Lymphangiomas in children

Forty-one patients presented with a diagnosis of lymphangioma to the Department of Pediatric Surgery between 1971-1995 and 36 of them were treated. The distribution of lymphangiomas was: cervical (41.5 %), trunk (17.1 %), craniofacial (14.6 %), intraabdominal (7.3 %), axillar (7.3 %), extremity (4.9 %), cevicoaxillothoracic (2.4 %) and cervicoaxillar (2.4 %). Of 36 patients undergoing primary therapy, total excision was performed in 77.8 % and partial excision in 16.7 % with recurrence rates of 3.6 % and 83.3 %, respectively. Only two patients required drainage alone without clinical recurrence. Resection for residual or recurrent disease accounted 11.4 % (5/44) of all operations. The postoperative complication rate was 29.5 %. Seroma was the leading complication with an incidence of 38.4 %. Neither drains nor antibiotics were found to be effective in preventing the occurrence of complications. The results of pathological examinations of this series were: cystic lymphangioma (55.9 %), simple lymphangioma (32.3 %), lymphohemangioma (8.8 %), cavernous lymphangioma (2.9 %). The overall mortality rate was 4.9 %. Only one patient was lost in the operative group due to pseudomonas sepsis. The mainstay of therapy for lymphangiomas is still complete resection of tumoral mass without compromising vital structures. It appears that local drains and perioperative antibiotics do not diminish postoperative complications

The Susy Safe project overview after the first four years of activity

Objectives: to collect relevant, up-to-date, representative, accurate, systematic information, related to foreign bodies (FB) injuries. Methods: The "Susy Safe" registry, a DG SANCO co-funded project gathering data on choking in all EU Countries and beyond, was established in order to create surveillance systems for suffocation injuries able to provide a risk-analysis profile for each of the products causing the injury. Main findings after 4 years of activities are resumed here. Results: 16,878 FB injuries occurred in children aged 0-14 years have been recorded in the SUSY SAFE databases; 8046 cases have been reported from countries outside EU. Almost one quart of the cases involving very young children (less than one year of age) presented a FB located in bronchial tract, thus representing a major threat to their health. Esophageal foreign bodies are still characterizing injuries occurred to children younger than one year, in older children the most common locations are the ears and the nose. FB type was specified in 10,564 cases. Food objects represented the 26% of the cases, whereas non-food objects were the remaining 74%. Among food objects, the most common were bones, nuts and seed, whereas for the non-food objects pearls, balls and marbles were observed most commonly (29%). Coins were involved in 15% of the non-food injuries and toys represented the 4% of the cases. Conclusions: this data collection system should be been taken into consideration for the calculation of the risk of injuries in order to provide the EU Commission with all the relevant estimates on FB injurie

Symptoms associated with button batteries injuries in children: An epidemiological review

Objectives: To provide an epidemiological framework of symptoms related to Foreign Body (FB) injuries due to Button Battery (BB). Methods: Data on BB ingestion/inhalation have been obtained from the ButtonBatteryDB. The ButtonBatteryDB is a database collecting information on BB injuries in children (0-18 years of age). Data on 348 BB injures have been derived from the Registry of Foreign Body Injuries "Susy Safe" (269 cases) and from published scientific literature reporting case reports of FB injuries (79 cases). Results: Most of injured children were male and BBs were found more often in the mouth/esophagus/stomach (ICD935) and in the nose (ICD932). Analyzing symptoms related to BB located in the esophagus/mouth/stomach, we found that children had higher probability of experiencing dysphagia (30.19%, 95% C.I. 17.83-42.55), fever and cough (26.42%, 95% C.I. 14.55-38.28), compared to the other symptoms. Referring to the probability that symptoms occurred simultaneously, fever and cough are more likely (3.72%, 95% C.I. 1.0-6-43) to jointly showing up in children with BB in mouth/esophagus/stomach (ICD935), followed by fever and dysphagia (2.66%, 95% C.I. 0.36-4.96) and by fever and irritability/crying, fever and drooling, dysphagia and irritability/crying (2.13% C.I. 0.00-4.19, 95% C.I.). Conclusions: These findings provide new insight in clinical presentation of BB injuries: the identification of unique patterns of symptoms related to BB injuries is useful to perform an early diagnosis (and to guarantee a prompt medical reaction), also when the injury is un-witnessed. © 2015 Elsevier Ireland Ltd