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Inguinal Lipoblastoma Masquerading as Obstructed Omentocele in a Girl 一名女孩腹股沟脂肪母细胞瘤伪装成阻塞性卵圆孔
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.4103/jiaps.jiaps_272_23
Avilash Sahu, Manita Tamang, B. Tripathy, S. Sahoo, Deepti Naik, A. Manekar, M. Mohanty
ABSTRACT Lipoblastoma in the inguinal regional is a rare occurrence in children and can present as a surgical surprise during pediatric herniotomies. Irreducible inguinal hernia is one of the most common surgical problems dealt by pediatric surgery residents in emergency. We report a case of inguinal lipoblastoma presenting as irreducible groin swelling. Complete excision of the mass was done with no recurrence till date.
摘要 腹股沟区脂肪母细胞瘤在儿童中很少见,在小儿疝气切除术中可能出现手术意外。不可复发的腹股沟疝是小儿外科住院医师在急诊中最常处理的外科问题之一。我们报告了一例腹股沟脂肪母细胞瘤病例,其表现为不可复发的腹股沟肿物。手术完全切除了肿块,至今没有复发。
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引用次数: 0
Dirofilariasis Causing Pediatric Acute Scrotum: A Case Series and Review of the Literature 引起小儿急性阴囊炎的丝虫病:病例系列和文献综述
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.4103/jiaps.jiaps_268_23
Naveen Wijekoon, Diroji Antony, Tharushihan Muhunthan, Malik Samarasinghe
ABSTRACT Dirofilarial infestation has been reported as an extremely rare cause of pediatric acute scrotum. We aimed to evaluate clinical, radiological, and intraoperative findings of children who underwent surgical management for acute scrotum due to dirofilariasis in an endemic country. A retrospective study of patient records of children who underwent surgery for acute scrotum due to dirofilariasis between 2018 and 2022. There were eight emergency presentations for acute scrotum due to dirofilariasis. Three presentations (37.5%) were not associated with scrotal pain. The median age at presentation was 59 (range: 19–100) months. Four patients (67.7%) underwent emergency scrotal exploration at the first presentation and another one during the second presentation. Recurrent episodes were seen in two patients who were initially managed nonsurgically with antibiotics alone. Ultrasonography was performed in all six patients and revealed a parasitic nodule in three (50%). Dirofilariasis causing acute scrotum may cause significant diagnostic dilemma for clinicians. It may resemble idiopathic scrotal edema since it predominantly affects boys under 6 years of age and is painless in a significant proportion. However, left unoperated, it appears to have a high recurrence rate.
摘要 据报道,双鞭毛虫感染是导致小儿急性阴囊炎的一个极为罕见的原因。我们的目的是评估一个地方病流行国家中因双鞭毛虫病导致急性阴囊炎而接受手术治疗的儿童的临床、放射学和术中发现。 对2018年至2022年期间因患双鞭毛虫病而接受急性阴囊手术治疗的患儿病历进行回顾性研究。 共有8例因迪罗丝虫病导致急性阴囊炎的急诊病例。其中3例(37.5%)与阴囊疼痛无关。发病时的中位年龄为59个月(范围:19-100)。四名患者(67.7%)在第一次发病时进行了紧急阴囊探查,另一名患者在第二次发病时进行了紧急阴囊探查。两名患者的病情反复发作,最初仅使用抗生素进行非手术治疗。所有六名患者均接受了超声波检查,其中三人(50%)发现了寄生虫结节。 导致急性阴囊炎的迪罗丝虫病可能会给临床医生带来诊断上的巨大困难。它可能类似于特发性阴囊水肿,因为它主要影响 6 岁以下的男孩,而且相当一部分患者无痛。然而,如果不进行手术,复发率似乎很高。
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引用次数: 0
Accessory Scrotum – Truly an Appendage? 附属阴囊--真正的附属物?
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.4103/jiaps.jiaps_54_24
Neha Masrani, Shravya Subhash Shetty, Kshitij Mane, Ameya Muzumdar, Salman Shiraz Radiowala, Suraj Gandhi, N. S. Shenoy, Hemanshi Shah
ABSTRACT Accessory scrotum is defined as extra scrotal tissue in the vicinity of the anatomically located normal scrotum. We report a case of 4-day full-term male neonate with a unilateral accessory scrotum. We have discussed clinical presentations and associated anomalies of an accessory scrotum thus guiding its evaluation and treatment.
