Internal hernia as cause of acute abdomen in a preterm neonate: when necrotizing enterocolitis is not the culprit.

Internal hernias in preterm neonates, although rare, can arise due to various anatomical and physiological factors associated with prematurity. We report a case of a preterm infant with symptoms of suspected necrotizing enterocolitis (NEC) that turned out to be an internal hernia during surgical exploration. Given the overlapping symptoms, it is crucial to maintain a high index of suspicion and utilize the appropriate imaging techniques, such as ultrasound or radiographic studies, to aid in the differentiation between NEC and internal hernia, especially when responding to cases that do not improve with standard NEC management or exhibit atypical features. Early recognition and accurate differentiation are crucial for appropriate management and prevention of complications in affected neonates.

Sinus Bradycardia after Extensive Neck Dissection and Total Thyroidectomy in a Pediatric Patient: A Case Report.

Postoperative complications after total thyroidectomy with extensive neck dissection in thyroid malignancies are well documented in the current literature. However, sinus bradycardia as a postthyroidectomy complication is a rare phenomenon and, to the best of our knowledge, few studies have identified it as a perioperative condition. In our study, we report a case of 9-year-old boy with papillary thyroid carcinoma, who underwent total thyroidectomy and bilateral neck dissection. Postoperatively, the surgery was complicated by initial vocal cord paresis and chyle leak. The patient also suffered from asymptomatic sinus bradycardia which self-resolved. Although causative factors cannot be determined by a single case, hypothyroidism, carotid sinus hypersensitivity, and bilateral damage to the middle cervical sympathetic ganglion could play a significant role in this uncommon pathophysiological condition.