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Pancreatitis in children

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https://www.readbyqxmd.com/read/29340827/single-incision-laparoscopic-hepaticojejunostomy-for-children-with-perforated-choledochal-cysts
#1
Mei Diao, Long Li, Wei Cheng
BACKGROUND: Conventionally, perforated choledochal cyst (CDC) is a contraindication of laparoscopic treatment. The current study is to evaluate efficacy of single-incision laparoscopic hepaticojejunostomy (SILH) in children with perforated CDCs. METHODS: One hundred and thirty-three children with perforated CDCs who underwent SILHs in our hospital between August 2011 and August 2017 were reviewed. RESULTS: Fifteen (11.3%) patients were converted to open procedures due to severe adhesions and oozing...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29331260/multifaceted-behavior-of-meckel-s-diverticulum-in-children
#2
Qingjiang Chen, Zhigang Gao, Lifeng Zhang, Yuebin Zhang, Tao Pan, Duote Cai, Qixing Xiong, Qiang Shu, Yunzhong Qian
PURPOSE/BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital malformations of gastrointestinal tract in children. However, the nonspecific clinical manifestations of MD often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. This study aimed to review our experience in managing this disease while evaluating the management strategies. METHODS: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our center between January 2010 and December 2015...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29327413/itpa-activity-in-children-treated-by-azathioprine-relationship-to-the-occurrence-of-adverse-drug-reactions-and-inflammatory-response
#3
Antony Citterio-Quentin, Mustapha Moulsma, Marie-Paule Gustin, Alain Lachaux, Roselyne Boulieu
Azathioprine (AZA), a thiopurine drug, is widely used in the treatment of children with immunological disease such as inflammatory bowel disease (IBD) and autoimmune hepatitis (AIH); however, interindividual variability in the occurrence of adverse drug reaction (ADRs) and drug response is observed. This study investigated 1) the relationships between inosine triphosphate pyrophosphatase (ITPA) activity, an enzyme involved in thiopurine metabolism, and the occurrence of ADRs in children with immunological disease on AZA therapy, 2) the relationship between ITPA activity and the inflammatory activity observed in children with IBD...
January 11, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29324630/perforated-meckel-diverticulum-a-rare-cause-of-acute-abdomen-in-children
#4
Saurabh Talathi, David Kelly, Scott Anderson, Yoginder Vaid, Jose Mestre
Meckel diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and the most common cause of gastrointestinal bleeding in children. Although it usually follows the rule of 2's, exceptions to this rule are reported in the literature. Often asymptomatic, MD is commonly an incidental finding during surgical interventions. When symptomatic, the most common presentation of this condition is painless rectal bleeding. A myriad of other nonspecific symptoms are however possible, especially in adults, thus making this diagnosis difficult...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29303286/-cystic-fibrosis-in-adults
#5
Libor Fila
Cystic fibrosis (CF) is an inherited disease caused by mutations in the transmembrane conductance regulator (CFTR) gene. The disease leads to dysfunction of the exocrine glands with high concentration of chloride in the sweat and formation of abnormally viscous mucus in the respiratory, digestive and reproductive tract. Chronic sinopulmonary disease, exocrine pancreatic insufficiency, liver disease, intestinal obstruction, impaired nutritional status, salt loss syndrome and male infertility dominates in the clinical presentation...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29302507/blunt-trauma-pancreas-in-children-is-non-operative-management-appropriate-for-all-grades
#6
Ravi Kumar Garg, Jai Kumar Mahajan
Purpose: Blunt trauma of pancreas in children is uncommon and its management varies from observational to early operative intervention. We analysed the feasibility and outcome of non-operative management in all grades of paediatric pancreatic injuries. Methods: A total of 15 patients of pancreatic trauma seen in a Paediatric Surgery Unit were retrospectively analyzed. Results: Age of the patients ranged from 3-11 years (mean, 7.7 years). The mode of injury was local trauma in 9 children...
December 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/29288372/robotic-assisted-laparoscopic-surgery-for-pediatric-tumors-a-bicenter-experience
#7
P Meignan, Q Ballouhey, J Lejeune, K Braik, B Longis, A R Cook, H Lardy, L Fourcade, Aurélien Binet
Mini-invasive surgery is more and more integrated in pediatric surgery. The robotic-assisted surgery brought new advantages from which the patient and the surgeon could benefit compared to laparoscopy. Its use in oncological surgery is still controversial. 12 robotic-assisted tumor resections with the da Vinci Surgical Robot (Intuitive Surgical, Sunnyvale, CA) were attempted in 11 children (mean age 7.65 years; age range 0.75-16.75 years; mean weight 30.3 kg; weight range 8.6-62 kg) in two centers. Mean total operative time was 145 min (range 72-263 min)...
