Short and long term complications after pediatric liver transplantation: A review and literature

Background Pediatric liver transplant (PLT) is a complex surgical procedure. Pediatric liver transplantation has evolved over the last two decades into an effective and widely accepted therapy for infants and children. We aimed to review the short and long term complications after oediatric liver transplantation. Materials and Methods The literature research was conducted in EMBASE, PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar; were searched from January 1984 to January 2016. The following keywords were used: Liver transplantation, Pediatric Liver transplantation, Risk factors, Complication, and Mortality. Results The main complications after pediatric liver transplantation were: infections (51.4) and surgical complications including (biliary complications 41.2%, and postoperative bleeding 27%). In general, vascular complications were observed in 35% of studied children. Conclusion Infections and biliary complications were the most common outcome occurring in children after LT. Advances in post-transplant care and monitoring of the recipients, technical refinements enable the better results

Short and long term complications after pediatric liver transplantation: A review and literature

Background Pediatric liver transplant (PLT) is a complex surgical procedure. Pediatric liver transplantation has evolved over the last two decades into an effective and widely accepted therapy for infants and children. We aimed to review the short and long term complications after oediatric liver transplantation. Materials and Methods The literature research was conducted in EMBASE, PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar; were searched from January 1984 to January 2016. The following keywords were used: Liver transplantation, Pediatric Liver transplantation, Risk factors, Complication, and Mortality. Results The main complications after pediatric liver transplantation were: infections (51.4) and surgical complications including (biliary complications 41.2%, and postoperative bleeding 27%). In general, vascular complications were observed in 35% of studied children. Conclusion Infections and biliary complications were the most common outcome occurring in children after LT. Advances in post-transplant care and monitoring of the recipients, technical refinements enable the better results

Jeune syndrome: description of 13 cases and a proposal for follow-up protocol

Jeune syndrome (asphyxiating thoracic dystrophy, ATD) is a rare autosomal recessive skeletal dysplasia characterized by a small, narrow chest and variable limb shortness with a considerable neonatal mortality as a result of respiratory distress. Renal, hepatic, pancreatic and ocular complications may occur later in life. We describe 13 cases with ages ranging from 9 months to 22 years. Most patients experienced respiratory problems in the first years of their life, three died, one experienced renal complications, and one had hepatic problems. With age, the thoracic malformation tends to become less pronounced and the respiratory problems decrease. The prognosis of ATD seems better than described in literature and in our opinion this justifies long term intensive treatment in the first years. We also propose a follow-up protocol for patients with ATD

Obstrução duodenal por hematoma parietal pós-trauma: relato de caso e revisão da literatura

Os hematomas parietais de alças intestinais por trauma abdominal fechado, determinando rápida obstrução luminal, são lesões raras e podem ser confundidas com afecções neoplásicas estenosantes (parietais ou por mecanismo de compressão extrínseca). Neste estudo é relatado um caso de obstrução intestinal por hematoma parietal da terceira porção duodenal pós-trauma e são discutidos o diagnóstico por imagem e o tratamento para tal obstrução

Shwachman-Diamond syndrome: a complex case demonstrating the potential for misdiagnosis as asphyxiating thoracic dystrophy (Jeune syndrome)

<p>Abstract</p> <p><b>Background</b></p> <p>The differential diagnosis of a neonate or fetus presenting with a bell-shaped or long narrow thorax includes a wide range of bony dysplasia syndromes. Where this is accompanied by respiratory distress, asphyxiating thoracic dystrophy (ATD, Jeune syndrome) is an important potential diagnosis. Shwachman-Diamond syndrome (SDS) is widely recognised as a cause of exocrine pancreatic dysfunction, short stature and bone marrow failure. It is not so well appreciated that rib and/or thoracic cage abnormalities occur in 30–50% of patients and that, in severe cases, these abnormalities may lead to thoracic dystrophy and respiratory failure in the newborn. There are, however, at least three previous case reports of children who were initially diagnosed with ATD who were subsequently shown to have SDS.</p> <p><b>Case presentation</b></p> <p>This report details the case history of a patient misdiagnosed as having ATD as a neonate following the neonatal asphyxial death of her brother. She subsequently developed progressive pancytopenia but was only diagnosed with SDS at 11 years of age after referral for haematopoietic stem cell transplantation for bone marrow failure accompanied by trilineage dysplasia and clonal cytogenetic abnormalities on bone marrow examination. Subsequent testing revealed the presence of fat globules in stools, reduced faecal chymotrypsin, fat-soluble vitamin deficiency, metaphyseal dysplasia on skeletal survey and heterozygous mutations of the SBDS gene.</p> <p><b>Conclusion</b></p> <p>This report highlights the potential for diagnostic confusion between ATD and SDS. It is important to include SDS in the differential diagnosis of newborns with thoracic dystrophy and to seek expert clinical and radiological assessment of such children.</p

Histamine H2 receptor antagonists and proton pump inhibitors: Best options for gastro-oesophageal reflux in children

Gastro-oesophageal reflux (GOR) in children can be managed by altering the viscosity of feeds, increasing gastric pH and altering gut motility with a variety of pharmacological agents. This article presents recommendations for the treatment of GOR and GOR disease in children based on a recent evidence-based systematic review that evaluated and graded individual treatments. © 2010 Adis Data Information BV. All rights reserved