Pneumomediastinum is sometimes observed in adult patients but its occurrence in pediatric patients (especially infants) is very rare. We here report a 14-month-old male infant who had subcutaneous emphysema, pneumomed...Pneumomediastinum is sometimes observed in adult patients but its occurrence in pediatric patients (especially infants) is very rare. We here report a 14-month-old male infant who had subcutaneous emphysema, pneumomediastinum, and importantly, pneumopericardium. He had no particular past <span>histories. He abruptly had cough, fever, and eruption on the abdomen.</span> Computed tomography and echocardiography revealed pneumomediastinum and <span>pneumopericardium. Antibiotics, rest, and supportive therapy ameliorated</span> the condition. We must be aware that pneumomediastinum, and importantly pneumopericardium, can be present in a pediatric patient with subcutaneous emphysema.</span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:"">The infant</span></span></span><span><span><span style="font-family:"">’</span></span></span><span><span><span style="font-family:"">s symptoms disappeared under strict monitoring of respiratory status, nasal oxygen therapy and antibiotic therapy</span></span></span><span><span><span style="font-family:"">.展开更多
Introduction: Laparoscopic cholecystectomy is the gold standard in the treatment of gallstones and lithiasis cholecystitis. It reduces post-operative complications especially in sickle cell patients. Aim: The aim of t...Introduction: Laparoscopic cholecystectomy is the gold standard in the treatment of gallstones and lithiasis cholecystitis. It reduces post-operative complications especially in sickle cell patients. Aim: The aim of this work was to compare the results of laparoscopic cholecystectomy in sickle cell and non-sickle cell patients. Methods: Sixty-six patients including 25 sickle cell patients and 41 non-sickle cell patients were identified from March 2013 to November 2014 (20 months). The χ2 test was used for comparisons. Values of p < 0.05 were used for a statistically significant difference threshold. Results: The mean age was 25.76 years for the sickle cell group and 45.61 years for the non-sickle cell group (p = 0.00008). There were 14/25 female patients in the sickle cell group and 28/41 in the non-sickle cell group. In per op, the diagnosis of acute cholecystitis was retained for 4/25 sickle cell patients and for 10/41 non-sickle cell patients. Diagnoses such as pyocholecyst (2 cases), porcelain vesicle (2 cases), hydrocholecyst (2 cases) were found in the group of non-sickle cell patients. Operative difficulties such as tight perivicular adhesions were encountered 9/25 times in the sickle cell group and 11/41 times in the non-sickle cell group. The average overall operative time was 55 min. There was no statistically significant difference between the different groups in mean operative time, occurrence of postoperative complication and average length of hospital stay. The mortality is not statistically different according to the group of patients. Conclusion: There is no significant difference between the cholecystectomy performed in sickle cell patients and that performed in non-sickle cell patients. The multidisciplinary perioperative management of sickle cell patients reduces the risk of complications arising from this pathology.展开更多
文摘Pneumomediastinum is sometimes observed in adult patients but its occurrence in pediatric patients (especially infants) is very rare. We here report a 14-month-old male infant who had subcutaneous emphysema, pneumomediastinum, and importantly, pneumopericardium. He had no particular past <span>histories. He abruptly had cough, fever, and eruption on the abdomen.</span> Computed tomography and echocardiography revealed pneumomediastinum and <span>pneumopericardium. Antibiotics, rest, and supportive therapy ameliorated</span> the condition. We must be aware that pneumomediastinum, and importantly pneumopericardium, can be present in a pediatric patient with subcutaneous emphysema.</span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:"">The infant</span></span></span><span><span><span style="font-family:"">’</span></span></span><span><span><span style="font-family:"">s symptoms disappeared under strict monitoring of respiratory status, nasal oxygen therapy and antibiotic therapy</span></span></span><span><span><span style="font-family:"">.
文摘Introduction: Laparoscopic cholecystectomy is the gold standard in the treatment of gallstones and lithiasis cholecystitis. It reduces post-operative complications especially in sickle cell patients. Aim: The aim of this work was to compare the results of laparoscopic cholecystectomy in sickle cell and non-sickle cell patients. Methods: Sixty-six patients including 25 sickle cell patients and 41 non-sickle cell patients were identified from March 2013 to November 2014 (20 months). The χ2 test was used for comparisons. Values of p < 0.05 were used for a statistically significant difference threshold. Results: The mean age was 25.76 years for the sickle cell group and 45.61 years for the non-sickle cell group (p = 0.00008). There were 14/25 female patients in the sickle cell group and 28/41 in the non-sickle cell group. In per op, the diagnosis of acute cholecystitis was retained for 4/25 sickle cell patients and for 10/41 non-sickle cell patients. Diagnoses such as pyocholecyst (2 cases), porcelain vesicle (2 cases), hydrocholecyst (2 cases) were found in the group of non-sickle cell patients. Operative difficulties such as tight perivicular adhesions were encountered 9/25 times in the sickle cell group and 11/41 times in the non-sickle cell group. The average overall operative time was 55 min. There was no statistically significant difference between the different groups in mean operative time, occurrence of postoperative complication and average length of hospital stay. The mortality is not statistically different according to the group of patients. Conclusion: There is no significant difference between the cholecystectomy performed in sickle cell patients and that performed in non-sickle cell patients. The multidisciplinary perioperative management of sickle cell patients reduces the risk of complications arising from this pathology.
