[Pediatric transfusion practices: A single-center retrospective study]. / Pratiques transfusionnelles en pédiatrie : étude rétrospective monocentrique.

OBJECTIVES: This study aimed to describe the professional practices in pediatric transfusion to assess the accuracy of transfusion guidelines in children. METHODS: The study retrospectively analyzed the characteristics of all the pediatric transfusions prescribed in the Clermont-Ferrand (France) university hospital center over 1 year and determined whether they conformed to the national guidelines. RESULTS: One thousand six hundred and seven blood products were delivered to 233 children (806 red cell units, 670 platelet units, and 131 plasma units), accounting for 5.3% of the center's whole blood products. Transfusions were mainly prescribed by the oncohematology unit (68.2%), the intensive care unit (15.4%), and for surgery (10.2%). Ten adverse events were reported in eight patients (0.6% of transfusions). The prescription conformed to the national guidelines in 35.9%, 41.6%, and 80.9% of the red blood cell, platelet, and plasma unit transfusions, respectively. Nonconformity was mainly due to abusive irradiation and "cytomegalovirus seronegative" specifications. CONCLUSION: Malignancies, intensive care, and surgery are the main indications for transfusion in children. Substantial discrepancy between recommendations and actual practices was observed. This illustrates the variability of risk evaluation. This should be made simpler by the use of photochemical pathogen inactivation techniques.

[Acute abdominal dilatation, a serious complication in the case of anorexia nervosa]. / Distension abdominale aiguë, une complication à redouter en cas d'anorexie mentale.

INTRODUCTION: The prognosis of anorexia nervosa (AN) is severe (death in 2 to 5% of cases). AN is closely linked to episodes of bulimia. OBSERVATION: A 25 year-old woman suffering from anorexia nervosa was hospitalised for an occlusive syndrome with vomiting, presence of abdominal cramps, absence of hydroaeric sounds and suspension of stools and gas. The biological examinations were normal. The abdominal scan revealed voluminous gastric dilatation. The diagnosis of functional occlusive syndrome was retained. With medical treatment and follow-up in intensive care the gastric dilatation progressively regressed. DISCUSSION: The periods of restricted nourishment during NA are interspaced by episodes of bulimia and at the origin of sometimes severe digestive complications. The abnormalities in gastric motility can lead to major dilatation of the stomach with the risk of perforation. The onset of abdominal pain in the context of AN during an episode of bulimia must evoke the diagnosis of acute gastric dilatation with major risk of perforation.