A. Jarraya, Manel Kammoun, Chiraz Regaieg, K. Ben Ayed, Abdennaceur Bouattour, S. Kallel, F. Karray, A. Ben Hamed, Nedia Ben Hamida
1. Anesthesiology Department, The Hedi Chaker University Hospital, University of Sfax, Tunisia. 2. Neonatal Intensive Care Unit, the Hedi Chaker University Hospital, University of Sfax, Tunisia. 3. Maxillofacial Surgery Department, The Habib Bourguiba University Hospital, University of Sfax, Tunisia. 4. Otorhinolaryngology Department, The Habib Bourguiba University Hospital, University of Sfax, Tunisia.
{"title":"Rapidly growing ranula and its management in a neonate","authors":"A. Jarraya, Manel Kammoun, Chiraz Regaieg, K. Ben Ayed, Abdennaceur Bouattour, S. Kallel, F. Karray, A. Ben Hamed, Nedia Ben Hamida","doi":"10.47338/jns.v12.1205","DOIUrl":"https://doi.org/10.47338/jns.v12.1205","url":null,"abstract":"1. Anesthesiology Department, The Hedi Chaker University Hospital, University of Sfax, Tunisia. 2. Neonatal Intensive Care Unit, the Hedi Chaker University Hospital, University of Sfax, Tunisia. 3. Maxillofacial Surgery Department, The Habib Bourguiba University Hospital, University of Sfax, Tunisia. 4. Otorhinolaryngology Department, The Habib Bourguiba University Hospital, University of Sfax, Tunisia.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48083339","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}
Background: Osteomyelitis in the neonatal age group is a rare entity. Its presentation and progression are quite different from osteomyelitis in adults, adolescents, and even children. Due to vague clinical features and the late appearance of changes on X-rays, the diagnosis often gets missed. Additionally, there is a risk of permanent damage to bones and joints. Case Presentation: Our experience of 3 such interesting cases showed the diagnostic dilemma involved in neonatal osteomyelitis. All 3 cases presented as cellulitis or subcutaneous abscess initially as x-ray changes appeared late (7-10 days after onset of disease). All the babies needed surgical debridement. The average duration of antibiotics given was 35.5 days. No residual sequelae were reported for up to 2 years. Conclusion: Neonatal osteomyelitis needs a high index of suspicion especially in late-onset neonatal sepsis or prolonged septicemia. This case series emphasizes the need for a low threshold for suspicion and early treatment to avoid permanent disability.
{"title":"Neonatal osteomyelitis: A case series","authors":"Parveen Kumar, Ankur Bhardwaj, Anil Agarwal, Divyamedha Agarwal","doi":"10.47338/jns.v12.1231","DOIUrl":"https://doi.org/10.47338/jns.v12.1231","url":null,"abstract":"Background: Osteomyelitis in the neonatal age group is a rare entity. Its presentation and progression are quite different from osteomyelitis in adults, adolescents, and even children. Due to vague clinical features and the late appearance of changes on X-rays, the diagnosis often gets missed. Additionally, there is a risk of permanent damage to bones and joints.\u0000Case Presentation: Our experience of 3 such interesting cases showed the diagnostic dilemma involved in neonatal osteomyelitis. All 3 cases presented as cellulitis or subcutaneous abscess initially as x-ray changes appeared late (7-10 days after onset of disease). All the babies needed surgical debridement. The average duration of antibiotics given was 35.5 days. No residual sequelae were reported for up to 2 years.\u0000Conclusion: Neonatal osteomyelitis needs a high index of suspicion especially in late-onset neonatal sepsis or prolonged septicemia. This case series emphasizes the need for a low threshold for suspicion and early treatment to avoid permanent disability.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46339742","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}
Abdullah Khan, Assad Ameer, A. Ditta, Laraib Amjad, Kashif Nawaz, S. Zaman, N. Talat
Background: Giant segmental dilatation of jejunum (SDJ) is rare in small infants where it often presents with intestinal obstruction. Occasionally, the giant SDJ may twist resulting in volvulus. Case Presentation: A 1-month-old female infant presented with intestinal obstruction. At surgery, isolated giant segmental dilatation of the jejunum causing volvulus of the bowel was found. The gut was viable. The SDJ was excised and jejuno-jejunal anastomosis was performed. Ladd’s procedure was also performed for the associated malrotation. Postoperative recovery remained uneventful. Conclusion: Giant SDJ is a rare entity, rarer still is its presentation with volvulus secondary to its twist. Early diagnosis and prompt management result in a good outcome.
