[Multiple abdominal hydatid disease. Case report]. / Hidatidoza abdominala cu localizare multipla. Prezentare de caz.

Hydatid disease, a parasitic infection caused by Echinococcus granulosus is relatively frequent in our country. Imaging techniques like ultrasound and CT made possible an early and accurate diagnosis prior to serious complications. Hydatid cysts can be ruptured spontaneously or following trauma. The authors report a case of multiple abdominal hydatid disease (hepatic, splenic and peritoneal) in a 11-year-old boy admitted into the Bacau County Hospital with severe abdominal pain and history of abdominal trauma 7 months ago in the right hypochondriac region. The case was managed surgically being performed pericystectomy, splenectomy and omentectomy. Albendazole was administered before and after surgery. The recovery course was uneventful and the evolution favorable. Although ruptured hydatid cyst of liver and multiple abdominal hydatid disease are rare clinic entities, in an endemic region as Romania, they should be taken into account when making the differential diagnosis of abdominal pain.

[Diagnosis and treatment of abdominal hydatid cysts in children. A multicentric study]. / Diagnosticul si tratamentul chistului hidatic cu localizare abdominala la copil--studiu multicentric.

UNLABELLED: Echinococcosis is one of the most frequent parasitosis and is endemic in Romania. MATERIAL AND METHOD: The data on 111 children with abdominal localization of hydatidosis who underwent exploration and treatment in 3 pediatric surgical clinics were reviewed. The study evaluated 59 patients who were treated at "Sf. Maria" pediatric hospital Iasi during 2004 and 2009, 47 at "Marie Curie" pediatric hospital from Bucharest during 2000 - 2009 and 5 children at Bacau General Hospital 2004-2009. The medical records were reviewed for: demographics, age, gender, location of the cyst, operative procedure, medical treatment, outcome, length of hospital stay and postoperative follow up. RESULTS: Age ranged between 2 and 17 years and male/female ratio was 1,1/1.67% of patients lived in rural areas. The liver was the most common organ involved: in 69 cases it was the only organ involved and there were 2 kidney cyst cases, 8 spleens involved, 2 cases in broad ligament, 13 peritoneal cases and 26 cases of cyst located in great omentum. The preferred surgical procedure was Lagrot partial pericystectomy. For medical antihelminthic treatment it was used Albendazole. As complications there were: biliary fistulas, postoperative cholangitis, infection of the residual cavity, anaphylactic reactions. The mortality rate was 0%. CONCLUSIONS: Most of the patients were from rural area. The liver was the major organ involved. The treatment includes both surgical and medical means. There is a relatively high rate of postoperative complications (although some of them being minor) in 31 patients.

[Caudal anesthesia in pediatric surgery]. / Anestezia caudala in chirurgia pediatrica. Experienta noastra pe 150 de cazuri.

UNLABELLED: The study analyses the efficacy and the safety of caudal anesthesia for the intra and postoperative pain management in children. MATERIAL AND METHOD: A retrospective study was conducted over a five years period enrolling 150 children scheduled for various surgical procedures. We used the standard technique ("loss of resistance", "single shot", lateral decubitus). RESULTS: The most important age groups were 1 month - 1 year, 64 cases (42.66%) and 1-6 years - 71 cases (47.33%). We performed 144 caudal blocks associated with general anesthesia, 3 associated with sedation and 3 simple caudal blocks. In 129 cases, we used bupivacaine 0.25% as a single analgetic substance, in five cases bupivacaine 0.25% with lidocaine 1%, and in 16 cases bupivacaine 0.25% with fentanyl 1 mcg/kg. The quality of the analgesia was very good in 128 cases (85.33%), good in 12 (8%) and poor in 10 cases (6.66%). The morbidity rate was 13.33% (20 cases), the most frequent complication being urinary retention (8 cases - 5.33%). CONCLUSIONS: The caudal block is an efficient procedure for intra and postoperative analgesia in children. Associated with general anesthesia it is very useful for the management of the age groups 1 month - 1 year and 1-6 years.

[Congenital oropharyngeal tumors in the newborn: problems in team diagnosis and treatment]. / Tumori congenitale cu localizare orofaringiana la nou nascut: probleme de diagnostic si tratament în echipa.

There are a great variety of lesions of oral cavity which may require surgical intervention in neonatal period. The differential diagnoses include tumors (malignant, teratoma, cystic hygroma, lymphangioma, hemangioma), congenital epulis, dermoid cysts, ranula. Congenital epulis of the newborn is a rare tumour which is usually benign. Epulis is also known as a congenital gingival granular cell tumour because of its histological features. Female babies are affected 8-10 times more often than males. Epulis is located on the maxillary ridge twice as often as on the mandible, mostly as single tumours but rarely as multiple tumours. The histogenesis of the tumour is unknown. Spontaneous regression of congenital epulis has been reported in a few cases. However, surgical excision is generally indicated due to interference with feeding or respiration. Recurrence of the tumour after surgery has not been reported yet. We report two cases of congenital epulis, one in 2 hour female neonate and one in a 7 days male neonate. In spite of the rarity of this pathology, the interval between presentation in this two cases was ten days. In one case it was an antenatal diagnosis by ultrasonography, in the other it was associated a genital anomalies (hypospadias). The treatment was surgical excision. The intra- and postoperative course was uneventful.

Complications following gastric tube esophagoplasty in children.

Surgery in children with caustic esophageal burns, esophageal atresia or other esophageal disorders can be performed using gastric tube esophagoplasty. Between 1991 and 1999, a number of 41 such procedures have been performed in our department, using the original technique developed by Gavriliu. The results were assessed as good and very good in 83% of the cases, and fair or bad in the rest of 17%. We recorded 13 cases with significant complications, 4 of which ended with exitus. The paper present our experience in using gastric tube esophagoplasty and the management of the complications related to this procedure.