate of lowering of natremia. Mild symptoms may include headaches, cognitive impairment, lethargy, nausea, and vomiting; however, the signs may be subtle, or it may be asymptomatic whatsoever. In severe hyponatremia consciousness disturbances, seizures, and coma are common. The most common cause of hyponatremia include vomiting and diarrhea, adrenal insufficiency, heart, liver and renal failure, syndrome of inappropriate antidiuretic hormone secretion (SIADH), cerebral salt wasting syndrome, osmotic diuresis, and hyperglycemia. One should not forget about overhydration as a potential reason of hyponatremia. Here we present a case of a child with severe hyponatremia due to fluid oversupply. A two-year-old boy was admitted to the Emergency Department after an episode of seizures lasting several minutes, with breathing disorders and loss of consciousness. Past medical history was not relevant, the psychomotor and physical development was normal (body mass 14kg = 72pc, height 91,5cm = 63pc, BMI 16,7kg/m 2 =75pc). Laboratory examination revealed a decreased natremia of 120mmol/L, which was gradually corrected with 3% sodium chloride,","PeriodicalId":153075,"journal":{"name":"Research in Pediatrics & Neonatology","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131319215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-24DOI: 10.31031/RPN.2020.05.000606
Audrey Miller
A zero-day old female infant is admitted to the NICU for persistent oxygen desaturations and cyanosis. She was born at a gestational age of 39 weeks to a 31-year-old Gravida 4 Para 4 mother by spontaneous vaginal delivery. The pregnancy was uncomplicated. Maternal blood type was O positive and the remainder of the maternal serologies are unremarkable. Delivery was complicated by the presence of meconium stained fluid and a tight nuchal cord. APGAR scores were six at one minute and eight at five minutes. The infant required administration of CPAP in the delivery room for an oxygen saturation of seventy percent at five minutes of life. Following admission to the NICU, the infant had an escalating oxygen requirement and recurrent apneic events resulting in endotracheal intubation and mechanical ventilation. The infant’s birth weight is 3.310kg (56 percentile on WHO Girls Curve), birth length is 49.5cm (58 percentile on WHO Girls Curve), and FOC is 35.6cm (92 percentile on WHO Girls Curve). Vital signs are significant for an axillary temperature of 36.8 degrees Celsius, heart rate of 132bpm, blood pressure of 88/62, and oxygen saturation of 97% on a fraction of inspired oxygen of 40%. Her physical exam is remarkable for easy respiratory effort on mechanical ventilation with clear breath sounds and equal air entry. Her respiratory rate is slow for a neonate at 20 breaths per minute. She does not have a murmur. Her capillary refill is brisk and she has a normal heart rhythm on the monitor. She has normal muscle tone and patellar reflexes. She did not have any striking dysmorphic craniofacial features and her abdominal, genitourinary, musculoskeletal, and skin exams are grossly normal. She continues to periods of apnea while on mechanical ventilation. A chest radiograph demonstrates clear lung fields and a normal cardiac silhouette. The family history is significant for three older siblings who are healthy and developmentally typical. Initial laboratory studies revealed a glucose of 77, a CBC with a WBC of 13.8, hemoglobin of 19.6, hematocrit of 58, platelet count of 221, with a normal cell differential. Her venous blood gas revealed a pH of 7.22, CO2 of 64, P02 of 41, bicarbonate of 26, and a base deficit of 3.6. Electrolyte and hepatic function panel revealed normal results. A lumbar puncture is performed and CSF analysis is normal. Blood and CSF cultures are negative. Herpes simplex virus studies are negative. A serum ammonia level is 85umol/L, which is within normal range for the hospital laboratory. A meconium drug screen is negative. Her state newborn screen is normal. A karyotype is performed which reveals a normal female chromosome complement, 46, XX. Her head ultrasound reveals no abnormality. A Brain MRI with and without contrast reveals a few punctate foci of restricted diffusion in the right hemisphere, with otherwise