{"title":"Giant segmental dilatation of jejunum causing volvulus in an infant: A case report","authors":"Abdullah Khan, Assad Ameer, A. Ditta, Laraib Amjad, Kashif Nawaz, S. Zaman, N. Talat","doi":"10.47338/jns.v12.1227","DOIUrl":"https://doi.org/10.47338/jns.v12.1227","url":null,"abstract":"Background: Giant segmental dilatation of jejunum (SDJ) is rare in small infants where it often presents with intestinal obstruction. Occasionally, the giant SDJ may twist resulting in volvulus.\u0000Case Presentation: A 1-month-old female infant presented with intestinal obstruction. At surgery, isolated giant segmental dilatation of the jejunum causing volvulus of the bowel was found. The gut was viable. The SDJ was excised and jejuno-jejunal anastomosis was performed. Ladd’s procedure was also performed for the associated malrotation. Postoperative recovery remained uneventful.\u0000Conclusion: Giant SDJ is a rare entity, rarer still is its presentation with volvulus secondary to its twist. Early diagnosis and prompt management result in a good outcome.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47688525","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}
Igb Adria Hariastawa, Yoshua Eric Irawan, Illona Okvita Wiyogo
Background: Most patients with choledochal cysts are diagnosed during childhood. Therefore, the aim of this study is to report a case of early detected choledochal cyst in a neonate patient presenting with intestinal obstruction. Case Presentation: A 5-day-old baby girl was brought to the hospital with a chief complaint of bilious vomiting. No history of jaundice was found. Ultrasound in the third trimester (37 weeks) showed an anechoic cyst with a smooth wall, no septum, with a size of 5.5x4.7x4.7 cm, suspected ovarian cyst. At 4 days old, MRCP showed dilated right and left Intrahepatic bile duct with a normal gallbladder, suspected as choledochal cyst Todani type 1. The patient was operated on at 7 days old and was discharged 15 days after surgery. Nine months after discharge, the patient was in good condition with no complaints of jaundice nor acholic stool and normal liver function test. Conclusion: Prenatal diagnosis of choledochal cyst gave awareness to receive appropriate treatment. Bowel obstruction without jaundice could be an early symptom of a choledochal cyst in neonates.
{"title":"Choledochal cyst presenting with neonatal intestinal obstruction: A case report","authors":"Igb Adria Hariastawa, Yoshua Eric Irawan, Illona Okvita Wiyogo","doi":"10.47338/jns.v12.1202","DOIUrl":"https://doi.org/10.47338/jns.v12.1202","url":null,"abstract":"Background: Most patients with choledochal cysts are diagnosed during childhood. Therefore, the aim of this study is to report a case of early detected choledochal cyst in a neonate patient presenting with intestinal obstruction. \u0000Case Presentation: A 5-day-old baby girl was brought to the hospital with a chief complaint of bilious vomiting. No history of jaundice was found. Ultrasound in the third trimester (37 weeks) showed an anechoic cyst with a smooth wall, no septum, with a size of 5.5x4.7x4.7 cm, suspected ovarian cyst. At 4 days old, MRCP showed dilated right and left Intrahepatic bile duct with a normal gallbladder, suspected as choledochal cyst Todani type 1. The patient was operated on at 7 days old and was discharged 15 days after surgery. Nine months after discharge, the patient was in good condition with no complaints of jaundice nor acholic stool and normal liver function test.\u0000Conclusion: Prenatal diagnosis of choledochal cyst gave awareness to receive appropriate treatment. Bowel obstruction without jaundice could be an early symptom of a choledochal cyst in neonates.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49453540","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}
Background: Gastroschisis is one of the common congenital anterior abdominal wall defects with uncovered abdominal contents (usually intestines) protruding through it. Immediate reduction of the abdominal contents is crucial after birth because of the grave consequences of delayed management. The aim of our study was to evaluate the early outcomes of Gastroschisis at a tertiary care institute in India. Methods: This prospective observational study was undertaken over a one-year duration extending from January to December 2021 at our pediatric tertiary care teaching institute. Results: There were 30 male and 28 female patients, out of which 37 were preterm neonates. The mean birth weight was 2019±357g. Seven patients (12.07%) had major associated malformations. Fifty (86.21%) patients underwent primary skin flap closure. Staged reduction with silo was accomplished in five (8.62%) patients; three patients died during resuscitation before any therapeutic procedure could be undertaken. Among 55 (94.83%) patients with surgical procedures, only 26 (47.27%) could be salvaged with overall favorable (survival) outcomes in 44.83% of patients. Mortality was high (92.59%, 25/27) in the patients presenting with markedly edematous bowel with leathery peel. Seventeen (29.31%, 17/58) neonates died in the first 72 hours (postoperatively) due to complications of abdominal compartment syndrome, eight (13.79%) patients died due to postoperative sepsis with thrombocytopenia, and two (3.44%) had intestinal perforation. The duration of hospital stay in neonates who survived ranged from one to four weeks. Conclusion: Overall survival rates in our study were 44.83% markedly in contrast to the series published in the recent literature. The outcome of preterm (premature) patients, associated intestinal atresia, presence of edematous bowel with leathery peel, patients requiring silo due to viscero-abdominal disproportion, necrotizing enterocolitis, and associated malformations, was dismal.
