ABSTRACT
PURPOSE: The "button" enteral feeding systems are widely used as a gastrostomy. We describe our use of this device to facilitate bladder drainage in children. MATERIALS AND METHODS: We prospectively reviewed all patients who underwent insertion of a cystostomy button between 2002 and 2005. Indications and complications were analyzed. RESULTS: A total of 17 children (8 female, 9 male) with a mean age of 7.1 years underwent insertion of a cystostomy button during the 4-year period. Mean followup was 16 months (range 2 to 40). Cases selected included those with a neuropathic bladder, prune belly syndrome, previous major bladder neck surgery and those unsuitable for Mitrofanoff stoma formation. Complications included 1 wound infection treated with antibiotics. Four children had leakage from the cystostomy site that was successfully treated with a change in button size, and 14 buttons remain in situ. CONCLUSIONS: Button cystostomy is a safe and effective form of bladder drainage in children. It is a good alternative to standard suprapubic drainage and it gives children an improved quality of life.
Subject(s)
Cystostomy/instrumentation , Urinary Retention/surgery , Age Factors , Child , Child, Preschool , Cohort Studies , Cystostomy/methods , Drainage/methods , Female , Follow-Up Studies , Humans , Male , Prospective Studies , Risk Assessment , Severity of Illness Index , Sex Factors , Treatment Outcome , Urinary Retention/diagnosis , Urodynamics/physiologyABSTRACT
Splenogonadal fusion is a rare congenital abnormality found in boys and girls. There is fusion of the developing splenic anlage and the gonadal mesoderm at approximately week 5 of intrauterine life. It commonly presents as a testicular mass treated with an unnecessary orchidectomy. We report two cases of the discontinuous type presenting with testicular swelling and review the literature.
Subject(s)
Choristoma/pathology , Spleen , Testicular Diseases/pathology , Biopsy , Child, Preschool , Diagnosis, Differential , Humans , Infant , MaleABSTRACT
PURPOSE: To assess the effectiveness and complication rate of laparoscopically placed peritoneal dialysis catheters using the single-port technique. MATERIAL AND METHODS: This is a prospective study conducted from 2002 to 2004. Children with established renal failure requiring insertion of a peritoneal dialysis catheter were included. The insertion was performed by a single surgeon using a single-port laparoscopic technique. Partial omentectomy was performed and the catheter accurately placed in the pelvis under vision. The catheter could then be used immediately postoperatively. RESULTS: Twenty-two children (13F:9M) with a mean age of 9 years (range 1.0-17.5) had a peritoneal dialysis catheter inserted laparoscopically between 2002 and 2004. Mean time for insertion was 26 min (range 23-29 min). Ten (45%) catheters were used within 4 h. Early complications included a minor leak that resolved within 24 h, one exit-site infection that resolved with oral flucloxacillin, one blockage due to a fibrin clot that resolved with urokinase, and one blockage after 2 weeks due to adhesions (not omentum) that was revised. CONCLUSIONS: Laparoscopic insertion of a peritoneal dialysis catheter allows accurate placement of the catheter under direct vision, immediate use postoperatively with minimum morbidity, and good cosmesis. The single-port laparoscopic technique is a safe, effective and quick technique for use in children.