Single incision laparoscopic surgery is used in many centres for routine cases such as appendectomy, splenectomy and cholecystectomy. Morgagni hernias are uncommon and account for 1-2% of all congenital diaphragmatic hernia. We report our first laparoscopic repair of two Morgagni hernias, using a single umbilical incision and full-thickness abdominal wall repair with standard straight laparoscopic instruments. Operative time was short and compared favourably with the laparoscopic repair.
Purpose: Methods to administer intramedullary medication and fluid infusion in both adults and children date to the early 20 th century. Studies have shown that intraosseous access in the proximal tibia is ideal for resuscitation efforts as fewer critical structures are at risk, and neither is the blood flow to the lower limbs compromised. Insertion of a needle in children younger than 5 years does have the risk to damage to the epiphyseal growth plate. Therefore, the aim of this study was to determine the ideal intraosseous insertion site distal to the epiphyseal growth plate in neonates.
Methods:The samples consisted of both the left and right sides of 15 formalin-fixed neonatal cadavers. The dimensions were measured on the superior surfaces of each section, anteromedial border, cortical thickness, medullary space.
Results:The most desirable location to gain vascular access is at 10 mm inferior to the tibial tuberosity.
Conclusion:The smallest cortical thickness (1.32 mm), the largest medullary space (4.50 mm) and the largest anteromedial surface (7.72 mm) was seen at 10mm inferior to the tibial tuberosity. It is imperative that health care professionals are familiar with the osteological sites that could be safely used for an intraosseous infusion procedure.
Massive hydrothorax is an uncommon complication in children on continuous ambulatory peritoneal dialysis (CAPD). In this paper, we present a case of a 6-year-old child on CAPD presenting with an acute hydrothorax after the introduction of peritoneal dialysis. The diagnosis was confirmed with thoracocentesis and comparing the presence of high glucose concentration in the aspirate to that of the serum. Video-assisted thoracoscopic surgery was performed, and a pleuroperitoneal communication was found and repaired. CAPD was resumed 1 week later. We recommend thoracoscopic repair as the first-choice method for repair of pleuroperitoneal communications in pediatric patients.
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