摘要 附属阴囊是指在解剖学上位于正常阴囊附近的额外阴囊组织。我们报告了一例出生 4 天的足月男新生儿的单侧附属阴囊。我们讨论了附属阴囊的临床表现和相关异常,从而为其评估和治疗提供指导。
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引用次数: 0
Use of Pedicled Latissimus Dorsi Muscle Flap for Reconstruction of Soft-tissue Defect in a 2-month-old Infant with Rhabdomyosarcoma on Back 使用带蒂背阔肌肌皮瓣重建 2 个月大背部横纹肌肉瘤婴儿的软组织缺损
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.4103/jiaps.jiaps_16_24
M. Vathulya, Arush Pasricha, B. Sree
ABSTRACT The latissimus dorsi muscle flap is a robust option for reconstructing defects over the back, but the use of this flap in infants is not widely documented. We did this flap to cover a defect that was created after wide local excision of a rhabdomyosarcoma on the back of a 2-month-old infant. Reconstructive surgery was completed successfully, and postoperative recovery was uneventful.
摘要 背阔肌肌皮瓣是重建背部缺损的有力选择,但在婴儿中使用这种皮瓣的记录并不多。我们使用该肌皮瓣覆盖了一名 2 个月大婴儿背部横纹肌肉瘤广泛局部切除后形成的缺损。重建手术顺利完成,术后恢复顺利。
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引用次数: 0
Reconstruction of Cloacal Defect: Switch Operation – A New Approach 重建泄殖腔缺损:开关手术--一种新方法
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.4103/jiaps.jiaps_239_23
A. Basu, K. Basu, K. Bhaumik, Jyotsna Basu, Abhishek Aanad
ABSTRACT Reconstruction of a cloacal defect in a girl is often difficult and complicated.[1] This is most often done either by the sacro-perineal route or through the posterior sagittal route.[2] The procedures may involve total mobilization of the cloaca with or without the creation of a lower vagina with the help of a loop of vascularized bowel.[3] In our approach, such defects can be corrected using the lower anorectum for the creation of a lower vagina and abdominoperineal pull-through of the proximal divided bowel. This method can be used both in short and long common channel cloaca. We have used this procedure in one patient of posterior cloaca and four patients of anterior cloaca. These operations were done in patients of 1 year and 6 months to 4 years. Only one patient is waiting for the closure of the colostomy. In all the cases, the urethra, the vagina, and the anus were successfully separated. This operation restores normal pelvic anatomy and physiology with minimal mutilation of the pelvic floor.
摘要 女孩泄殖腔缺损的重建通常既困难又复杂。[2]手术可能需要完全移动泄殖腔,也可能不借助一圈血管化的肠管来创建下阴道。[3]在我们的方法中,这种缺陷可以通过使用下肛门直肠创建下阴道和腹会阴部拉通近端分裂的肠管来矫正。这种方法既可用于短的共同通道泄殖腔,也可用于长的共同通道泄殖腔。 我们曾在一名后泄殖腔患者和四名前泄殖腔患者中使用过这种手术。这些手术分别在 1 岁、6 个月至 4 岁的患者身上完成。只有一名患者在等待结肠造口的关闭。 所有病例都成功分离了尿道、阴道和肛门。 该手术恢复了正常的骨盆解剖和生理结构,对骨盆底的损伤极小。
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引用次数: 0
Pediatric Solid Pseudopapillary Neoplasm of the Pancreas. 小儿胰腺实性假乳头状瘤
Q3 Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-06 DOI: 10.4103/jiaps.jiaps_7_24
Ashish Sam Samuel, Deepthi Boddu, S Patricia, Thomas Alex Kodiatte, Kanjiyil Thamarapilli Sreekanth, Priyanka Hegde, Susan Jehangir

Background: Solid pseudopapillary neoplasm (SPN) of the pancreas in children is a rare tumor with low malignant potential. Some tumors, however, behave aggressively. There is very little literature on managing these variants, especially in children. We share our experience of managing large and recurrent SPN and explore the clinicopathological findings correlating to the risk of recurrence.

Methods: This is a retrospective study of children treated for SPN between 2012 and 2022 at a tertiary care center in India. The clinicopathological features and management strategies in these children were evaluated.

Results: Sixteen children with SPN were treated during this period (88% of girls). The median age of presentation was 12 years (interquartile range [IQR]: 9-14). All children presented with abdominal pain. Computed tomography gave a definitive diagnosis in 81% of cases. The tumor predominantly involved the head of the pancreas (n = 9, 56%). Eight of nine children classified as high-grade (HG) malignant had a benign course. One child had a recurrence of the tumor 4 years after the initial resection and further recurrence on chemotherapy. She required radiation therapy in addition to reoperation following which she was disease free for 77 months. The overall median follow-up was 46 months (IQR: 18-72 months).

Conclusion: Complete resection of the tumor provides a cure in most patients with SPN. Recurrent tumors require a multi-modality approach. Long-term survival is good. There is a need for clear definitions of the components within the WHO criteria for HG malignancy.

