Case report of multiple hepatic microabscesses in a term neonate

Neonatal liver abscess is a rare entity, which usually occurs in preterm infants with sepsis and certain risk factors like umbilical vein catheterization. Neonatal hepatic abscess has a non-specific clinical presentation, and a high index of suspicion for this condition is warranted in case of unresolving sepsis especially in the presence of risk factors. Ultrasonography of abdomen is an important investigation in a febrile neonate with sepsis. Here, we report a case of hepatic microabscesses in a term neonate without any significant risk factors. We want to report this case because of its rare occurrence particularly in a term neonate without significant risk factors. This case also emphasizes the utility of abdominal ultrasonography in a febrile neonate with unresolving sepsis

Pelvic Fracture Urethral Injury in Females

BackgroundPelvic fracture urethral injuries (PFUI) in females are very rare. The available literature on the management of this condition is scarce and not clear, mainly because of limited experience among reconstructive surgeons. We present our experience of management of these complex urethral injuries in female patients.Materials and MethodsWe collected data, retrospectively and prospectively for 22 female patients referredto our center for PFUI repair between 1995 and 2021. During the clinical assessment of these complex injuries, following our internal institutional protocol, all patients underwent pelvic MRI (bladder and urethra are filled with saline solution and jelly to enhance the urethral lumen and the level of the distraction) before anastomotic urethroplasty. ResultsPFUI compromised the mid urethra in 10 patients (45.5%). A transabdominal approach was used in 8 patients (80%), and urethra-vaginal fistula repair was undertaken in 6 patients (60%). After a median follow-up of 36 months, only 1 patient with proximal PFUI required a surgical revision without compromising urinary continence. ConclusionsThe most common site of urethral involvement in pelvic fracture is mid urethral, which is owing to avulsion. Urethra-vaginal fistula should be suspected. Treatment consists in anastomotic urethroplasty, mainly through the abdominal approach

Flaps for bulbar urethral ischemic necrosis in pelvic fracture urethral injury

Bulbar urethral ischemic necrosis (BUIN) is an iatrogenic entity resulting from repeated attempts at performing anastomotic urethroplasty for pelvic fracture urethral injuries. Etiologically speaking, BUIN is related to a compromised blood supply of the bulbar urethra, which normally relies on anterograde supply from bulbar arteries and retrograde supply from recurrent branches of dorsal penile arteries, through the glans. At each transection of the bulbar urethra, both the anterograde and retrograde supplies are compromised, increasing the risk of BUIN. Even though this term is widely used among reconstructive urologists, BUIN is orphan of an accepted scientific definition. We aim to report our personal perspective on BUIN, to identify factors associated with its occurrence, and to describe the management options in these patients