{"title":"Early outcome analysis of Gastroschisis from a high-volume tertiary care institute in India: A prospective observational study","authors":"Rahul Gupta, B. Gurjar","doi":"10.47338/jns.v12.1197","DOIUrl":"https://doi.org/10.47338/jns.v12.1197","url":null,"abstract":"Background: Gastroschisis is one of the common congenital anterior abdominal wall defects with uncovered abdominal contents (usually intestines) protruding through it. Immediate reduction of the abdominal contents is crucial after birth because of the grave consequences of delayed management. The aim of our study was to evaluate the early outcomes of Gastroschisis at a tertiary care institute in India.\u0000Methods: This prospective observational study was undertaken over a one-year duration extending from January to December 2021 at our pediatric tertiary care teaching institute.\u0000Results: There were 30 male and 28 female patients, out of which 37 were preterm neonates. The mean birth weight was 2019±357g. Seven patients (12.07%) had major associated malformations. Fifty (86.21%) patients underwent primary skin flap closure. Staged reduction with silo was accomplished in five (8.62%) patients; three patients died during resuscitation before any therapeutic procedure could be undertaken. Among 55 (94.83%) patients with surgical procedures, only 26 (47.27%) could be salvaged with overall favorable (survival) outcomes in 44.83% of patients. Mortality was high (92.59%, 25/27) in the patients presenting with markedly edematous bowel with leathery peel. Seventeen (29.31%, 17/58) neonates died in the first 72 hours (postoperatively) due to complications of abdominal compartment syndrome, eight (13.79%) patients died due to postoperative sepsis with thrombocytopenia, and two (3.44%) had intestinal perforation. The duration of hospital stay in neonates who survived ranged from one to four weeks.\u0000Conclusion: Overall survival rates in our study were 44.83% markedly in contrast to the series published in the recent literature. The outcome of preterm (premature) patients, associated intestinal atresia, presence of edematous bowel with leathery peel, patients requiring silo due to viscero-abdominal disproportion, necrotizing enterocolitis, and associated malformations, was dismal.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44916990","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}
Riccardo Rizzo, F. Paradiso, S. Silvaroli, L. Nanni
Background: Esophageal perforation is uncommon and often iatrogenic in the neonatal period, and premature and low birth weight infants (<1500 g) are particularly susceptible. Esophageal injury in neonates usually occurs at the pharyngoesophageal junction and can be confused with esophageal atresia due to respiratory signs and excessive salivation. Diagnostic evaluation and treatment are still debated. Case Presentation: This case report aims to describe two neonatal cases of iatrogenic esophageal perforation. The suspected diagnosis was confirmed only with thoracotomy. Diagnostic difficulties and therapeutic modalities are discussed. Conclusion: These two cases show the importance of the clinical clues (anamnesis and clinical findings) to suspect the diagnosis of esophageal perforation.
{"title":"Iatrogenic esophageal perforation in infants: how to avoid thoracotomy? Two case reports","authors":"Riccardo Rizzo, F. Paradiso, S. Silvaroli, L. Nanni","doi":"10.47338/jns.v12.1181","DOIUrl":"https://doi.org/10.47338/jns.v12.1181","url":null,"abstract":"Background: Esophageal perforation is uncommon and often iatrogenic in the neonatal period, and premature and low birth weight infants (<1500 g) are particularly susceptible. Esophageal injury in neonates usually occurs at the pharyngoesophageal junction and can be confused with esophageal atresia due to respiratory signs and excessive salivation. Diagnostic evaluation and treatment are still debated. \u0000Case Presentation: This case report aims to describe two neonatal cases of iatrogenic esophageal perforation. The suspected diagnosis was confirmed only with thoracotomy. Diagnostic difficulties and therapeutic modalities are discussed. \u0000Conclusion: These two cases show the importance of the clinical clues (anamnesis and clinical findings) to suspect the diagnosis of esophageal perforation.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41430999","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}
Jimmy Israel Andrade- Montesdeoca, Vicente Salinas Salinas, D. Acosta Farina, Daniel Acosta Bowen
Background: Autologous blood patch pleurodesis (ABPP) has been used in adults as an efficient and safe technique to address persistent air leak (PAL). A fibrin glue patch is also an alternative, but its elevated cost and technique can limit its routine use. Evidence of their use in the pediatric population, specifically in the neonatal age is scant. Case Presentation: We share our management experience in a series of 3 cases. The first 2 were treated exclusively with ABPP and showed clinical and radiographic improvement. The 3rd case, due to the persistence of the air leak, required extended thoracotomy and fibrin patch placement. Conclusion: The use of ABPP as an alternative for the treatment of neonates with PAL is a safe and efficient technique. The procedure is replicable and can be done at the bedside at a low cost. A fibrin glue patch should be considered as an alternative option when ABPP fails to resolve the leak.
