Journal of Pediatric Diseases

Abstract Developmental malformations of the lung are common but complete agenesis of the lung is quite rare and usually the patients presented are in early childhood; though according to literature, a few cases have come to light even in the adult age group. A 10-month-old male child presented with a sudden onset of respiratory distress with opacity of the right hemithorax on X-ray, raising suspicion of foreign body bronchus. Subsequent CT scans and bronchoscopy revealed agenesis of the right lung. Patient was managed conservatively and his parents were counseled about the anomaly. The child is doing well and is in a regular follow-up with us. Agenesis of the lung should be suspected in children with recurrent respiratory distress with opacity of the hemithorax on X-ray and herniation of the opposite lung across the mediastinum.

Abstract The management of gastroschisis is a challenging problem for pediatric surgeons the world over. There are so many different options ranging from primary closure to staged closure using various kinds of silo. Silos are expensive and not available everywhere. A cheaper and easily available urobag has been tried for staged reduction with more than satisfactory outcome. We reported three cases of gastroschisis in preterm and low birth weight infants managed by this method.

Abstract Appendicitis is the most common cause of emergency abdominal surgeries in children. Ultrasound (US) has been proven to be a helpful imaging modality in patient evaluation, especially in children suspected of appendicitis. The Alvarado score is a 10-point scoring system for the diagnosis of appendicitis based on clinical data and differential leukocyte count. The aim of the present study was to evaluate a combination of clinical scoring (Alvarado score) and US findings for accurate diagnosis of appendicitis in children. The study was done in Menoufia University Hospitals from March 2011 to January 2013. 322 children with abdominal pain clinically suspected of having appendicitis were included in the study and clinically assessed to calculate the Alvarado score. Patients were referred to the radiology department for abdominal US. Among the 153 of the 322 patients who were operated on, 149 patients were diagnosed pre-operatively with acute appendicitis and 4 girls were diagnosed with complex ovarian cysts. Of the 149 patients diagnosed with appendicitis, the percentage of appendicitis was 93% (139/149) and 10 (7%) patients had normal appendix. The prevalence of appendicitis among the patients of the study was 43% (139/322). In conclusion, a combination of Alvarado scores and abdominal US is a good approach for the diagnosis of appendicitis in children to reduce the number of laparotomies for normal appendix. In the case of normal appendix or nonvisualization of the appendix via abdominal US without a high Alvarado score, appendicitis can be safely ruled out. If it is proven as an inflamed appendix on US or a high Alvarado score, patient should be subjected for appendectomy without delay.