Juvenile polyps remain the most common colonic polyps in children. A significant number of cases of polyps are multiple and proximally located, which emphasizes the need for total colonoscopy in all. Juvenile polyps should be removed even if asymptomatic because of their neoplastic potential. Colonoscopic polypectomy is effective even in juvenile polyposis. Surveillance colonoscopy is required in juvenile polyposis only.
Freedom from pain has almost developed to be a fundamental human right. Providing pain relief via epidural catheters in thoracic and upper abdominal surgeries is widely accepted. Pain relief through this technique not only provides continuous analgesia but also reduces post-operative pulmonary complications and also hastens recovery. But being a blind procedure it is accompanied by certain complications. Hypotension, dura puncture, high epidural, total spinal, epidural haematoma, spinal cord injury and infection are some of the documented side effects of epidural block. There are case reports eliciting neurological complications, catheter site infections, paresthesias, radicular symptoms and worsening of previous neurological conditions. Few technical problems related to breakage of epidural catheter are also mentioned in the literature. The patient had no sequelae on long term follow up even when a portion of catheter was retained. We present a case report where epidural catheter punctured pleura in a patient undergoing thoracotomy for carcinoma oesophagus.
The presence of hepatic portal venous gas (HPVG) may be secondary to bowel necrosis, mechanical distension, or intraabdominal sepsis. We describe an unusual and hitherto unreported presence of HPVG manifesting as gas embolization and the unique "aquarium sign" in a patient of Kawasaki's disease. Continuous passage of bubble-like echoes flowing from the hepatic portal venous system into the inferior vena cava and right-sided chambers of heart was noted on echocardiography. The patient was treated with intravenous immune-globulins and made an uneventful recovery.
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