A male infant aged 45 days presented with projectile nonbilious vomiting for 2 weeks. Ultrasound showed picture of idiopathic hypertrophic pyloric stenosis. Laparoscopic pyloromyotomy was done, but postoperative vomiting that was mainly nonbilious continued without improvement. After 4 days of persistent vomiting, laparoscopic exploration was done and complete pyloromyotomy was confirmed and malrotation with complete Ladd's band was found, then case converted to open laparotomy and Ladd's procedure was done. Postoperatively, vomiting stopped completely and baby began gradual feeding till reaching full feed. Despite that the presentation of concurrent Idiopathic Hypertrophic Pyloric Stenosis with malrotation is extremely rare; a formal laparoscopic abdominal exploration should be done as the first step before proceeding to pyloromyotomy.
Central venous catheter (CVC) access is needed for chronic use in newborns and infants. Open venous catheterization is a well established technique for treating children. 1 In neonates; it is especially useful for long-term venous access, parenteral feeding, monitoring, and administration of centrally acting drugs. 1,2 Different types of catheters were used including totally implantable and non totally implantable depending upon its use and indications. From the literature, Broviac catheters appear to be the most widely used surgically inserted catheters, with acceptable complication rates even in low birth weight infants. 1,3 Improvement of the manufacturing material leads to minimizing the complication rate. [4][5][6] Originally CVC was performed for three main reasons; total parental nutrition and administration of drugs, venous pressure
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