The Rapunzel syndrome (trichobezoar) causing gastric perforation in a child: a case report.

UNLABELLED: The Rapunzel syndrome (RS), is a rare form of gastric trichobezoar extending throughout the bowel. We report on a patient with RS causing gastric perforation and discuss the aetiology, pathogenesis, diagnosis and treatment of this unusual syndrome. RS is found characteristically in girls with varying gastro-intestinal symptoms. The recommended treatment for large or complicated trichobezoars is surgery. Psychiatric follow up is essential to diminish the frequency of recurrence. CONCLUSION: Symptoms of trichobezoars are nonspecific and may mimic those of other pathological gastro-intestinal conditions. Early diagnosis and treatment of this condition is of prime importance and may avoid later fatal complications.

Morgagni hernia in infants and children.

The cumulative data regarding five cases of Morgagni hernias in infants and children over the last six years have been reviewed. All five patients were clinically normal upon presentation; however, the most common symptoms and signs were respiratory. Chest x-ray was the most common diagnostic test. The diagnoses were also later confirmed with preoperative barium meal studies. All of the patients had additional congenital anomalies, of which malrotation of the gut was the most commonly encountered. Upon operation, all of the cases contained a hollow viscus, and had a sac. The defects were repaired through abdominal approaches. There was no mortality and postoperative complication in these series.

External jugular phlebectasia in children.

The most common cause of a mass in the neck appearing only during straining is a laryngocele. On the other hand, the rare jugular phlebectasia may present in a similar manner. The cause of the jugular phlebectasia remains unclear. No treatment is indicated for this benign self-limiting condition. However, surgical removal for cosmetic purposes alone consists of a unilateral excision of the internal or external jugular vein; this produces no gross side-effects. Conclusion. Every patient with a swelling in the neck that enlarges in size after the Valsalva manoeuvre, straining, coughing or sneezing should be suspected of having jugular phlebectasia.

The role of calcium channel entry blocker in experimental ischemia-reperfusion-induced intestinal injury.

The effect of verapamil on mesenteric ischemia reperfusion trauma was evaluated. Ischemia was performed with clamping a mesenterica superior for a period of 15 min. In 55 rats in histopathologically investigated group, the abdomen was opened 4 h after from ischemia and intestinal biopsies were performed. 55 rats were classified into 5 groups. In the first group 13 rats were chosen as control, in the second group 11 rats were chosen as SHAM control. Only midline incision was made for these animals without superior mesenteric artery clamping; in the third group (n = 10) intravenous verapamil (0.3 mg/kg) was given 15 min before ischemia; in the group 4 (n = 10) 10 min after ischemia; in the group 5 (n = 11) 10 min after reperfusion. There was statistically significant difference between group 2 and group 1 in injury severity (p < 0.05). Similarly, the injury severity of group 3 was statistically significant as compared to group 1 (p < 0.05). There was no significant change in severity of injury in group 4 and group 5 as compared to group 1 (p > 0.05). We concluded that verapamil was protective when administered during the ischemic period but did not exert this action if administered after established ischemia.

Cavernous haemangioma of the penis in an infant.

We report on a 6-month-old boy with cavernous haemangioma of the penile shaft. He was admitted to our Department with the finding of a slowly enlarging penile mass two months in duration. Physical examination revealed an ovoid, solid and cystic subcutaneous mass 2 x 1, 5 x 1, 5 cm in size at the right side of the penile shaft. The tumour was completely removed surgically and histological examination demonstrated a cavernous haemangioma.

Spigelian hernia in children--report of two cases and review of the literature.

Two children with spigelian hernias are presented in this report. The etiopathogenesis and surgical anatomy of these rare hernias were discussed. Our cases are the fourth and fifth cases of spigelian hernia (SH) in patients under 2 years of age. Surgical intervention is indicated in all cases of SH because of the danger of strangulation of the bowel.

McKusick-Kaufman syndrome associated with esophageal atresia and distal tracheoesophageal fistula: a case report and review of the literature.

A female infant with McKusick-Kaufman syndrome associated with esophageal atresia and distal tracheoesophageal fistula is presented. To the best of our knowledge, this is the second report in the literature of this association.

Congenital lumbar (Grynfelt-Lesshaft) hernia.

Two children with superior lumbar hernias are presented in this report. The first one had many additional anomalies different from the literature and the other one is the second case report of congenital lumbar hernia with posterior meningomyelocele in the literature. Operative repair is recommended for these patients before 12 months of age.

Comparison of the effects of surgical and autologous fascial suture materials on testicular histology in rats subjected to orchiopexy.

In this study orchiopexy was performed in 30 Sprague-Dawley rats in order to compare traumatic effects of surgical and autologous fascial suture materials on testicular histology. Abscess formation was observed in 72.7% of the chromic, in 36.3% of the nylon, and in 18.1% of the vicryl fixed groups. There were no abscess formations in the dartos and autologous fascial fixed group. Examination of the testes revealed complete absence of spermatogenesis in the chromic fixed group. Spermatogenesis was normal, 72% in the vicryl, 18.1% in the nylon, 90.9% in the dartos and autologous fascial suture fixed groups. Antisperm antibody was not observed in any rat sera. We consider that it is preferred to use dartos pouch fixation. If necessary, it is advisable to use autologous fascial suture materials.