Background: Perforation of the appendix can lead to life-threatening complications. Early identification of a perforation before surgery has important clinical implications. Hyponatremia was previously proposed as a marker to differentiate between perforated and non-perforated acute appendicitis. This study aims to determine the role of sodium levels as a predictive factor in the incidence of perforated appendicitis in children at Dr. M. Djamil General Hospital Padang. Methods: This research is an analytic observational study with a cross-sectional design. The research took place from March to May 2022 at Dr. M. Djamil General Hospital Padang. Samples were taken by consecutive sampling with criteria aged 0-18 years and diagnosed with acute appendicitis at Dr. M. Djamil General Hospital Padang. Results: A total of 112 samples with most of the patients (52.7%) aged 6-11 years and found a greater proportion of men (57.1%). Most of the patients underwent laparotomy procedures (57.2%). Hyponatremia was found in 58% of patients. Perforation occurred in most (59.8%) patients. SPSS results showed a significant difference between the incidence of hyponatremia in perforated and non-perforated appendicitis with a p-value <0.001. Conclusion: There is a significant relationship between sodium levels and the incidence of perforation, where the lower the sodium level, the higher the incidence of perforation.
Amyand’s hernia is rare condition defined as the inclusion of the appendixin an ingunal hernia sac, It is an uncommon and rare condition estimatedto be found in approximately 1 % of hernia. However, in just 0.08 %, thecondition is complicated by an acute appendicitis. It may present as atender inguinal or inguinoscrotal swelling. In patients presenting amyand’shernia with mechanical bowel obstruction, signs of acute appendicitis maynot be initially recognized. This was the case while our patient was insurgery, as signs suggestive of acute appendicitis were discovered and thepatient received appendectomy and herniotomy. Presently, We report a caseof Amyand’s hernia in a 9-month-old male, who presented as a left-sidedcongenital hernia with distended abdominal and pain in the left groin. Heunderwent appendectomy and herniotomy, which revealed that the herniasac containing elongated inflamed appendix appeared with some adhesionsto sac, lying in the inguinal canal.
Background: The incidence of corrosive ingestion is high and largely unreported in developing countries due to lack of parental supervision and careless storing of these chemicals at home. Case presentation: A 5 years, 1-month-old boy came to the outpatient clinic department of pediatric Dr. M. Djamil General Hospital with a chief complaint of recurrent vomit since 6 weeks before admission. There was a history of ingested accumulator water 1,5 months before admission. The patient vomits every day, especially after eating and drinking. Conclusion: The most common symptoms are vomiting, feeding problems in oral intake, and rapid weight loss. The clinical diagnosis of prepyloric stricture is based on the history of the disease, physical examination, and supporting the investigation. Treatment of gastric outlet obstruction caused by corrosive ingestion should be treated surgically.
Background: Cholelithiasis is a condition in which rare in children but in recent years has been increasing due to ultrasound used. This problem associated to inflammation, infection, obesity, children who received long total parenteral nutrition, resection of bowel, chronic liver disease or genetic. Most of cholelithiasis in children are asymptomatic. Gallstones are divided into cholesterol stones and pigment stones, could be on lucent or opaque description in abdominal x-ray. There are no special guidelines defined indications for medical or surgical treatment in children with cholelithiasis. Case Presentation: A 7 years 2 months old boy complaint of abdominal pain getting worse since 6 hours before admission; colicky pain, does not spread to other region of abdominal, and especially after eating. Vomit was frequently after eating. Symptoms are repeated for 3 times hospitalization and established as acute pancreatitis in second hospitalization but confirmed as cholelithiasis in recent admission. Conclusion: cholelithiasis in children could be related to inflammation and/ or infection of organs around the gallbladder. Keywords: Cholelithiasis, acute pancreatitis, chronic cholecystitis, case report.
Treatment of pediatric inguinal hernia can be done with conventional and laparoscopy methods. Laparoscopic percutaneous extraperitoneal ligation closes the internal inguinal ring by making sutures that are knotted by the extraperitoneum and implanted in the subcutaneous tissue. The rate of recurrence and postoperative complications are still a major concern. Division of pediatric surgery at Dr. M.Djamil Hospital Padang made modifications using an 18G intravenous catheter that was bent to form an angle of 100-150. This study aims to determine the success of laparoscopic herniotomy with modification performed by recurrence rate. This study is a retrospective analytic design method. Data was taken from the medical record status of pediatric inguinal hernia patients undergoing laparoscopic herniotomy at RSUP Dr. M.Djamil Padang from January 2018 -December 2019. Data were analyzed by crosstabulation using the Fisher test. Recurrence was seen in 7,4% of patients (5/68 patients). Three cases in boys and 2 cases in girls. Two cases in the age group ≤1 year and 3 cases in the age group >1 year. One case in the weight group ≤10 kg and 4 cases in the bodyweight >10 kg. Three recurrent cases appeared on the right side and 2 cases on the left side. There were no differences in the incidence of recurrence after laparoscopic-assisted extraperitoneal ligation with intravenous catheter 18G as needle puncture according to age, sex, body weight, and location of the hernia.
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