Accuracy of Ultrasound in the Evaluation of Pediatric Abdominal Surgical Emergency: A Comparison with Intra-Operative Findings
Issue:
Volume 8, Issue 1, June 2020
Pages:
1-4
Received:
12 December 2019
Accepted:
23 December 2019
Published:
6 January 2020
Abstract: Background: Pediatric abdominal surgery emergency (PASE) is a frequent reason for emergency admission and surgery in children. PASE is a significant cause of morbidity and mortality especially in developing countries and it constitutes a significant workload of the pediatric surgeon. Ultrasound is available, affordable and accessible in most centers. Though ultrasound is operator dependent, its evaluation of children who have abdominal symptom plays a central role in surgical decision making. Methodology: We evaluated the medical records of all the consecutive children who presented with abdominal symptoms, had abdominal ultrasound and were operated upon between October 2017 and March 2019. This study was carried out in a teaching hospital in Enugu, Nigeria. We compared the ultrasound reports and intra-operative findings; and determined the extent of accuracy of the ultrasound report. Results: One hundred and forty seven children were retrospectively analyzed. There was male dominance and abdominal pain was the predominant presenting symptom. The mean age of the patients at presentation was 6 years. All the patients had abdominal ultrasound and the overall accuracy of ultrasound was 65.8%. Intussusception is the disease condition that had the highest level of ultrasound accuracy. Most of the patients (93.2%) did well and were discharged home. There were 10 deaths accounting for 6.8% of the patients. Conclusion: Abdominal ultrasound is reliable and fairly accurate in the evaluation of children who have abdominal disease conditions.
Abstract: Background: Pediatric abdominal surgery emergency (PASE) is a frequent reason for emergency admission and surgery in children. PASE is a significant cause of morbidity and mortality especially in developing countries and it constitutes a significant workload of the pediatric surgeon. Ultrasound is available, affordable and accessible in most center...
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Endoscopic-assisted Transoral Approach to Parapharyngeal Space Tumours
Ștefan Iemima,
Tonu Angela,
Ghiță Dragoș,
Ivodii Mirela,
Othieno Theresa Mary,
Zainea Viorel,
Rădulescu Marian,
Marinescu Andreea,
Hainăroșie Răzvan
Issue:
Volume 8, Issue 1, June 2020
Pages:
5-10
Received:
8 December 2019
Accepted:
8 January 2020
Published:
7 February 2020
Abstract: Parapharyngeal space tumours are rare, mostly benign and present few symptoms, being difficult to diagnose it early. CT scan and MR are necessary for topographical diagnosis. Surgical resection is the best possible treatment option, but the approach remains a challenge, as there are several vital elements contained in the parapharyngeal space and, thus, adequate visualization is needed. Different surgical approaches have been described: transcervical-submandibular, transparotid, transmandibular, transoral and combined approaches. Transoral approach is the most controversial one due to cited limited exposure, which can lead to neurovascular injury or incomplete removal of the lesion. It is seldom performed and only for small, extra-parotid and non-vascular tumours of the parapharyngeal space. Wide access to endoscopic equipment in our institute allowed us to perform medium to large benign parapharyngeal tumour resection usig the transoral approach. The use of endoscopic assistance for transoral approach provided direct and magnified visualization of the parapharyngeal space, reducing tissue damage, ensuring adequate hemostasis (which lead to less amount of bleeding) and also confirming complete resection prior to closure. In addition, compared to transcervical approach, transoral approach shortened hospitalization time and improved cosmetic appearance. Benign parapharyngeal space tumours not involving critical structures from the parapharyngeal space can be completely resected by an endoscopic-assisted transoral approach with good functional and cosmetic outcome.
Abstract: Parapharyngeal space tumours are rare, mostly benign and present few symptoms, being difficult to diagnose it early. CT scan and MR are necessary for topographical diagnosis. Surgical resection is the best possible treatment option, but the approach remains a challenge, as there are several vital elements contained in the parapharyngeal space and, ...
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A Rare Case of Orbital Hydatid Cyst
Nabil Albab,
Ibrahim Madiq,
Sarah Belghmaidi,
Ibtissam Hajji,
Abdeljalil Moutaouakil,
El Ghali Boufrioua,
Brahim Admou,
Houda Kabbaj,
Zakaria Aziz,
Nadia Mansouri
Issue:
Volume 8, Issue 1, June 2020
Pages:
11-13
Received:
10 December 2019
Accepted:
26 February 2020
Published:
30 April 2020
Abstract: Background: Cystic echinococcosis, also known as hydatid disease, which is mostly caused by larval stage of Echinococcusgranulosus. The orbital localization in rare and uncommon. Preoperative diagnosis is important to prevent from complications. Case information: Here we report the case of a child admitted for chronic proptosis whose investigations concluded with an orbital hydatid cyst. Result: We describe the case of an 8-year-old child, who consulted in our ophthalmic emergency department for a painful proptosis of the right eye with a progressive decrease in visual acuity and chronic fatigue that had been evolving for 6 months. Due to this highly evocative lesion of an orbital hydatid cyst, we carried out with an ELISA and Western Blot hydatid serology which ended negative. Faced with this orbital involvement, we performed an orbital MRI which objectified two right T2-hypersignal eye cystic lesions, well-limited, exerting a mass effect on the optic nerve and responsible of a grade 2 exophthalmos. We also performed a biological assessment including hemogram, renal and hepatic function that had been normal. The patient remained under medical treatment with albendazole before and after surgery. Conclusion: Orbital involvement, although rare, should not be ignored especially when it comes to chronic proptosis with or without a visual impact in children living around dogs or breeders or in deplorable hygienic conditions.
Abstract: Background: Cystic echinococcosis, also known as hydatid disease, which is mostly caused by larval stage of Echinococcusgranulosus. The orbital localization in rare and uncommon. Preoperative diagnosis is important to prevent from complications. Case information: Here we report the case of a child admitted for chronic proptosis whose investigation...
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