Online Exclusives
Brachial plexus palsy, a rare delayed complication of the Nuss procedure for pectus excavatum: a case report
We report a rare complication after the Nuss procedure for the correction of pectus excavatum in a 15-year-old adolescent boy. He began to have delayed right brachial plexus injury on the 15th postoperative day. Careful physical check-up revealed a painful and enlarged subaxillary lymph node. He was successfully treated using anti-inflammatory medications and physical therapy.Repair of duodenal atresia under spinal anesthesia in a low-birth-weight preterm neonate: case report
Duodenal atresia is a well-recognized cause of neonatal bowel obstruction. General anesthesia with tracheal intubation is the traditional anesthetic technique for surgical correction of this condition. Metabolic abnormalities and fluid deficits coupled with residual anesthetics are known to increase the risk of postoperative apnea, prolonging the operating room time and delaying extubation. Spinal anesthesia (SA) is an accepted alternative to general anesthesia in formerly preterm infants. In the current literature, there are reports of successful use of SA for simple infraumbilical surgery and, occasionally, for upper abdominal surgery, but there is no information on the use of SA in neonates for duodenal atresia repair.Invasive thymoma in a child: a rare case report
Thymomas are neoplasms of the anterior mediastinum and generally occur between the fourth and sixth decades of life. In children, they are rare, with few reported cases. We describe a 9-year-old boy with invasive thymoma treated successfully by surgery alone. The patient was previously healthy and under treatment for a community-acquired pneumonia. A chest radiograph showed an opacity at the left lung base, and thoracic computed tomographic scan showed a mass with thick walls and liquid content situated in the lingula with no cleavage plane with the mediastinum.Toxic epidermal necrolysis complicated by small bowel intussusception: a case report
Intestinal involvement in toxic epidermal necrolysis (TEN) has been identified only rarely. We report a case of TEN complicated by small bowel intussusception. The patient was a previously healthy 8-year-old boy who presented with TEN and extensive lesions, including up to 40% of the body surface area as well as conjunctival, oropharyngeal, respiratory, and genital mucosa. Rapidly after the onset of a constant rate of enteral feeding, he developed bilious vomiting, diarrhea, and significant abdominal distension.Modified technique of meso-Rex shunt in case of insufficient length of the jugular vein graft
Meso-Rex shunt (MRS) can relieve portal hypertension and restore a physiological portal flow in patients with portal vein thrombosis. We describe a technical variant where the autologous internal jugular vein (IJV) was too short to bridge the superior mesenteric vein (SMV) and the Rex recessus.Primary intestinal lymphangiectasia successfully treated by segmental resections of small bowel
Primary intestinal lymphangiectasia is a rare cause of protein-losing enteropathy and usually presents with intermittent diarrhea or malnutrition. Diagnosis depends largely on its pathologic condition demonstrating greatly dilated lymphatics mainly in the lamina propria of the mucosa. We report a case of primary intestinal lymphangiectasia, of the diffuse type, presenting with abdominal pain and voluminous diarrhea in a previously healthy 8-year-old boy. He had periumbilical pain for 3 months before presentation.Glial heterotopia of the face
The authors report a case of combined subcutaneous and intranasal glial heterotopia of the face in a 4-month-old boy. The pathogenesis and differential diagnoses of this rare developmental disorder are discussed as is the importance of careful radiologic findings for appropriate surgical decision.Symptomatic anterior sternoclavicular joint secondary to a Bicipital rib
This case report details the diagnosis and treatment of a previously unreported complication of a congenital chest wall anomaly. Our patient presented with a painful anterior sternoclavicular joint subluxation secondary to a bicipital rib. Thoracic magnetic resonance and computed tomographic imaging provided the diagnosis. Complete resolution of symptoms was achieved after resection of the bicipital rib.Tinea capitis: no incision nor excision
Tinea capitis is a fungal infection of the scalp and hair shaft that mainly affects prepubescent children. Its clinical aspects range from a mild noninflammatory infection resembling seborrheic dermatitis to a highly inflammatory swelling reaction (kerion). We report the cases of 2 children who underwent surgical treatment of their kerions under general anesthesia. One lesion had been incised and the other excised. This inappropriate treatment made conservative treatment after surgery more difficult.Continuous hyperthermic peritoneal perfusion for desmoplastic small round cell tumor
Desmoplastic small round cell tumor (DSRCT) is a rare disease of children, adolescents, and young adults that begins and spreads on the peritoneal surfaces. Desmoplastic small round cell tumor usually presents with diffuse abdominal metastatic disease similar in gross appearance to carcinomatosis. To date, very aggressive treatment programs have yielded dismal outcomes. Here we present 2 cases of DSRCT that were treated with aggressive surgical excision followed by intraoperative continuous hyperthermic peritoneal perfusion using cisplatin.Complete surgical resection of inflammatory myofibroblastic tumor with carinal reconstruction in a 4-year-old boy
Inflammatory myofibroblastic tumor of the carina and the main bronchus is a rare tumor. The authors report here on a case of a 4-year-old boy with an inflammatory myofibroblastic tumor at the carina and extending to the left main bronchus. He presented with fever and a cough of 2 months' duration. Preoperative assessment of the tumor revealed an intraluminal round mass arising from the carina and extending into the left main bronchus, and this caused near-total obstruction of the left main bronchus and the subsequent total collapse of the entire left lung.