背景:儿童胰腺实体假乳头状瘤(SPN)是一种罕见的低恶性肿瘤。然而,有些肿瘤具有侵袭性。关于如何治疗这些变异性肿瘤,尤其是儿童肿瘤的文献很少。我们将与大家分享处理大面积复发性 SPN 的经验,并探讨与复发风险相关的临床病理结果:这是一项回顾性研究,研究对象是 2012 年至 2022 年期间在印度一家三级医疗中心接受 SPN 治疗的儿童。结果:16名SPN患儿接受了治疗:在此期间,16 名 SPN 患儿接受了治疗(88% 为女孩)。发病年龄中位数为 12 岁(四分位数间距 [IQR]:9-14 岁)。所有患儿均伴有腹痛。81%的病例可通过计算机断层扫描明确诊断。肿瘤主要累及胰腺头部(9 例,56%)。在被列为高级别(HG)恶性肿瘤的九名患儿中,有八名患儿的病程为良性。一名患儿在首次切除肿瘤4年后复发,化疗后又再次复发。除了再次手术外,她还需要接受放疗,术后 77 个月无病。中位随访时间为 46 个月(IQR:18-72 个月):结论:彻底切除肿瘤可治愈大多数 SPN 患者。结论:对大多数 SPN 患者来说,肿瘤完全切除可使其痊愈。长期生存率良好。在世界卫生组织的HG恶性肿瘤标准中,需要明确定义肿瘤的组成部分。
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引用次数: 0
Biliary Perforation in a Neonate – A Rare Cause of Infantile Cholestasis 新生儿胆道穿孔--婴儿胆汁淤积症的罕见病因
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.4103/jiaps.jiaps_50_24
P. Mishra, Tanushree Sahoo, T. Som, S. Sahoo
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引用次数: 0
Hard End of a Guide wire: An Easy Way to Untangle knotted Urethral Catheters 导丝的硬端:解开尿道导管打结的简便方法
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.4103/jiaps.jiaps_70_24
Emine Burcu Cigsar Kuzu
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引用次数: 0
Beyond the Needle: Unmasking Atypical Mycobacteria in Postvaccination Abscesses in Children 针头之外揭示儿童接种疫苗后脓肿中的非典型分枝杆菌
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.4103/jiaps.jiaps_262_23
Amar A. Shah, Devesh N. Joshi, A. Shah
ABSTRACT Atypical or nontuberculous mycobacteria (NTM) are an environmental organism responsible for opportunistic infection. Rapid-growing NTM are more commonly associated with hospital-acquired infections. Many of the organisms responsible for diseases in immunocompromised patients and hospital-acquired infections originate from tap water, such as Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium gordonae, Mycobacterium simiae, Mycobacterium mucogenicum, Mycobacterium fortuitum, Mycobacterium chelonae, and Mycobacterium abscessus. NTM is a rare organism responsible for the injection abscess. Considering low incidents, not much clinical data are available for this condition. Here, we discuss such cases which can be helpful to spread awareness and provide data for future policy makers. This was a retrospective study. Data on patients with injection abscess were collected from the last 6 years. Detailed history and clinical examination findings were analyzed. Children with injection abscess were operated and their further management and outcome were studied. A total of 13 cases with confirmed culture of NTM were treated over 6 years. The age ranged from 2½ months to 5¾ years with male:female ratio of 7:6. All patients hailed from the same geographical area. All children were healthy with no history of any long-term or chronic illness, without additional symptoms and had received Bacillus Calmette-Guérin vaccination at birth. The total duration of illness varied from 1 to 5 months, with a mean of 3 months. All patients had a history of intramuscular age-appropriate vaccination as per the national immunization schedule. All patients were followed up to 6 months after intervention and none of our patients developed relapse. Patient who does not respond with optimum treatment should have a high suspicion of such opportunistic infection, which is crucial to their management. Hospital-acquired NTM infections often result from contaminated instruments or fluids. Adherence to strict aseptic precautions, hand hygiene and environmental precautions are the key to preventing these infections. In case of skin and soft tissue infections / abscesses, surgical intervention plays a significant role for managing the patient.
