Perforation of the vermiform appendix in a septic neonate with an Amyand's hernia resulted in the formation of a scrotal enterocutaneous fistula. In conclusion from this exceptional complication, active parental awareness for any neonatal scrotal swelling is required, and an early operative policy for the neonatal inguinal hernia is significant.
A double jejunoileal fistula was diagnosed intraoperatively 10 months since a 4-year-old boy had swallowed an object consisted of multiple magnetic items. Magnet ingestion presents characteristics that are misdiagnosing, critical time-consuming, dangerous, and occasionally fatal. The particularities and pitfalls of ingested magnetic items are outlined.
The commonest type of hernia in children is the inguinal one. Either scheduled or as an emergency, hernia surgery is performed daily in every pediatric surgical institution worldwide, regardless of age or gender. In this chapter we deal with the embryology of the inguinal canal and its pathophysiological association with hernia formation. We also discuss the most frequent clinical and diagnostic issues of the pediatric hernia. The management and treatment of the strangulated hernia, the differential diagnosis, and the particular uncommon hernia types are presented as well. We finally present the evolution of hernia surgery from the classical operative methods to the modern laparoscopic and robotic techniques.
An impaction formed of undigested foreign bodies or nutrients in the gastrointestinal tract is called a bezoar (Arabic: bazahr, Persian: padzehr, antidote). 1,2 Bezoars collected from animal stomachs were used as antidotes for poisons and therapies for numerous maladies, until Baudament in 1779 became the first to consider them as a cause of human disease. 1 A bezoar may occur at any part of the gastrointestinal tract, more frequently in proximal segments (stomach and duodenum). 3 The most familiar type is the trichobezoar (Greek: tricha, hair) of the stomach, occurring most commonly in patients younger than 30 years (80%), who are mainly (90%) young females who swallow their hair. 1,2 The phytobezoar type (Greek: phyto, plant) formed by vegetable fibre concretions is most commonly located in the small bowel of children. 2 Other types are caused by milk (lactobezoar), food boluses and medications (i.e. antacids). 1,3 Among the more uncommon causes of bezoar formation are candies, chewing gum included, with only a handful of cases reported in children.A 12-year-old female patient presented with acute abdominal pain and bile-stained vomiting. Abdominal plain radiography in upright position showed distended small bowel loops with airfluid levels (Fig. 1). A bolus of 300 mL of bilious content passed Key Points 1 In a child with gastrointestinal distress, do not omit to include swallowing and chewing habits in history. 2 It is a myth that bezoars occur mainly in mentally impaired children. The majority occur in healthy children. 3 The paediatrician should consult the parents on their child's swallowing and chewing habits and advise them to try to prevent their children swallowing candy or chewing gum.
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