ABSTRACT
The patient is a 2-year-old Caucasian boy with acute acalculous cholecystitis (AC) but none of the predisposing factors that are typically found in patients with this disease. The presentation and clinical course of the disease was typical of AC. Nonsurgical intervention resulted in resolution of the child's initial symptoms. After recurrent bouts of biliary colic over the ensuing ten weeks, further evaluations were completed. Persistent inflammation of the gallbladder was seen on computerized tomographic scans and a nonfunction of the gallbladder was demonstrated through radio-nucleotide scanning. After discussing the findings with the parents, we performed a routine laparoscopic cholecystectomy on the child. The typical presentation, diagnosis, and pathogenesis of AC are discussed.
Subject(s)
Cholecystitis/therapy , Acute Disease , Child, Preschool , Cholecystectomy, Laparoscopic , Cholecystitis/diagnosis , Humans , MaleABSTRACT
Vascular injuries in children are not rare. The rising incidence of general trauma in children and the frequent use of diagnostic procedures in this age group may contribute to an overall increase in these injuries. A 10-year experience with severe vascular injuries in children at The Johns Hopkins Hospital has been reviewed. The mechanisms of production may be similar to those in adults, but many injuries are unique to the pediatric age group. The sequelae of such injuries in infants and children may include abnormal growth and development of the involved extremity. Complications and special surgical management of our group of 71 children have been discussed and preventive measures have been suggested.
Subject(s)
Blood Vessels/injuries , Iatrogenic Disease , Wounds, Nonpenetrating/surgery , Wounds, Penetrating/surgery , Blood Vessel Prosthesis , Catheterization/adverse effects , Child , Growth Disorders/prevention & control , Humans , Ligation , Wounds, Nonpenetrating/complications , Wounds, Penetrating/complicationsABSTRACT
A patient with a huge mesenteric lipoma is discussed. A review of the literature reveals that there are less than 30 reported cases and consequently this diagnosis is rarely made preoperatively. An upper gastrointestinal series with a small bowel follow-through and a mesenteric arteriogram may suggest this condition. Surgical excision is the treatment of choice, since these large tumors may undergo malignant degeneration.