Fire in the Operating Room During Hypospadias Repair

Fire in the operating room (OR) is a very distressful and shocking occurrence with potential dramatic consequences. Despite safety rules and rigorous recommendations, such unintentional events do occur every so often. Notably, the vast majority of cases have been reported in the adult population, with very few pediatric cases described to date. Herein, we report on a 16-month-old boy undergoing reconstructive surgery for penoscrotal hypospadias, who experienced an OR fire most likely related to the use of alcohol-based solution ignited by monopolar electrocautery

Burying the appendiceal stump during appendicectomy: State of art

Burying the appendiceal stump during appendicectomy has been considered in the past a key point of the open procedure, in order to protect the abdominal cavity and surgical wound from a possible contamination. Moreover, this operative step is described but not usually performed during laparoscopic appendicectomy in both adult and pediatric patients (3,4) and, only 1 year after first minimally invasive appendicectomy, authors began to wonder whether burying the appendiceal stump was useful or no

Pathogenetic and prognostic factors for neonatal gastric perforation: Personal experience and systematic review of the literature

Introduction: Neonatal gastric perforation (NGP) is a rare entity. Our aim was to report our experience and review the recent literature to characterize NGP, describe associated factors, and define prognostic factors.Materials and methods: Retrospective review of all consecutive patients with NGP treated between June 2009 and December 2017 in a third level pediatric hospital. In addition, a systematic review of Medline and Scopus database was performed using a defined strategy. All articles referring to NGP published between 2005 and 2017 were retrieved. Variables considered: prematurity (< 37 weeks gestation), birth weight (BW), Apgar score, prenatal complications, age at diagnosis, bag ventilation, pathogenetic events, site of perforation, treatment of perforation, sepsis, and outcome. Mann-Whitney or Fisher's test were used as appropriate. Results are median (range) or prevalence.Results: Between 2009 and 2016 we treated 8 consecutive patients for NGP and 199 further cases were retrieved from the systematic review (total of 207 patients). Overall survival was 73%. Most frequently reported pathogenesis: iatrogenic (20 patients), hypoxic/ ischemic or infection stress (13 patients), duodenal/jejunal obstruction (11 patients), drugs (11 patients), esophageal atresia (10 patients). 60% patients had only primary repair of the perforation as gastric surgery. Sepsis developed in 56 patients (34%).Conclusion: Although the pathogenesis of NGP is pleomorphic, prematurity and low BWs are frequent in these patients. Reviewing our experience and the available literature, none of the variables considered, but sepsis was associated with mortality

Esophageal Stricture as a Complication After Scald Injury in Children

Burn injuries are distressful and shocking events, which can lead to noteworthy sequelae on metabolic markers and organs. Such traumatic accidents do occur every so often in both adult and pediatric populations, requiring prompt and adequate treatments. Notably, scald injuries occur due to direct contact with hot liquids and these are the most common cause of burns in early childhood. Herein, we report on an 18-month-old boy admitted to our pediatric surgery unit for an extensive scald injury, who has experienced an unusual esophageal stricture following the traumatic event