Extensive porto-splenic venous thrombosis postsplenectomy in a sickle cell disease: a rare complication.

Hereditary haemoglobinopathies are common disorders in Oman. The most common haematological disorder among Omani population is sickle cell disease (SCD). The spleen is one of the organs that is affected early in the first decade of life in SCD patients. Splenectomy has shown a high success rate in improving the quality of life in SCD patients, through eliminating acute splenic sequestration crises, thus reducing the need for hospital admission and transfusion requirements. One of the rare complications of splenectomy is porto-splenic vein thrombosis. Multiple factors are responsible for this complication including: thermal and mechanical injury during ligation of splenic hilum, sudden increase in the platelet count and large spleen size. We report a rare case of extensive porto-splenic vein thrombosis that responded to early initiation of anticoagulation with resolution of the thrombosis and recanalisation.

Spontaneous Intravesical Knotting of a Feeding Tube in a Late Preterm Neonate: A Case Report.

Feeding tubes (FTs) are commonly used as urinary catheters in neonates and children. Though generally safe, serious complications can result if the catheter spontaneously knots inside the bladder. We report a case of a spontaneous knotting of an intravesical Fr 6 FT in a late preterm female baby following urethral catheterization to collect a urine sample. The knotted catheter was removed via suprapubic cystotomy. The infant had good postoperative recovery.

Factors responsible for the prolonged stay of surgical neonates in intensive care units.

OBJECTIVES: The length of hospital stay (HS) for patients is a major concern due to its social, economic and administrative implications; this is particularly important for neonates admitted to intensive care units (ICUs). This study aimed to determine the factors responsible for prolonged HS in surgical neonates. METHODS: This retrospective study was conducted at Sultan Qaboos University Hospital, in Muscat, Oman. The medical records of 95 neonates admitted to the neonatal ICU who underwent general surgical procedures between July 2009 and June 2013 were reviewed. Mann-Whitney U and Pearson's Chi-squared tests were used for non-parametric numerical and categorical variables, respectively. A multiple regression analysis was performed to find a relationship between the variables and to detect the most important factor responsible for prolonged HS. A P value of <0.05 was considered statistically significant. RESULTS: Gestational age, birth weight, number of days on a ventilator and postoperative morbidity were associated with prolonged HS. Furthermore, the age of neonates at first full enteral feed was associated with increased HS using both independent and multiple regression analyses. CONCLUSION: Prolonged HS can occur as a result of many factors. In this study, a number of factors were identified, including low gestational age, low birth weight, increased number of days on a ventilator and postoperative morbidity. Additionally, neonate age at first full enteral feeds also correlated with increased HS. Further research on this topic is suggested to explore this correlation in more detail and to inform future practices.

Noncommunicating multiple intra-abdominal enteric duplication cysts.

A very rare case of noncommunicating multiple intra and retroperitoneal enteric duplication cysts (EDCs) is reported and discussed. Two large noncommunicating EDCs, one within the mesentery of proximal jejunum causing complete luminal obstruction and other isolated cyst in retroperitoneal area displacing duodenum and extrahepatic biliary system, were resected successfully in a 2-day-old neonate along with correction of malrotation.