Miscellaneous conditions of the peritoneal cavity--peritoneal tumors, pseudomyxoma, mesothelioma, fibroblastic reaction, cocoon, cystic lymphatic malformations, blue-bleb, and chylous ascites.

The peritoneum is subject to both primary neoplasia and secondary malignancy from direct, trans-coelomic, or hematogenous spread from any cancer. The knowledge base in the pediatric age group is very limited due to the rarity of peritoneal conditions in children, and much of the information is extrapolated from adult literature. There have been few reports in the pediatric population on the diagnosis and management of peritoneal conditions including peritoneal malignancy. In this article, we aim to highlight some of these conditions and the treatments available with a special emphasis on the evolving role of cytoreduction surgery and hyperthermic intraperitoneal chemotherapy in the treatment of certain peritoneal malignancies in children.

Kite flying: ancient tradition or death trap?

BACKGROUND: Kite flying has been popular in India since ancient times, especially during harvest festivals of Lohri, Basant and Makar Sankranti. It often takes form of a competitive sport and in recent times has been associated with multiple, sometimes fatal injuries. This prognostic study was conducted to try and understand the epidemiology and factors associated with kite flying injuries in the state of Punjab, India. METHODS: Case reports of patients who presented to the ED with trauma as a result of kite flying were reviewed. The study included patients reporting to the Christian Medical College, Ludhiana, between January 2005 and January 2010. Details of the type and mode of injury, and outcomes were recorded. RESULTS: The highest incidence of injuries occurred during months of the kite flying festivals. The most common mode of injury was fall from heights, associated with traumatic brain injury. The mortality rate in this series was 6.25%. CONCLUSIONS: This study highlights the importance of kite flying injuries as a common mode of injury in children and adolescents. It is an easily preventable mode of injury with simple safety regulations and possibly stronger legislation.

Primary intra-renal teratoma associated with renal dysplasia: an unusual entity.

Primary intrarenal teratomas are uncommon, and their association with renal dysplasia is rarer. We report a case of primary renal teratoma in a 1-year-old child who had undergone a retroperitoneoscopic nephrectomy. Pathologic examination showed evidence for a primary mature teratoma with renal dysplasia.

Unusual coexistence of caudal duplication and caudal regression syndromes.

Caudal duplication syndrome includes anomalies of the genitourinary system, gastrointestinal tract, and the distal neural tube. Caudal regression syndrome presents with lumbosacral hypogenesis, anomalies of the lower gastrointestinal tract, genitourinary system, and limb anomalies. Both happen as a result of insult to the caudal cell mass. We present a child having features consistent with both entities.

Pediatric foreign body aspiration: How much does our community know?

AIMS: Foreign body aspiration (FBA) is one of the main causes of accidental death in childhood. This study was designed to evaluate the level of awareness of FBA and its resultant dangers in the community. MATERIALS AND METHODS: Sixty-three primary caregivers were interviewed about their awareness of FBA, its attendant dangers, preventive measures taken, and how will they take care of a child in the event of a FBA according to an agreed protocol. RESULTS: Awareness levels about FBA were abysmally low in the population that was studied. Twenty-five percentage of the study population had not heard about this condition, and 46% could not recognize a FBA if it happened. Also, 76% of the study group did not know about the attendant dangers of this condition. CONCLUSIONS: There is a dire need to spread awareness about both prevention and treatment of this morbid condition. Health care professionals need to increase their efforts to spread more knowledge in the community about FBA.

The appendix as ureteral substitute: a report of 10 cases.

BACKGROUND: Ureteric replacement in part or in total is rarely needed in children. We present our experience in using the appendix to replace the ureter. METHODS: A retrospective case note review was carried out at Sheffield Children's Hospital (UK), Ekta Institute of Child Health (Raipur, Chhattisgarh, India) and Christian Medical College Hospital (Vellore, India) of all cases of ureteric substitution using the appendix. RESULTS: Ten patients were identified, operated in 2002-2007: seven males and three females with a median age of 2.5 years (range 2.5 months to 12 years). The reasons for ureteric replacement were traumatic ureteric avulsion (n=1), congenital ureteric stenosis (n=5), non-drainage following previous pyeloplasty for pelvi-ureteric junction obstruction (n=3) and ureteric stricture following reimplantation for vesico-ureteric reflux (n=1). The appendix was used in an anti-peristaltic manner in all cases, and in one case a transureteroureterostomy was performed. At a median follow up of 16months (1-72 months), all the patients were well except one whose kidney function had deteriorated. CONCLUSIONS: Total or partial replacement of the ureter using the appendix, even in the first year of life, preserved renal function in nine cases. Ureteric continuity can be successfully restored in children using the appendix.