Endometriosis in the Canal of Nuck presenting with suprapubic pain: A case report and literature review.

The endometriosis in the Canal of Nuck is a rare condition. Most patients exhibited groin swelling but this case present with a rare condition which is suprapubic pain for 2 years. This case is a 34-year-old healthy woman had developed chronic intermittent right suprapubic pain for 2 years. Physical examination revealed a 2-cm. Reducible mass at right suprapubic area. MRI was performed and the result showed a 2.7 × 1.3 × 4.9 cm-size multiloculated cystic mass located near the round ligament of the uterus which was consistent with a Nuck's canal cyst. The definitive treatment was done by excision of mass.

The outcomes of a frenulotomy on breastfeeding infants followed up for 3 months at Thammasat University Hospital.

PURPOSE: To study the effects of frenulotomy on nipple pain, latch and the success in exclusive breastfeeding (EBF) at 3-month follow-up. METHODS: A prospective cross-sectional study of 328 mother-infant pairs with both tongue-tie and breastfeeding problems was performed. Nipple pain and latch were evaluated using numeric rating scale and LATCH score, respectively, and compared between pre and post-operatively at 24 h and 1 week. The success rate of EBF was assessed at 3 months after frenulotomy. RESULTS: Nipple pain score were significantly decreased (median difference = 3 and 4, P < 0.001) and LATCH score were significantly increased (mean difference = 1.92 and 2.13, P < 0.001) at 24 h and 1 week post-operatively. At 3 months, a success rate of EBF was 66.67 %. Multivariable analysis clustering by maternal age of 18 years was performed. Factors that were significantly (P < 0.05) associated with the success were: girls, age at surgery ≤24 h, higher number of children in family, low birth weight, tongue-tie severity, nipple grading, LATCH score ≥8 and nipple sensation at 1 week after surgery. CONCLUSION: Frenulotomy could significantly reduce nipple pain and increase LATCH score in tongue-tied infants with breastfeeding difficulty. Several factors are positively associated with the success of EBF. Tongue-tie severity, LATCH score and nipple sensation were the factors that can be modified by frenulotomy.

Enema reduction of intussusception: the success rate of hydrostatic and pneumatic reduction.

PURPOSE: Intussusception is a common surgical emergency in infants and children. The incidence of intussusception is from one to four per 2,000 infants and children. If there is no peritonitis, perforation sign on abdominal radiographic studies, and nonresponsive shock, nonoperative reduction by pneumatic or hydrostatic enema can be performed. The purpose of this study was to compare the success rates of both the methods. METHODS: Two institutional retrospective cohort studies were performed. All intussusception patients (ICD-10 code K56.1) who had visited Chiang Mai University Hospital and Siriraj Hospital from January 2006 to December 2012 were included in the study. The data were obtained by chart reviews and electronic databases, which included demographic data, symptoms, signs, and investigations. The patients were grouped according to the method of reduction followed into pneumatic reduction and hydrostatic reduction groups with the outcome being the success of the reduction technique. RESULTS: One hundred and seventy episodes of intussusception occurring in the patients of Chiang Mai University Hospital and Siriraj Hospital were included in this study. The success rate of pneumatic reduction was 61% and that of hydrostatic reduction was 44% (P=0.036). Multivariable analysis and adjusting of the factors by propensity scores were performed; the success rate of pneumatic reduction was 1.48 times more than that of hydrostatic reduction (P=0.036, 95% confidence interval [CI] =1.03-2.13). CONCLUSION: Both pneumatic and hydrostatic reduction can be performed safely according to the experience of the radiologist or pediatric surgeon and hospital setting. This study showed that pneumatic reduction had a higher success rate than hydrostatic reduction.