Hydrothorax following delayed extravascular migration of a totally implantable venous access device in a childTotally implantable venous access devices are widely used in pediatric oncology. The authors encountered a 10-year-old boy with implantation of the device at the age of 7 years owing to acute lymphoblastic leukemia. In the recent half-year, the device was not used except for regular heparin flushing. However, hydrothorax occurred when fluid therapy was required from the device during this admission. Thoracoscopic approach showed extravascular migration and intrapleural malposition of the catheter.
Early laparoscopic repair for blunt duodenal perforation in an adolescentDuodenal perforation secondary to blunt abdominal trauma in children is rare and usually associated with delays in diagnosis and surgical intervention. The authors encountered such a case in a 12-year-old boy owing to his falling over the handlebar of a bicycle. Imaging examination showed that there was a perforation over the fourth portion of the duodenum without concomitant injuries. Using a 5-port transperitoneal laparoscopic technique, primary closure of the perforation was successfully performed at 6 hours after the impact.
A retroperitoneal gastric duplication cyst mimicking a simple exophytic renal cyst in an adolescentGastric duplications are rare anomalies and usually occur along the greater curvature of the stomach. The authors herein describe an uncommon case of a retroperitoneal gastric duplication, which was not found during previous emergency laparotomy for suspected peritonitis at another institution. On subsequent computed tomography scan, the lesion was misinterpreted as a simple exophytic renal cyst. Laparoscopy was undertaken because of unresolved symptoms, and a retroperitoneal duplication cyst was successfully excised.
Pneumatic dilation in treatment of late-onset primary gastric outlet obstruction in childhoodLate-onset primary gastric outlet obstruction in childhood is a rare condition. Only 8 cases of such were reported. Diagnosis should be considered while ruling out mechanical and structural lesions. Up to now, Heineke-Mikulicz pyloroplasty has been the standard treatment. However, we succeeded in treating this condition by using pneumatic dilation. There is no sign of recurrence for 1 year. We propose the etiology, diagnosis, and the relationship between late-onset primary gastric outlet obstruction and esophageal achalasia in childhood.