The effect of hyperbaric oxygen treatment on the inflammatory changes caused by intraperitoneal meconium

Exposure of the peritoneal cavity to meconium causes a marked inflammatory response. The effect of intraperitoneal meconium on intestinal morphology and plasma nitrite and nitrate (NO2(-) + NO3(-)) levels and how this inflammatory process is influenced by hyperbaric oxygen (HBO) treatment were investigated in this study. The purpose was to determine whether HBO treatment could be considered a useful adjunct in the resuscitative treatment of severely ill patients admitted with meconium peritonitis (MP). Rats were divided into three groups. Human meconium (MP group, n=10) and sterile saline (control group, n=10) were injected intraperitoneally for 3 days. The procedure for meconium injection was combined with HBO treatment for the HBO group (n=10). HBO was administered for 7 days. In all groups, peritoneal swap cultures, plasma NO2(-) + NO3(-) levels, intestinal diameters, and macroscopic and microscopic changes in the intestine were determined on the 8th day. Bacterial growth was not detected in the peritoneal swap cultures. There was a significant difference in NO2(-) + NO3(-) levels between the MP and HBO groups ( P<0.05), between the MP and control groups ( P<0.01), and between the HBO and control groups ( P<0.05). Thin fibrinous adhesions in both the MP and HBO groups, and thickened and dilated intestinal loops in the MP group were observed macroscopically. The intestinal diameter in the MP group was significantly greater than in the HBO and control groups. The only microscopic difference was seen in the serosal layer. Compared with the animals in the control and HBO groups, the intestine of the rats in the MP group showed prominent serosal thickening, edema, capillary proliferation and cellular infiltration. The ameliorated inflammatory changes and decreased dilatation of the intestine accompanied by a significant decrease in NO2(-) + NO3(-) levels suggest that as an adjunctive treatment, HBO may have a beneficial effect in the resuscitative treatment of meconium peritonitis.

Diagnostic steps and staged operative approach in Currarino's triad: a case report and review of the literature

The Currarino triad is a combination of a presacral mass, a congenital sacral bony abnormality and an anorectal malformation. It mostly presents with constipation. Rectal examination, plain radiographs and magnetic resonance imaging are the main tools for the diagnosis. If the mass is a meningocele, colostomy and neurosurgical exploration should precede anoplasty due to the risk of meningitis. A 14-month-old female patient with anal stenosis, a sacral scimitar defect and an anterior meningocele is presented in this report.

Benign rheumatoid nodules of childhood

The nodules associated with rheumatoid arthritis and rheumatic fever appear with other signs of active rheumatic disease. Rheumatoid nodule-like lesions irrelevant to rheumatoid disease occasionally occur in children who are well and have no complaints associated with rheumatoid diseases. Laboratory tests are normal. Children with benign rheumatoid nodule are not at increased risk for rheumatic disease. No therapy or prophylaxis is required. We present a two-year-old girl with a subcutaneous nodule on the right pretibial region who was diagnosed with clinical and histological findings.

Giant mesenteric lipoma

Mesenteric lipoma is a rare benign tumor of mature fat cells. Asymptomatic abdominal mass, progressive abdominal distension, and intraperitoneal radiolucent fat density mass on computed tomography are the main diagnostic criteria. Main differential diagnosis is lipoblastoma or lipoblastomosis. Treatment is surgical excision. As an unusual case, a 3-year-old boy with a giant mesenteric lipoma is presented in this report.

Amniotic membrane wrapping: an alternative method to the splenorrhaphy in the injured spleen

Human amnion, which has been used experimentally and clinically as an ideal bioprosthesis, was used in the present study to wrap the experimentally injured spleens and the technique was compared to splenorrhaphy. Standard splenic injuries were made on 30 male albino rats. 15 of the spleens were repaired by splenorrhaphy and the other 15 were wrapped with sterile human amniotic membrane. Isotope uptakes of the spleens calculated at the 30th postoperative day were similar in both groups (p less than 0.05). But the histopathological examination revealed a better healing in the amnion group with better preservation of the splenic architecture. It was concluded that in heavily injured spleens, amnion wrapping may be an effective alternative to splenorrhaphy.