Aim:Debatable issues in the management of inguinal hernia in premature infants remain unresolved. This study reviews our experience in the management of inguinal hernia in premature infants.Materials and Methods:Retrospective chart review of premature infants with inguinal hernia from 1999 to 2009. Infants were grouped into 2: Group 1 had repair (HR) just before discharge from the neonatal intensive care unit (NICU) and Group 2 after discharge.Results:Eighty four premature infants were identified. None of 23 infants in Group 1 developed incarcerated hernia while waiting for repair. Of the 61 infants in Group 2, 47 (77%) underwent day surgery repair and 14 were admitted for repair. At repair mean postconceptional age (PCA) in Group1 was 39.5 ± 3.05 weeks. Mean PCA in Group 2 was 66.5 ± 42.73 weeks for day surgery infants and 47.03 ± 8.87 weeks for admitted infants. None of the 84 infants had an episode of postoperative apnea. Five (5.9%) infants presented subsequently with metachronous contralateral hernia and the same number of infants had hernia recurrence.Conclusions:Delaying HR in premature infants until ready for discharge from the NICU allows for repair closer to term without increasing the risk of incarceration. Because of low occurrence of metachronous hernia contralateral inguinal exploration is not justified. Day surgery HR can be performed in former premature infant if PCA is >47 weeks without increasing postoperative complications.

Rectal atresia is a rare anorectal malformation, and it has been reported to represent 1%–2% of all anorectal malformations. We report three newborns who were admitted to the neonatal intensive care unit for abdominal distention, bilious vomiting and failure to pass meconium. The external anus and genitalia were normal and well formed. Digital rectal examination showed a blind-ending anal canal. All three infants were initially managed with diverting colostomy and then transanal resection of the rectal atresia with primary anastomosis, followed by colostomy closure. All patients eventually developed normal bowel habits and gained complete bowel control at 3–5 years of age, with mild constipation managed with laxatives. Contrast enema in a newborn with distal bowel obstruction is helpful to delineate the anatomy to show the gaps and to facilitate the procedure. In conclusion, transanal endorectal pull-through is a feasible and safe procedure with satisfactory clinical outcomes.

a b s t r a c tRetained foreign bodies and penetrating injuries to the plantar aspect of the foot are a common childhood problem. Inflammations or infections are common complications whereas vascular injury and pseudoaneurysm' formation are rare. Three cases of post -traumatic lateral plantar artery (LPA) pseudoaneurysms due to foot lacerations by glass have been reported in children. This case is a six year-old boy who presented with two episodes of bleeding after a foot laceration sustained when he stepped on glass. CT angiography showed an LPA pseudoaneurysm that was successfully managed by surgery. It should be recognized that penetrating injuries to the plantar aspect of the foot, may be associated with vascular injury and pseudoaneurysm' formation. Appropriate investigations and management is important to prevent further complications.Ó 2015 The Authors. Published by Elsevier Inc. All rights reserved.Foreign bodies (FB) and penetrating injuries in the plantar aspect of the foot are a common childhood problem. The most common complications, if not properly treated, are infections and inflammatory reactions. Vascular complications and pseudoaneurysms are rare. Lateral plantar artery (LPA) pseudoaneurysms have been reported following plantar fasciotomy, calcaneal osteotomy, calcaneal fracture, foot lacerations from glass and nail prick injuries, and after corrective foot deformities in children [1e3]. Three reports of LPA pseudoaneurysms in children were found in the English medical literature, all had sustained foot lacerations from glass injury [2,4]. Herein we report a fourth case which occurred in a 6-year-old child.

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