摘要 非典型或非结核分枝杆菌(NTM)是一种导致机会性感染的环境微生物。快速生长的非结核分枝杆菌通常与医院感染有关。导致免疫力低下患者患病和医院获得性感染的许多病原菌都来自自来水,如堪萨斯分枝杆菌(Mycobacterium kansasii)、异种分枝杆菌(Mycobacterium xenopi)、戈登分枝杆菌(Mycobacterium gordonae)、西米亚分枝杆菌(Mycobacterium simiae)、粘液分枝杆菌(Mycobacterium mucogenicum)、富特分枝杆菌(Mycobacterium fortuitum)、螯合分枝杆菌(Mycobacterium chelonae)和脓肿分枝杆菌(Mycobacterium abscessus)。非结核分枝杆菌是导致注射脓肿的罕见病原体。由于发病率较低,有关这种病症的临床数据并不多。在此,我们将讨论此类病例,这将有助于提高人们的认识,并为未来的政策制定者提供数据。 这是一项回顾性研究。我们收集了过去 6 年中注射脓肿患者的数据。我们分析了详细的病史和临床检查结果。对患有注射脓肿的儿童进行了手术,并研究了他们的进一步治疗和结果。 在过去 6 年中,共治疗了 13 例确诊为 NTM 的病例。患者年龄从 2 个半月到 5¾ 岁不等,男女比例为 7:6。所有患者均来自同一地区。所有儿童均身体健康,无长期或慢性疾病史,无其他症状,并在出生时接种过卡介苗。总病程为1至5个月不等,平均为3个月。所有患者都曾按照国家免疫计划接种过适龄的肌肉注射疫苗。所有患者在接受干预后都接受了长达 6 个月的随访,无一复发。 经最佳治疗无效的患者应高度怀疑此类机会性感染,这对他们的治疗至关重要。医院获得性 NTM 感染通常是由受污染的器械或液体引起的。严格遵守无菌预防措施、手部卫生和环境预防措施是预防这些感染的关键。在皮肤和软组织感染/脓肿的情况下,手术治疗在控制患者病情方面发挥着重要作用。
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引用次数: 0
Clinical Profile, Management, and Outcome of Posterior Urethral Valves in Children – Experience from a Tertiary Care Hospital 儿童后尿道瓣膜的临床概况、管理和结果 - 一家三级医院的经验
Q3 Medicine Pub Date : 2024-07-01 DOI: 10.4103/jiaps.jiaps_27_24
Gali Divya, V. Kundal, Rajasekhar Addagatla, Ritesh Kumar, Sandeep Kumar Jaglan, P. Debnath, A. Meena, Shalu Shah
ABSTRACT Posterior urethral valves (PUV) are the most common obstructive anomaly of the lower urinary tract in children. End-stage renal disease (ESRD) in 17% of the children is due to PUV. The present study helps know the spectrum of the disease, management options, and the outcome in these children. The present study is a descriptive type of study by review of medical records of all the children presented to the hospital from 2015 to 2019. Profile of PUV includes any abnormality in antenatal ultrasonography (USG), age at presentation, presenting complaints, general condition at the time of presentation, biochemical investigations like serum creatinine and electrolytes at admission, clinical progression during hospital stay and the type of intervention. Outcome variables studied were improvement in the stream and overall well-being of the child, renal function, recurrent urinary tract infections (UTIs). Follow-up period varied from 1 to 6 years. A total of 73 patients were included in the study. The mean age of presentation was 3.4 years. The most common presenting complaints were poor urinary stream and dribbling of urine. Antenatal USG showed abnormality in 23 patients. Renal function was abnormal in 28 patients. Out of 73 patients, 51 underwent endoscopic ablation of valves, 19 underwent vesicostomy, and three patients underwent supravesical diversion. During the follow-up recurrent UTI was observed in 11 patients, 15 patients progressed to chronic kidney disease, and 15% of patients were hypertensive. Mortality in the present study was 4%. PUV includes a spectrum of diseases from mild form to lethal conditions. Early intervention by relieving obstruction may prevent or delay the ESRD; hence, timely intervention is necessary in these children.
摘要 后尿道瓣膜(PUV)是儿童下尿路最常见的梗阻性畸形。17%的儿童终末期肾病(ESRD)是由 PUV 引起的。本研究有助于了解这些儿童的疾病谱、治疗方案和结果。 本研究是一项描述性研究,通过审查 2015 年至 2019 年期间在医院就诊的所有儿童的病历。PUV 的概况包括产前超声波检查(USG)中的任何异常、发病时的年龄、主诉、发病时的一般状况、入院时的生化检查(如血清肌酐和电解质)、住院期间的临床进展以及干预类型。研究的结果变量包括患儿血流和整体健康状况的改善、肾功能、复发性尿路感染(UTI)。随访时间从 1 年到 6 年不等。 研究共纳入了 73 名患者。平均发病年龄为 3.4 岁。最常见的主诉是尿流不畅和小便滴沥。23 名患者的产前 USG 显示异常。28 名患者的肾功能异常。在 73 名患者中,51 人接受了内窥镜瓣膜消融术,19 人接受了膀胱造口术,3 人接受了膀胱上分流术。在随访期间,11 名患者出现了尿毒症复发,15 名患者发展为慢性肾病,15% 的患者患有高血压。本研究的死亡率为 4%。 PUV 包括从轻微到致命的各种疾病。通过缓解梗阻进行早期干预可预防或延缓 ESRD;因此,有必要对这些儿童进行及时干预。
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引用次数: 0
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Journal of Indian Association of Pediatric Surgeons
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