December 29, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29286576/cytoreductive-surgery-and-hyperthermic-intraperitoneal-perfusion-with-chemotherapy-in-children-with-peritoneal-tumor-spread-a-french-nationwide-study-over-14-years
#8
Aurélien Scalabre, Pascale Philippe-Chomette, Guillaume Passot, Daniel Orbach, Dominique Elias, Nadège Corradini, Laurence Brugières, Simon Msika, Marc-David Leclair, Solène Joseph, Cécile Brigand, François Becmeur, Christine Soler, Denis Pezet, Johan Gagniere, Olivier Glehen, Sabine Sarnacki
BACKGROUND: Efficacy and role of cytoreductive surgery (CRS) and hyperthermic peritoneal perfusion with chemotherapy (HIPEC) remain poorly documented in pediatric tumors. METHODS: This retrospective national study analyzed all pediatric patients with peritoneal tumor spread treated by CRS and HIPEC as part of a multimodal therapy in France from 2001 to 2015. RESULTS: Twenty-two patients (nine males and 13 females) were selected. The median age at diagnosis was 14...
December 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29280782/management-of-acute-pancreatitis-in-the-pediatric-population-a-clinical-report-from-the-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-pancreas-committee
#9
Maisam Abu-El-Haija, Soma Kumar, Jose Antonio Quiros, Keshawadhana Balakrishnan, Bradley Barth, Samuel Bitton, John F Eisses, Elsie Jazmin Foglio, Victor Fox, Denease Francis, Alvin Jay Freeman, Tanja Gonska, Amit S Grover, Sohail Z Husain, Rakesh Kumar, Sameer Lapsia, Tom Lin, Quin Y Liu, Asim Maqbool, Zachary M Sellers, Flora Szabo, Aliye Uc, Steven L Werlin, Veronique D Morinville
BACKGROUND: Although the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS: The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas committee performed a MEDLINE review using several preselected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed...
January 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29280746/congenital-hyperinsulinism-diagnosis-and-treatment-update
#10
Hüseyin Demirbilek, Khalid Hussain
Pancreatic β-cells are finely tuned to secrete insulin so that plasma glucose levels are maintained within a narrow physiological range (3.5-5.5 mmol/L). Hyperinsulinaemic hypoglycaemia (HH) is the inappropriate seretion of insulin in the presence of low plasma glucose levels and leads to severe and persistent hypoglycaemia in neonates and children. Mutations in 12 different key genes (ABCC8, KCNJ11, GLUD1, GCK, HADH, SLC16A1, UCP2, HNF4A, HNF1A, HK1, PGM1 and PMM2) that are involved in the regulation of insulin secretion from pancreatic β-cells have been described to be responsible for the underlying molecular mechanisms leading to congenital HH...
December 27, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29279643/meckel-s-diverticulitis-masquerading-as-acute-pancreatitis-a-diagnostic-dilemma
#11
C Danny Darlington, G Fatima Shirly Anitha
Meckel's diverticulum is a remnant of the proximal part of the vitellointestinal duct and is the most common congenital anomaly of the gastrointestinal tract. It may either remain asymptomatic or present with myriad of clinical presentations. Gastrointestinal bleeding is the most common presentation in children whereas it is intestinal obstruction in the case of adults. We report a 9-year-old boy who presented with acute onset of periumbilical pain and nonbilious vomiting. His clinical and laboratory parameters were unremarkable, except for serum amylase levels...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29277262/pancreatectomies-for-pancreatic-neoplasms-in-pediatric-and-adolescent-age-a-single-institution-experience
#12
Chiara Scandavini, Roberto Valente, Elena Rangelova, Ralf Segersvärd, Urban Arnelo, Johan Permert, Pär-Johan Svensson, Jakob Stenman, Marco Del Chiaro
BACKGROUND: There are very few data in the current literature regarding the short- and long-term outcome of surgery for pediatric pancreatic tumors (PPT). No data are available on the impact of pancreatic surgery on the children's growth. METHODS: This is a retrospective cohort study on a consecutive series of pediatric/adolescent patients who underwent pediatric surgery at Karolinska University Hospital from January 2005 to July 2017. RESULTS: Overall 14 pancreatic operations were performed in 13 patients...
December 19, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29247329/understanding-childhood-diabetes-mellitus-new-pathophysiological-aspects
#13
REVIEW
Juergen Grulich-Henn, Daniela Klose
Diabetes mellitus (DM) is not a single disease, but several pathophysiological conditions where synthesis, release, and/or action of insulin are disturbed. A progressive autoimmune/autoinflammatory destruction of islet cells is still considered the main pathophysiological event in the development of T1DM, but there is evidence that T1DM itself is a heterogeneous disease. More than 50 gene regions are closely associated with T1DM and a variety of epigenetic factors and metabolic patterns have been characterized, which may play a role in the development of T1DM...
