SM Journal of Pediatric Surgery

Archive Articles

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A Plea for Consistency in Orbital Cellulitis Terminology

Purpose: To urge and remind authors in appropriate use of terminology to describe and classify orbital cellulitis subtypes including eyelid edema, peri-orbital or pre-septal cellulitis.

Methods: Review of classical and recent peer-reviewed literature.

Results: Historical classification of various stages of orbital cellulitis traces as far back as to the initial Hubert publication on orbital infections. Countless follow-up articles present periorbital cellulitis as the first of the 5 non-progressive types of orbital infections. Presently the orbital cellulitis classification, however, is associated to Chandler’s name. The only discrepancy between Hubert’s and Chandler’s classifications was the nature of eyelid edema. It is inflammatory as described by Hubert whereas it has a vascular origin as described by Chandler. Labeling an eyelid edema as pre-septal cellulitis is conceptually imprecise.

Conclusion: Proper use of orbital cellulitis in correlation to clinical symptoms and signs in the literature is paramount. This will lead to uniformity and a better understanding amongst surgeons. Eyelid edema without any radiological sign of orbital inflammation should not be referred as preseptal cellulitis. Eyelid edema is sufficient enough.

Augusto Antonio V Cruz¹,² and Amir Pirouzian²,³*


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Large Cervical Cystic Hygroma in Infants: Report of Two Cases

Cystic lymphangiomas are also called as cystic hygromas and are benign, congenital malformation of the lymphatic system, and reported to occur in the head and neck regions in 90% of the cases. This is a report of two cases of large cystic hygromas involved at the neck in both the cases, while in the second case also involved the face along with the neck. Case one was 45-days male and he was admitted with a large swelling at the right side of the neck, while the second case was 3-months-old female and she was admitted with a large swelling involved the right side of the neck and face as well, and she also had mild respiratory distress. Both were investigated with Ultrasonography (USG) and Computed Tomography (CT) scans of the swellings, which showed multiloculated, cystic hygromas. In both the cases complete surgical excision of the cystic hygromas was successfully accomplished. Immediate post-operative period in both the cases were uneventful. In first case, follow-up done 3 months after surgical excision of the cystic hygroma was good and he was doing well. In second case, follow - up was done after a month of surgical excision of cystic hygroma and she had features of neuropraxia of mandibular branch of right facial nerve, and was expected to correct with time.

Rajendra K. Ghritlaharey*


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Surgical Aspect of Pediatric Peritoneal Dialysis: A Survey of the Maghreb Pediatric Surgeon

Objective: To assess the routine surgical practices of consultant pediatric surgeon in the Maghrebian country in their management of peritoneal dialysis.

Methods: During the twelve Maghrebiancongess of pediatric surgery in Tunis May. 2012, a session of quiz survey (4 Questions) about the surgical aspect of pediatric peritoneal dialysis was dedicated. 60 surgeons participate to this session. An electronic voting system was used.

Results: 60% of surgeons practice a mini-laparotomy for catheter insertion. Half of the participants use a double cuff catheter while the other half uses a simple cuff catheter. 65% of participant allows initiation of dialysis within 7 days post catheter insertion. Only 13% of the pediatric surgeons perform an omentectomy at the time of the insertion of the catheter.

Conclusion: The placement of a PD catheter requires an experienced surgeon and should be given appropriate priority. Adhesions to guidelines may improve outcome of patient by reducing the early peritoneal dialysis catheter failure in children in our countries.

Mohamed Jallouli¹*, Mahdi BenDhaou², and Riadh Mhiri²


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Routine Use of Pulse Oximetry in the Newborn to Detect Critical Congenital Heart Disease

Critical Congenital Heart Disease’s (CCHD’s) are potentially life-threatening cardiac abnormalities where the systemic or pulmonary circulation is dependent on a patent ductus arteriosus and include those with duct-dependent pulmonary blood flow, inter-circulatory mixing, and systemic hypoperfusion. The seven main CCHD’s screening targets for neonatal pulse oximetry are hypoplastic left heart syndrome, pulmonary atresia (with intact ventricular septum), Tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia and truncus arteriosus. Early diagnosis improves outcomes.

Vicki L Mahan*


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Medical Anthropometry in Pediatric Surgery

Purpose: To inform about the excellent non-invasive scientific method in pediatric surgery and to establish a significance of anthropometry as first-line diagnostic method. We focused on the Slovak patients with craniosynostosis and pectusexcavatum in this study.

Methods: Anthropometric measurements are performed by standard anthropological technique according to Martin and Saller [1] and its modifications. Special instruments are required: the spreading caliper, the sliding caliper, the measuring tape and anthropometer. Patients are monitored longitudinally.

Results: We summarized the most important facts from anthropometrical evaluation in Slovak patients with craniosynostosis andpectusexcavatum deformity in this study.

Conclusion: Anthropometric measurements are helpful in accurate documentation of growth, longitudinal observation of the patient and can support decision concerning the type of surgery. We can predict trend of growth by anthropometric measurements in these deformities and we think that anthropometry should be performed prior to CT examination.

Štefánková Eva¹, Horn František¹, Omaník Pavol¹, and Neščáková Eva²