Surgical management of traumatic hemobilia in children by direct ligation of the bleeding vessel

The surgical management of traumatic hemobilia by direct ligation of the bleeding vessel is described in two children. The operative procedures were performed with ease and without postoperative problems. Other available operative procedures are also discussed. Direct ligation of the bleeding vessel is recommended as the operative procedure of choice.

Pulmonary blastoma in a neonate

A rare case of pulmonary blastoma in a neonate is reported. Only one other neonate has been documented in the available English literature. The treatment consisted of surgical excision only.

Pharmacokinetics of intravenous metronidazole in neonates

Metronidazole is being extensively used in neonates for the prevention and treatment of anaerobic infections. However, detailed pharmacokinetic studies are not available. Thirty neonates receiving intravenous metronidazole 7.5 mg/kg at eight-hour intervals were studied with serial blood levels. The levels increased up to the third day of treatment and then reached a plateau. Neonates less than seven days of age showed higher levels than older infants. Septicemic neonates, however, showed continually rising levels. The half-life of metronidazole was 22.3 to 22.5 hours, approximately twice that in adults. This study indicates that neonates handle the drug differently than adults and may require it in lesser doses or at greater time intervals.

Hemangiolymphangioma of the urinary bladder in a child

A rare case of hemangiolymphangioma of the urinary bladder with associated cutaneous hemangiomas of the shaft and glans penis and the scrotum is presented. Unusual features of clinical presentation, noninvasive diagnosis, and the surgical management are discussed.

Mid-anal sphincteric malformation, cause of constipation in anterior perineal anus

Constipation characterized by straining at defecation has been reported in association with an anteriorly located, but otherwise "normal' anus, however its cause is not known. In this communication the pathogenesis of constipation has been discussed on the basis of clinical features and intraoperative findings seen in seven children with this syndrome. The primary cause of constipation lies in the congenital malformation of the mid-portion of the external sphincter and weakness of the corresponding segment of the anal canal.

Hydrocephalus caused by tuberculous meningitis: clinical picture, CT findings and results of shunt surgery

This study is an analysis of 70 children, five months to eleven years of age, with hydrocephalus secondary to tuberculous meningitis. They presented as an acute illness, mostly in early childhood, with disturbance of consciousness, convulsions, rigidity and, sometimes, neurological deficit. CT scans showed ventricular dilatation, periventricular translucency and exudates in basal cisterns. Shunt surgery performed early produced gratifying results without dissemination of tuberculosis. Residual ventricular dilatation following shunt surgery was inversely related to intellectual status. Even with advanced degrees of tuberculous meningitis, thirteen of the twenty-eight children tested for intellectual status were found to be educable or having near normal intelligence. Fatal intraventricular haemorrhages were seen in six cases as a late complication.