December 15, 2017: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/29242734/images-from-18f-dopa-scan-in-congenital-hyperinsulinism-not-always-a-clue-for-diagnosis
#14
Evelina Maines, Luca Giacomello, Mirko D'Onofrio, Matteo Salgarello, Rossella Gaudino, Laura Baggio, Andrea Bordugo
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycaemia in childhood (Horm Res 70:65-72, 2008; J Clin Endocr Metab 93:869-875, 2008). 18-Fluoro-L-dihydroxy-phenylalanine (18F-DOPA) positron emission tomography (PET) can detect areas of increased activity in the pancreas and may differentiate focal from diffuse CHI (J Clin Endocr Metab 93:869-875, 2008; Radiology 253:216-222, 2009). We here report the case of a girl who complained of recurrent episodes of severe hypoglycaemia despite previous partial pancreatectomy...
December 2017: Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29235528/identification-of-newly-committed-pancreatic-cells-in-the-adult-mouse-pancreas
#15
Mairobys Socorro, Angela Criscimanna, Patricia Riva, Manuj Tandon, Krishna Prasadan, Ping Guo, Abhinav Humar, Sohail Z Husain, Steven D Leach, George K Gittes, Farzad Esni
Multipotent epithelial cells with high Aldehyde dehydrogenase activity have been previously reported to exist in the adult pancreas. However, whether they represent true progenitor cells remains controversial. In this study, we isolated and characterized cells with ALDH activity in the adult mouse or human pancreas during physiological conditions or injury. We found that cells with ALDH activity are abundant in the mouse pancreas during early postnatal growth, pregnancy, and in mouse models of pancreatitis and type 1 diabetes (T1D)...
December 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29230341/pancreatic-laceration-in-a-pediatric-patient-an-unexpected-diagnosis
#16
Michelle J Hong, Lauren M Porter, Debra D Esernio-Jenssen, Andrew C Miller, Marna Rayl Greenberg
Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29229482/selective-intraoperative-cholangiography-during-laparoscopic-cholecystectomy-in-children-is-justified
#17
Benjamin Martin, Evelyn Geok Peng Ong
AIMS: Intraoperative cholangiograms (IOC) during laparoscopic cholecystectomy have been advocated to detect biliary anomalies and intraductal calculi. However, IOC increases operative time and patient irradiation, and therefore is not universally used. We hypothesise selective IOC may be a valuable tool in children. METHODS: A retrospective case note review was performed of all children who underwent laparoscopic cholecystectomy at a single institution by a single surgeon between January 2011 and March 2017...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29228523/advanced-therapeutic-gastrointestinal-endoscopy-in-children-today-and-tomorrow
#18
Zaheer Nabi, Duvvur Nageshwar Reddy
Gastrointestinal (GI) endoscopy plays an indispensable role in the diagnosis and management of various pediatric GI disorders. While the pace of development of pediatric GI endoscopy has increased over the years, it remains sluggish compared to the advancements in GI endoscopic interventions available in adults. The predominant reasons that explain this observation include lack of formal training courses in advanced pediatric GI interventions, economic constraints in establishing a pediatric endoscopy unit, and unavailability of pediatric-specific devices and accessories...
December 12, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/29222263/crisis-management-in-the-treatment-of-childhood-acute-lymphoblastic-leukemia-putting-right-what-can-go-wrong-emergency-complications-of-disease-and-treatment
#19
REVIEW
Rachael Hough, Ajay Vora
The improvement in overall survival in children with acute lymphoblastic leukemia (ALL) over the last 5 decades has been considerable, with around 90% now surviving long term. The risk of relapse has been reduced to such an extent that the risk of treatment-related mortality is now approaching that of mortality caused by relapse. Toxicities may also lead to the suboptimal delivery of chemotherapy (treatment delays, dose reductions, dose omissions), potentially increasing relapse risk, and short- and long-term morbidity, adding to the "burden of therapy" in an increasing number of survivors...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29218844/predictors-of-hepatotoxicity-and-pancreatitis-in-children-and-adolescents-with-acute-lymphoblastic-leukemia-treated-according-to-contemporary-regimens
#20
Christopher C Denton, Yasmin A Rawlins, Matthew J Oberley, Deepa Bhojwani, Etan Orgel
BACKGROUND: Hepatotoxicity and pancreatitis are common treatment-related toxicities (TRTs) during contemporary treatment regimens for acute lymphoblastic leukemia (ALL). Limited detailed data from Children's Oncology Group (COG) regimens has been previously reported to enable identification of patient and treatment risk factors for these toxicities and their impact on outcomes. PROCEDURE: We analyzed a retrospective pediatric ALL cohort treated at a single institution according to COG regimens from 2008 to 2015...
December 8, 2017: Pediatric Blood & Cancer
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