Abdomen In Pediatric Patients Research Articles

Tuberculosis: A rare cause of acute abdomen in pediatric patients - surgical considerations

BackgroundAbdominal tuberculosis (ATB) is a rare presentation of tuberculosis (TB) in pediatric patients, and its diagnosis can be challenging. This study aimed to analyze the role of surgery in patients with ATB presenting with acute abdomen. MethodsWe conducted a retrospective analysis of pediatric patients under 18 years of age who underwent surgical intervention for acute abdomen (AA) and were diagnosed with ATB at a tertiary-care center in Latin America between June 2003 and March 2023. The diagnosis was confirmed through histopathology or bacteriological analysis. Demographics, clinical presentation, diagnostic methods, and operative findings were collected, and surgical procedures and postoperative outcomes were assessed. ResultsFifteen patients were included in the study. Symptoms and signs were nonspecific. Imaging studies revealed ascites, adenopathies, and intestinal wall thickening, among other findings. Histopathological examination with identification of caseating granulomas proved essential for diagnosis. The peritoneal form was the most frequent presentation, followed by the intestinal type. There were no differences between stoma reversal surgery performed during or after treatment. Complications were observed in 73 % of cases, with intestinal perforation being the most common one. ConclusionAccurate diagnosis of ATB in pediatric patients with acute abdomen is crucial to avoid unnecessary surgeries. Surgery in acute ATB is indicated to manage intestinal complications however surgical management should be approached cautiously. Conservative procedures, such as biopsies and drainage, are recommended when intraoperative findings reveal ATB. Level of evidenceLevel III, Retrospective study

Solid organ injury in blunt trauma abdomen in pediatric patients

Solid organ injury in blunt trauma abdomen in pediatric patients

Cystic Lesions Of Gastrointestinal Tract Presenting As Acute Abdomen in Pediatric Patients

Introduction Cystic lesions involving the gastrointestinal tract are rare in infants and children. Clinical presentations include asymptomatic lesions, pain abdomen, mass per abdomen and vomiting. The aim of the present study is to study the acute presentation of cystic lesions of the gastrointestinal tract in pediatric patients. Methods All patients below the age of 12 years with acute abdomen in the setting of a gastrointestinal cyst were included in the study. The patients underwent ultrasound of the abdomen or CECT or both. All patients underwent laparotomy. Either resection and anastomosis or excision of cyst was done for all patients. Results 16 patients were included in the study. The age of the patients ranged from 1 day to 12 years. The most common presenting symptoms were abdominal pain, distension and vomiting. Most common signs were abdominal lump, distension and tenderness. Ultrasound was done in 14 cases, CECT was done in 10 patients. Resection and end to end anastomosis was done in 11 cases and excision of the cyst was done in 5 cases. Conclusion Cystic lesions of the gastrointestinal tract can present in children of both sexes at any age. Due to the improvement in antenatal scans some of these cystic lesions can be diagnosed antenatally. Nearly two thirds of the cystic lesions of the abdomen present with an acute abdomen. All these patients require immediate surgical management. The cysts which are in proximity with the bowel are more prone for complications. The management may involve resection and anastomosis of involved or excision of cyst.

Small bowel obstruction due to anomalous congenital bands in children: A case report and literature review

Abstract Anomalous congenital bands (ACB) is a rare cause of acute intestinal obstruction, it is difficult to identify preoperatively. We report a case of a three-month-old girl who presented with symptoms and signs of intestinal obstruction. On her medical history, there was no abdominal pain, fever, and no history of previous surgery. Surgical intervention was performed for the correction of the disorder. A good result can be expected with an early diagnosis. Anomalous congenital bands should be considered in the differential diagnosis of acute abdomen in pediatric patients. ACB may cause serious morbidities due to ischemic intestinal.

Imaging Findings of Gastrointestinal Emergency in Infants and Young Children

급성 복증(acute abdomen)은 갑자기 발생하는 심한 복부 통증으로 즉각적인 수술적 치료를 필요로 할 수도 있는 상태를 말한다. 소아 환자의 급성 복증의 원인은 다양하며, 수술적 치료를 해야 하는 질환부터 투약 치료를 받아야 하거나 임상적 관찰 만을 요하는 질환까지 다양하게 분류될 수 있다. 이러한 급성 복증의 환자에서 영상 검사의 역할은 가능하다면 복통의 원인이 되는 질환을 밝혀서 수술적 치료를 해야 하는 환자와 투약 치료를 해야 하는 환자를 구분해 주는 것이다. 장중첩증과 충수돌기염이 소아 환자에서 수술적 치료를 필요로 하는 급성 복증의 가장 흔한 원인 질환이므로, 급성 복통을 호소하는 영아에서는 장중첩증을, 좀 더 나이가 많은 소아에서는 충수돌기염을 영상 검사를 이용해 배제해 주는 것이 중요하다. 이 논문에서는 영유아 환자의 급성 복통을 유발할 수 있는 질환 중 특징적 영상 소견을 보이는 장중첩증, 충수돌기염, 중장 염전, 메켈 게실 및 중복낭종에 대해 소개하고자 한다

A study of evaluation of chronic pain abdomen in pediatric patients by laparoscopy

Background: Pain in abdomen of chronic nature is common in children but being so common difficult to determine the exact cause. It has been estimated that around 2-4% of all the pediatric patients attend the outpatient department are due to pain in the abdomen that is of chronic nature in children. It has been seen that routine diagnostic and therapeutic procedures fail to make a justice of the diagnosis and management for the pain in the abdomen of chronic nature. The aim was to study the role of laparoscopy in children with chronic pain abdomen.Methods: Interventional follow up study was carried out among 19 children with pain in the abdomen of chronic nature. Detailed history pertaining to pain in the abdomen, history of surgical explorations was taken. As a part of the work up of a patient the investigations were done routinely. All children were evaluated by laparoscopy.Results: Majority of the children were in the age group of 11-12 years i.e. 42.1%. Male and female children were almost equal in distribution. USG was diagnostic in 9 patients (47.36%). Laparoscopy was diagnostic in all 18 other cases (95% cases). 73.68% had not complication after the procedure. Only four patients had fever after the surgery and only one patient had wound infection. Thus, overall the laparoscopic procedure was very successful. Laparoscopy and USG were equally effective in diagnosing inguinal hernia.Conclusions: Laparoscopy had better diagnostic value compared to ultrasonography. Laparoscopic intervention was successful with minimum complications.

