Congenital hepatic cyst: Eleven case reports.

BACKGROUND: Liver cysts in infants are uncommon. With modern diagnostic imaging, we can achieve an early diagnosis of congenital hepatic cysts. Our purpose was to investigate the clinical features, surgical treatment methods and prognosis of infants with congenital hepatic cysts. Herein, we report a case series of congenital hepatic cysts. CASE SUMMARY: Eleven infants with hepatic cysts were retrospectively analysed. Ten of them had simple hepatic cysts, and a girl with a large hepatic mass was diagnosed with a solitary intrahepatic biliary cyst accompanied by a choledochal cyst. Among the ten simple hepatic cysts, eight were solitary and two were multiple. A total of 87.5% (7 of 8) of infants with solitary hepatic cysts were detected before delivery, and 86% (6 of 7) of those cysts were located in the right lobe of the liver. Surgical intervention was required for symptomatic hepatic cysts. Cyst resection or unroofing with fulguration of the cyst bed was employed. No recurrence of cysts was observed in these infants. CONCLUSION: Congenital hepatic cyst is a condition with a narrow differential diagnosis. Accurate diagnosis is essential for appropriate management. Unroofing is the favoured treatment in infants with symptomatic cysts. Most infants with congenital hepatic cysts have a good prognosis.

Extensive myocardial calcification in critically ill patients receiving extracorporeal membrane oxygenation: A case report.

BACKGROUND: Myocardial calcification is a rare complication in critically ill patients. The prognosis of myocardial calcifications in critically ill patients is very poor if not treated in a timely manner. We describe a rare case of acute extensive myocardial calcifications due to acute myocarditis after receiving extracorporeal membrane oxygenation (ECMO) support. CASE SUMMARY: We report a 17-year-old male patient who developed extensive myocardial calcifications while receiving prolonged ECMO support for severe myocarditis and cardiogenic shock. Extensive myocardial calcifications were confirmed by chest computed tomography (CT). Myocardial calcifications were observed in the left ventricle walls on CT examination 10 days after admission. The patient was then discharged with heart function class II on the NYHA classification. Two years later, the patient was still alive with adequate quality of life. We then included this patient and 7 other cases retrieved from the PubMed, Cochrane Library, EMBASE, and MEDLINE databases in our study, in order to provide a reference for the clinical diagnosis and treatment of this disease. CONCLUSION: Multiple causes including prolonged hemodynamic failure, profound acidosis, high vasopressor doses, and acute renal failure may jointly lead to extensive myocardial calcifications. The precise role of ECMO support in the timing and frequency of acute myocardial calcifications deserves further investigation.

[Effects of surgical treatment for low birth weight neonates with critical acute abdomen].

OBJECTIVE: To evaluate the effects of the surgical treatment in critical acute abdomen in low birth weight neonates. METHODS: The clinical data of 228 neonates with critical acute abdomen who underwent surgical treatment from January 2000 to January 2003, aged (4.1 +/- 0.7) days (1 h-7 days), 141 being preterm infants and 87 being small for date infants, 26 with the birth weight < or = 2000 g and 202 with the birth weight of 2000 - 2500 g, and 83 cases admitted between Jan 2000 and Dec 2002 (first 3-year group) and 145 admitted between Jan 2003 and Jan 2006 (last 3-year group), were analyzed retrospective Follow-up was conducted for 4 approximately 48 months. RESULTS: Twenty-six pediatric patients died after operation with a hospital mortality rater of 11.4%. The mortality rates of the group of preterm infants, newborns with the birth body weight < or = 2000 g, and the first 3-year group were 14.89% (21/141), 53.84% (14/26), and 18.07% (15/83) respectively, all significantly higher than the full-term small for date infants, newborns with the birth weight of 2000 approximately 2500 g, and the last 3-year group [5.75% (5/87, chi(2) = 4.455, P < 0. 05), 5.94% (12/202, chi(2) = 52.324, P < 0. 01); and 7.59% (11/145, chi(2) = 5.745, P < 0. 05) respectively. Follow-up showed that all surviving infants had good gastrointestinal functions and approximately normal growth. CONCLUSION: Death of low birth weight neonates with critical acute abdomen is associated with premature birth and low birth weight. With the development of neonatal surgery, prenatal diagnosis, and perioperational therapy, the curative rate of critical acute abdomen in low birth weight neonates is increasing.

Enteroenteroanastomosis near adjacent ileocecal valve in infants.

AIM: To investigate the feasibility and the effectiveness of ileoileostomy in the region adjacent to the ileocecal valve, which can retain the ileocecal valve in infants. METHODS: This is a retrospective review of 48 patients who underwent ileoileostomy in the region adjacent to the ileocecal valve (group 1) and 34 patients who underwent ileocecal resections and ileotransversanastomosis (group 2). Patients were monitored for the time to flatus, resumption of eating, length of hospital stay after surgery, serum total bile acid, vitamin B12 and postoperative complications. RESULTS: The time to flatus, time until resumption of eating and post-operative length of hospital stay showed no statistically significant differences between the two groups. Serum total bile acid and vitamin B12 were not significantly different between the two groups at post-operative day 1 and day 3, but were significantly decreased at 1 wk after operation in group 2. None of the patients died or suffered from stomal leak in these two groups. However, the incidence of diarrhea, intestinal infection, disturbance of acid-base balance and water-electrolytes in group 1 was lower than in group 2. CONCLUSION: Ileoileostomy in the region adjacent to the ileocecal valve is safe and results in fewer complications than ileotransversanastomosis in infants.