A 16-year-old adolescent with a history of minor abdominal trauma diagnosed with a giant isolated primary splenic hydatid cyst: a case report.

Introduction: Hydatosis is a zoonotic parasitic disease caused by echinococcosis larval infection. South America, Africa, the Middle East, South Europe, India, and Australia are endemic to this disease. Splenic involvement is a rare and complicated hydatid disease presentation. A splenic hydatid cyst is an infrequent clinical occurrence, even in regions where the disease is endemic. Case presentation: A 16-year-old male, having a background of mild abdominal trauma and non-resolving dull abdominal pain attended a paediatric surgical outpatient office and following a thorough examination, was diagnosed with a giant solitary isolated splenic hydatid cyst. Subsequently, the patient received albendazole and underwent total splenectomy, necessitated by the considerable size of the cyst, classified as a giant. Clinical discussion: Splenic involvement of hydatid disease is a rare presentation (0.5-8%.). With the initial clinical finding often involving the accidental discovery of a palpable mass, the most frequently reported symptoms and signs include the presence of a palpable mass, fever, dull pain, or splenomegaly. Ultrasound and computed tomography are the most helpful tools for evaluating focal splenic diseases. The preferred treatment involves the use of antihelminthic drugs such as albendazole or mebendazole in conjunction with splenectomy. Total splenectomy is the preferred approach and is associated with decreased hospital stay, reduced healthcare costs, and a lower likelihood of recurrence. Conclusion: in endemic areas, in patients with splenic cysts, hydatidosis should be contemplated.

Comparison of cystectomy and lobectomy of lung hydatid cyst in pediatrics: a retrospective study.

Objective: Hydatid cyst is an endemic disease in Iran. The treatment of choice for paediatric lung hydatid cysts is surgical removal of the cyst. However, due to its high prevalence the risk of recurrence after the surgery, cystectomy with capitonnage, which preserves the lung tissue, is a favourable surgical approach compared to lobectomy. Herein, the authors compared the outcome of cystectomy and lobectomy of lung hydatid cysts. Methods and materials: This is a retrospective study conducted in the paediatric surgery department. Paediatric patients who had undergone surgery due to pulmonary hydatid cysts were enroled. The patients were divided into two groups including cystectomy and non-anatomic lobectomy. Then, the length of surgery, length of hospitalization, postoperative complications, and the time required to remove the chest tube were calculated in each group. Results: A total of 32 patients were enroled in this retrospective study. Age, sex, location, and size of cysts were not significantly different between the two groups. The duration of surgery in the lobectomy and cystectomy groups was 116.3±33.7 versus 116.1±28.2 min, respectively (P=0.53). Surgery complications including the need for blood transfusion, pneumothorax, need for bronchoscopy and atelectasis were not different between the study groups. The mean time for first chest tube removal was significantly different between the groups with the lobectomy group having a shorter time (P=0.02). The length of hospital and ICU stay were not different between the two surgical procedures. The time to remove the first chest tube was significantly higher in cystectomy compared to lobectomy (P=0.02). Conclusion: The complications and outcome of the cystectomy are comparable to the lobectomy technique. However, the cystectomy method has the advantage of preserving the lung tissue, therefore it's a favourable technique in endemic areas for hydatid cysts where reoperation may be indicated.

Investigating the effect of sudden occlusion of the testicular vessels on the testicular tissue in rat models.

One of the ways to treat undescended testicles is to use orchiopexy surgery, which is modified into the two-stage Fowler-Stephens technique in cases of short or immobile testes. The disadvantage of using this technique is the probability of testicular ischaemia following the sudden closure of the testicular artery; although the collateral arteries prevent atrophy, the testis loses its germ cells during this stress and may no longer be functional. Therefore, this study aims to examine the changes in testicular tissue regarding necrosis and infarction after the occlusion of the vessels. Methods and materials: In this experimental study 15 male rats weighing 200-250 g were prepared and first, one of the rats was sacrificed and testicles on both sides were used for pathology control. After general anaesthesia vascular ligature was performed with the left testes undergoing both venous and arterial occlusion and the right testes only arterial occlusion. After 1 month, all specimens were killed and the testes were completely removed and sent for histopathological evaluation. Results: A total of 14 rats and 28 testes were studied in two equal groups of case and control. There was no significant difference between the case and control groups in terms of testicular volume, consistency, and viability. Microscopic findings revealed that necrosis, infarction, and state of inflammation were significantly higher in the case group than in the control group. Conclusion: The results of this study show that abrupt closure of the testicular artery in rats is associated with necrosis and infarction, decreased spermatogenesis, and more inflammation. However, no significant differences were found in terms of macroscopic findings including volume, consistency, and viability.

Tracheal hemangioma: a case report and literature review.

Hemangiomas are the most common vascular tumors in children. Although hemangiomas are common, they are rarely seen in areas like the trachea and larynx.The most common clinical manifestations in tracheal hemangiomas are stridor and respiratory distress. The main diagnostic method is bronchoscopy. Other imaging techniques like computed tomography scans and MRIs are also helpful. Various treatment options are now used for treating the disease, including beta blockers like propranolol, local and systemic steroids, and surgical resection. Case presentation: An 8-year-old boy with the chief complaint of severe progressive dyspnea and a history of neonatal postbreastfeeding cyanosis was admitted. On physical examination, he had tachypnea, and stridor was heard upon auscultation. There was no history of fever, chest pain, or coughing. He underwent a rigid bronchoscopy followed by a neck computed tomography scan. The results indicated a soft tissue mass with a vascular nature. An MRI of the neck confirmed the diagnosis of tracheal hemangioma. The mass was not resectable during surgery; hence, angioembolization was carried out. Treatment was successful and there was no recurrence on the follow-up. Clinical discussion: Based on the findings in this literature review tracheal hemangiomas present with stridor, progressive respiratory distress, dyspnea, hemoptysis, and chronic coughs. Advanced tracheal hemangiomas commonly do not reduce in size by themselves and need treatment. A close follow-up ranging from 3 months to 1 year is recommended. Conclusion: Although tracheal hemangiomas are rare they should be considered in the differential diagnosis of severe dyspnea and stridor.

Evaluating the utility of cystoscopy, distal colostography, and sonography for locating the fistula in patients with anorectal malformation: a case series.

Anorectal malformations are congenital conditions ranging from a simple perianal fistula to a complex cloacal malformation. Since the precise determination of the location of the fistula is the central pillar in choosing the type of surgery, this study aims to evaluate and compare the efficacy of three techniques, transperineal ultrasound, distal colostography, and cystoscopy. Materials and methods: This study was performed on patients with anorectal abnormalities who had undergone decompressive colostomy and were planned for anorectoplasty in the period from September 2017 to March 2019 in a pediatric surgical center. To answer our question, all three mentioned methods were conducted before the surgery and were compared with the intraoperative findings. Results: Sonography, distal colostography, and the second cystoscopy findings were similar to intraoperative conclusions concerning the presence of a fistula in patients, whereas blind cystoscopy had 30% accuracy and similarity. Regarding the type of fistula sonography, distal colostography, and second cystoscopy each had 50, 37.5, and 10 inconsistency with the intraoperative findings. In all cases where a fistula was detected in blind cystoscopy, the location of the fistula was correctly determined by this modality. Data analysis on the pouch to perineum distance measurements obtained from sonography and colostography were significantly different from that of surgery. Conclusion: The results of this study emphasize the need to perform several diagnostic modalities to determine the location and type of fistula to improve diagnostic accuracy.