Acute Abdomen in Pediatric Patients With Lassa Fever: Prevalence and Response to Nonoperative Management.

Few reports on the prevalence of acute abdomen (AAbd) in pediatric patients with Lassa fever (LF) are available, and no firm policy on its management exists. Here, we report on its prevalence in and the response to treatment among a cohort of children with confirmed LF. Six (10.3%) of 58 children with LF had AAbd, whereas 6 (2.8%) of 215 children with AAbd had LF. Nonoperative treatment was successful in 5 of the 6 children with both AAbd and LF. We conclude that AAbd is not uncommon in pediatric patients with LF, and it could be responsive to nonoperative treatment. Testing for LF in all children with febrile AAbd might be justified in areas in which LF is endemic.

Accessory spleen presenting as acute abdomen: A case report and operative management

Abstract Accessory spleens are found in 10–30% of patients and are asymptomatic. Rarely, torsion of an accessory spleen can cause abdominal pain and acute abdomen. We present the case of an 8-year-old girl who arrives to the emergency room with left upper quadrant abdominal pain. CT scan revealed a non-enhancing soft tissue mass and multiple small splenules. Laparoscopy revealed a torsed accessory spleen and malrotation. Accessory spleen is a common congenital anomaly that is frequently asymptomatic. Rarely, an accessory spleen may become torsed around its vascular pedicle resulting in severe abdominal pain. Treatment is surgical resection. Torsion of accessory splenic tissue is a rare cause of acute abdomen in pediatric patients.

Efficacy of ambroxol combined with penehyclidine hydrochloride for prevention of pulmonary complications after surgery due to acute abdomen in pediatric patients with upper respiratory tract infection

Objective To investigate the efficacy of ambroxol combined with penehyclidine hydrochloride for prevention of pulmonary complications after surgery due to acute abdomen in pediatric patients with upper respiratory tract infection.Methods Fifty pediatric patients with acute abdomen complicated with respiratory infection,of ASA physical status Ⅰ or Ⅱ,aged 6 months-5 yr,were randomly divided into test group (group A) and control group (group B),with 25 cases in each group.Immediately after admission to the operating room,ambroxol 1 mg/kg and penehyclidine hydrochloride 0.02 mg/kg were injected intravenously in group A,and atropine 0.02 mg/kg was given in group B.Extubation time and development of laryngospasm,bronchospasm and hypoxemia were recorded.The patients were followed up for 72 h after surgery and the development of postoperative pulmonary complications was recorded.Results Compared with group B,the incidence of hypoxemia and pulmonary complications was significantly decreased,and extubation time was shortened in group A.Conclusion Ambroxol combined with penehyclidine hydrochloride can prevent pulmonary complications after surgery due to acute abdomen and is helpful for prognosis in pediatric patients with upper respiratory tract infection. Key words: Ambroxol ; Cholinergic antagonists ; Respiratory tract infections ; Postoperative complications; Abdomen, acute ; Child

小児急性腹症の診断に対するMDCTの有用性と限界について

小児急性腹症の診断に対するMDCTの有用性と限界について

Acute Abdomen in Pediatric Patients Admitted to the Pediatric Emergency Department

Acute abdomen in children is a serious condition frequently encountered in the pediatric emergency department (ED). This study aimed to analyze the clinical spectrum of acute abdomen, and to investigate the prevalence of various etiologies in different age groups of children admitted to the pediatric ED. From 2005 to 2007, we retrospectively recruited 3980 consecutive pediatric patients who presented to the pediatric ED suffering from acute abdominal pain. Of these patients, 400 were identified as having acute abdomen. These patients were then divided into traumatic and non-traumatic groups, and also divided into four age groups: infant, preschool-age, school-age and adolescent. Differences between the traumatic and non-traumatic groups in the prevalence, clinical presentations, laboratory and imaging findings, and hospital courses were analyzed statistically. In the non-traumatic group (n=335), the most common etiology in infants was incarcerated inguinal hernia (14/31, 45.1%), followed by intussusception (13/31, 41.9%), while acute appendicitis was the major cause in children older than 1 year (68.7%). In the traumatic group (n=65), the major cause of acute abdomen was traffic accidents (76.9%). The liver was the most frequently injured organ, followed by the spleen. The mortality rate was highest in patients with multiorgan injury. In both groups, bowel loop dilation and local ileus were the two most common findings demonstrated by plain film X-rays. Children in the traumatic group who underwent abdominal computed tomography (CT) scans all showed positive findings for their diagnoses. Patients with bowel perforation or obstruction had the longest durations of hospitalization in the non-traumatic group, while those with multiorgan injury had the longest duration in the traumatic group. The etiology of acute abdomen varied depending on the age of the patient. Acute appendicitis was the most common cause of acute abdomen in children older than 1 year of age, followed by traumatic injury. Abdominal CT scanning was a useful diagnostic imaging modality in patients with both traumatic and nontraumatic abdominal pain.