No abstract

No abstract

Case selection is a crucial factor that influences the quality of tubularized incised urethral plate results. However, in most repeat cases scarring may lead to an increased complication rate after tubularized incised urethral plate surgery. The grafted modification has the advantage of extending indications for the tubularized incised urethral plate to cases in which another surgical procedure would be necessary. To our knowledge we present the first series of primary and repeat cases.

Roux-en-Y jejunostomy (RYJ) permits enteral feeding in children unable to tolerate oral or intragastric feeds. It avoids many of the complications of nasojejunal and gastrojejunal tubes. Here we report our experience of intubated RYJ. By retrospective review of patient notes from 1998 - 2003, thirty-five children were identified. The median age was seven months (1 month - 16 years) and median follow-up was twenty-five months (1 - 55 months). There were no early postoperative complications or deaths. There were eighteen (51 %) late complications: peristomal leak (6), peristomal infection (2), bilious vomiting (5), tube displacement (3), abscess (1) and jejuno-colic fistula (1). Five children progressed to full oral feeds and had the RYJ resected. Fourteen of the twenty-eight children still alive remain fed by RYJ. Nine infants subsequently underwent fundoplication and gastrostomy with RYJ resection. Seven children died during the study period. RYJ is a straightforward procedure which can be performed safely in the face of poor nutrition and significant comorbidity. We recommend RYJ as a medium-term measure for enteral feeding.

Children affected with chronic granulomatous disease develop severe infections, which frequently evolve to abscess. In most instances the liver is involved. We report a case of liver abscess successfully treated by percutaneous transhepatic alcoholization after antibiotic therapy and percutaneous drainage had failed. This procedure avoided the need for hepatic resection, which is associated with high morbidity in such patients.