{"title":"Management of persistent air leak in Neonates: A case series","authors":"Jimmy Israel Andrade- Montesdeoca, Vicente Salinas Salinas, D. Acosta Farina, Daniel Acosta Bowen","doi":"10.47338/jns.v12.1200","DOIUrl":"https://doi.org/10.47338/jns.v12.1200","url":null,"abstract":"Background: Autologous blood patch pleurodesis (ABPP) has been used in adults as an efficient and safe technique to address persistent air leak (PAL). A fibrin glue patch is also an alternative, but its elevated cost and technique can limit its routine use. Evidence of their use in the pediatric population, specifically in the neonatal age is scant.\u0000Case Presentation: We share our management experience in a series of 3 cases. The first 2 were treated exclusively with ABPP and showed clinical and radiographic improvement. The 3rd case, due to the persistence of the air leak, required extended thoracotomy and fibrin patch placement.\u0000Conclusion: The use of ABPP as an alternative for the treatment of neonates with PAL is a safe and efficient technique. The procedure is replicable and can be done at the bedside at a low cost. A fibrin glue patch should be considered as an alternative option when ABPP fails to resolve the leak.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47969267","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}
{"title":"Intrauterine toes gangrene in a neonate","authors":"F. Hemmati, H. Barzegar","doi":"10.47338/jns.v12.1186","DOIUrl":"https://doi.org/10.47338/jns.v12.1186","url":null,"abstract":"","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47522530","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}
{"title":"Re: Constrained evidence-based practice","authors":"A. Trivedi, N. Badawi, Gordon Thomas","doi":"10.47338/jns.v12.1208","DOIUrl":"https://doi.org/10.47338/jns.v12.1208","url":null,"abstract":"","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44024011","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}
Verónica Polit-Guerrero, Jimmy Andrade-Montesdeoca, Ernesto Fabre-Parrales, Vicente Salinas-Salinas, Daniel Acosta-Farina
Background: Horseshoe lung is a rare congenital malformation, and even rarer is its association with congenital pulmonary airway malformations. Case Presentation: We report a case of horseshoe lung associated with congenital pulmonary airway malformation (Stocker type 2) who underwent surgical management in two stages. The patient had a right posterolateral thoracotomy with lower right lobectomy at 14 days of life, followed by a left posterolateral thoracotomy with lower left lobectomy at 7 months of age. He is doing fine after both surgeries and follow-up visits are ongoing. Conclusion: The treatment of horseshoe lung should be individualized, surgical management is an effective option and the two-stage approach in neonates would reduce the risk of the simultaneous bilateral procedure.
{"title":"Two-stage surgical management of horseshoe lung associated with congenital pulmonary airway malformation in a neonate: A case report","authors":"Verónica Polit-Guerrero, Jimmy Andrade-Montesdeoca, Ernesto Fabre-Parrales, Vicente Salinas-Salinas, Daniel Acosta-Farina","doi":"10.47338/jns.v12.1215","DOIUrl":"https://doi.org/10.47338/jns.v12.1215","url":null,"abstract":"Background: Horseshoe lung is a rare congenital malformation, and even rarer is its association with congenital pulmonary airway malformations.\u0000Case Presentation: We report a case of horseshoe lung associated with congenital pulmonary airway malformation (Stocker type 2) who underwent surgical management in two stages. The patient had a right posterolateral thoracotomy with lower right lobectomy at 14 days of life, followed by a left posterolateral thoracotomy with lower left lobectomy at 7 months of age. He is doing fine after both surgeries and follow-up visits are ongoing.\u0000Conclusion: The treatment of horseshoe lung should be individualized, surgical management is an effective option and the two-stage approach in neonates would reduce the risk of the simultaneous bilateral procedure.","PeriodicalId":34201,"journal":{"name":"Journal of Neonatal Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49006226","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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