Background: Omphalocele is an abdominal wall defect. Herniated organs can be small or large intestine, liver, and stomach. The use of conventional techniques has always been a challenge for the surgeon. The goal of using NPWT is to provide a quick, simple, and effective method to reduce the eviscerated content and enlarge the visceral continent.
Case Presentation: The record of 3 patients with omphalocele was reviewed. There were two females and one male neonate. All the babies were born by C-section and were antenatally diagnosed for omphalocele. In all cases, NPWT was applied. Two cases were discharged in good condition while one patient with complex cardiac defects succumbed.
Conclusion: NPWT is an effective and safe alternative for omphalocele management.
Background: The management of dehiscence of esophageal anastomosis is challenging and requires a multidisciplinary approach. Endoluminal vacuum therapy (EVT) has shown promising results.
Case Presentation: Herein we present the data of two cases with esophageal atresia who developed esophageal anastomotic leakage, during 2021-2022, and who underwent EVT. The first case had 60% dehiscence of the anastomosis, anastomotic leak repair was performed followed by esophageal EVT placement. In the second case, the dehiscence was limited to 10%, and only esophageal EVT was provided. Within four and six days of EVT, upper gastrointestinal endoscopy and fluoroscopy were performed which showed tissue proliferation in situ and the absence of contrast leakage. Both patients were able to resume oral tolerance on the 4th day.
Conclusion: Esophageal EVT has shown promising results in the management of esophageal anastomotic leakage in newborns with esophageal atresia.
Background: Autologous blood patch pleurodesis (ABPP) has been used in adults as an efficient and safe technique to address persistent air leak (PAL). A fibrin glue patch is also an alternative, but its elevated cost and technique can limit its routine use. Evidence of their use in the pediatric population, specifically in the neonatal age is scant.
Case Presentation: We share our management experience in a series of 3 cases. The first 2 were treated exclusively with ABPP and showed clinical and radiographic improvement. The 3rd case, due to the persistence of the air leak, required extended thoracotomy and fibrin patch placement.
Conclusion: The use of ABPP as an alternative for the treatment of neonates with PAL is a safe and efficient technique. The procedure is replicable and can be done at the bedside at a low cost. A fibrin glue patch should be considered as an alternative option when ABPP fails to resolve the leak.
Antecedentes: La aspiración de cuerpos extraños en los niños es un evento potencialmente peligroso, con el uso de la técnica de broncoscopía rígida su mortalidad ha disminuido. La repercusión de un cuerpo extraño implantado en la vía aérea va a depender de su naturaleza, de su localización y del grado de obstrucción que origine. Objetivo:Presentar nuestra experiencia en el diagnóstico y el tratamiento de cuerpos extraños traqueobronquiales en niños. Métodos: Entre mayo de 2016 y julio de 2019, 15 pacientes acudieron a la emergencia y entraron para extracción de cuerpo extraño mediante Broncoscopia rígida. Se analizaron características demográficas, tiempo de evolución, síntomas, hallazgos en la radiografía de tórax, tipo y localización del cuerpo extraño y tratamiento. Resultados: Nuestros 15 pacientes requirieron broncoscopia por aspiración de cuerpos extraños; los resultados son: edad de 2 meses a 168 meses, la relación hombre: mujer 1 :0.9. El bronquio más afectado es el derecho 53%, tráquea 27%, bronquio izquierdo 20%. El hallazgo radiológico hiperinsuflación unilateral 40%, atelectasia pulmonar 30%, hiperinsuflación bilateral, atelectasia lobar y neumonía 13,3%. El tiempo de permanencia del cuerpo extraño en vía aérea tuvo un rango de 858 horas, un mínimo de 6 horas, media de 168 horas, moda de 336 horas y máximo de 864 horas. La sintomatología más frecuente fue tos y disnea en un 40% Los cuerpos inorgánicos en 73,3% y los orgánicos en 26,6%. La sobrevida es de 93%. Conclusiones: La sospecha clínica, diagnóstica terapéutica oportuna disminuye la morbimortalidad.
Palabras claves: Broncoscopia, Cuerpos extraños, Pediatría
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