'Grumbling' Midgut Volvulus in an Older Paediatric Patient With Congenital Solitary Kidney: A Case Report.

Midgut volvulus is a life-threatening condition, with the majority of cases presenting before the first year of life. Congenital gastrointestinal abnormalities can be associated with midgut volvulus; however, similar associations have not been described with congenital renal abnormalities. Congenital solitary kidney (CSK) means that a child is born with only one functional kidney. Here, we describe a case of a five-year-old child with CSK who atypically presents with midgut volvulus. The case highlights how midgut volvulus may present with chronic symptoms in those over the age of one and the importance of upper GI contrast studies for diagnosis of midgut volvulus in this population and suggests CSK along with other causes of solitary kidney as possible risk factors for volvulus.

Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic.

Objective To describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK. Methods Data on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus testing, vital signs and mortality at Oxford University Hospitals were summarised using descriptive statistics. Results Between 1-March-2016 and 30-July-2021, 155,056 ED attendances occurred and 7,195 respiratory virus PCRs were performed. Detection of all pathogens was suppressed during the first national lockdown. Rhinovirus and adenovirus rates increased when schools reopened September-December 2020, then fell, before rising in March-May 2021. The usual winter RSV peak did not occur in 2020/21, with an inter-seasonal rise (32/1,000 attendances in 0-3 yr olds) in July 2021. Influenza remained suppressed throughout. A higher paediatric early warning score (PEWS) was seen for attendees with adenovirus during the pandemic compared to pre-pandemic (p = 0.04, Mann-Witney U test), no other differences in PEWS were seen. Conclusions SARS-CoV-2 caused major changes in the incidence of paediatric respiratory viral infection in Oxfordshire, with implications for clinical service demand, testing strategies, timing of palivizumab RSV prophylaxis, and highlighting the need to understand which public health interventions are most effective for preventing respiratory virus infections.