{"title":"Apnea In A Term Neonate: Expanding The Differential Diagnosis","authors":"Audrey Miller","doi":"10.31031/RPN.2020.05.000606","DOIUrl":"https://doi.org/10.31031/RPN.2020.05.000606","url":null,"abstract":"A zero-day old female infant is admitted to the NICU for persistent oxygen desaturations and cyanosis. She was born at a gestational age of 39 weeks to a 31-year-old Gravida 4 Para 4 mother by spontaneous vaginal delivery. The pregnancy was uncomplicated. Maternal blood type was O positive and the remainder of the maternal serologies are unremarkable. Delivery was complicated by the presence of meconium stained fluid and a tight nuchal cord. APGAR scores were six at one minute and eight at five minutes. The infant required administration of CPAP in the delivery room for an oxygen saturation of seventy percent at five minutes of life. Following admission to the NICU, the infant had an escalating oxygen requirement and recurrent apneic events resulting in endotracheal intubation and mechanical ventilation. The infant’s birth weight is 3.310kg (56 percentile on WHO Girls Curve), birth length is 49.5cm (58 percentile on WHO Girls Curve), and FOC is 35.6cm (92 percentile on WHO Girls Curve). Vital signs are significant for an axillary temperature of 36.8 degrees Celsius, heart rate of 132bpm, blood pressure of 88/62, and oxygen saturation of 97% on a fraction of inspired oxygen of 40%. Her physical exam is remarkable for easy respiratory effort on mechanical ventilation with clear breath sounds and equal air entry. Her respiratory rate is slow for a neonate at 20 breaths per minute. She does not have a murmur. Her capillary refill is brisk and she has a normal heart rhythm on the monitor. She has normal muscle tone and patellar reflexes. She did not have any striking dysmorphic craniofacial features and her abdominal, genitourinary, musculoskeletal, and skin exams are grossly normal. She continues to periods of apnea while on mechanical ventilation. A chest radiograph demonstrates clear lung fields and a normal cardiac silhouette. The family history is significant for three older siblings who are healthy and developmentally typical. Initial laboratory studies revealed a glucose of 77, a CBC with a WBC of 13.8, hemoglobin of 19.6, hematocrit of 58, platelet count of 221, with a normal cell differential. Her venous blood gas revealed a pH of 7.22, CO2 of 64, P02 of 41, bicarbonate of 26, and a base deficit of 3.6. Electrolyte and hepatic function panel revealed normal results. A lumbar puncture is performed and CSF analysis is normal. Blood and CSF cultures are negative. Herpes simplex virus studies are negative. A serum ammonia level is 85umol/L, which is within normal range for the hospital laboratory. A meconium drug screen is negative. Her state newborn screen is normal. A karyotype is performed which reveals a normal female chromosome complement, 46, XX. Her head ultrasound reveals no abnormality. A Brain MRI with and without contrast reveals a few punctate foci of restricted diffusion in the right hemisphere, with otherwise","PeriodicalId":153075,"journal":{"name":"Research in Pediatrics & Neonatology","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121263824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-24DOI: 10.31031/RPN.2020.05.000605
Chang-Hsien Yu
A male newborn was born to a 18y/o mother at gestational age of 38weeks, birth weight 3295gm via emergent Cesarean section with the indication of fetal distress. The mother was diagnosed with type II DM and pregnancy-induced hypertension. Aspirin was given by a family doctor for prevention of preeclampsia during gestational age of 29 to 36 weeks. After birth, the baby presented persistent desaturation (SpO2 77-85%) and severe respiratory acidosis despite of resuscitation. CXR revealed cardiomegaly. Echocardiography showed remarkable dilatation of right ventricle and a huge Patent Ductus of Arteriosus (PDA) with almost right-toleft shunt. Persistent Pulmonary Hypertension of Newborn (PPHN) was diagnosed. However, the isthmus of aorta was restricted (the narrowest diameter was 0.220cm) (Figure 1).
{"title":"A Presentation of Persistent Pulmonary Hypertension of a Newborn Mimicking Coarctation of Aorta","authors":"Chang-Hsien Yu","doi":"10.31031/RPN.2020.05.000605","DOIUrl":"https://doi.org/10.31031/RPN.2020.05.000605","url":null,"abstract":"A male newborn was born to a 18y/o mother at gestational age of 38weeks, birth weight 3295gm via emergent Cesarean section with the indication of fetal distress. The mother was diagnosed with type II DM and pregnancy-induced hypertension. Aspirin was given by a family doctor for prevention of preeclampsia during gestational age of 29 to 36 weeks. After birth, the baby presented persistent desaturation (SpO2 77-85%) and severe respiratory acidosis despite of resuscitation. CXR revealed cardiomegaly. Echocardiography showed remarkable dilatation of right ventricle and a huge Patent Ductus of Arteriosus (PDA) with almost right-toleft shunt. Persistent Pulmonary Hypertension of Newborn (PPHN) was diagnosed. However, the isthmus of aorta was restricted (the narrowest diameter was 0.220cm) (Figure 1).","PeriodicalId":153075,"journal":{"name":"Research in Pediatrics & Neonatology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126724006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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