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Laparoscopic repair of Morgagni hernia has been described in adults and children. In the published reports, the crux of the repair consists of suturing the posterior part of the diaphragmatic defect to the undersurface of the sternum or the posterior rectus sheath. The tissue on the undersurface of the sternum is variable is in its nature and may be inadequate for suturing, hence compromising the strength of the repair. A technique that circumvents this problem and offers a strong anatomical repair is described. A Morgagni hernia was diagnosed in a 2-year-old girl with trisomy 21, who presented with recurrent chest infections. She underwent laparoscopic repair of the hernia using three ports. The tissue on the undersurface of the sternum was inadequate for a conventional repair. The procedure was modified as follows: a small transverse incision was made over the lower end of the sternum. Three nonabsorbable mattress sutures were inserted through the sternum, the anterior edge of the diaphragmatic defect, and back through the sternum and tied with extracorporeal knots. The child was discharged home on the second postoperative day. At 6-month follow up, the child was asymptomatic, and had been infection free. A chest radiograph was normal. This is a simple, novel, noninvasive method, which offers a secure anatomical repair and it is not dependent on the adequacy of the tissue on the undersurface of the sternum.

Juvenile dermatomyositis classically manifests as necrotising vasculitis in multiple organs. It mainly involves the vessels of skin and muscle and is associated with subcutaneous deposits of calcium. Ureteric involvement in dermatomyositis is extremely rare. The authors present a case of a 14-year-old girl with juvenile dermatomyositis with intramural ureteric calcification mimicking pelviureteric junction (PUJ) obstruction.

Context: Postoperative fever is known to occur after all surgical procedures irrespective of the type of anesthesia. Thermometry devices that work without touching or disturbing the child seem to be appreciated more than the conventional skin contact thermometers. However, whether this technology is reliable to be adapted for routine pediatric surgical care is debatable. Aims: The aim of this study was to study the accuracy of infrared nonskin contact digital thermometer (IRT) compared to the skin contact digital thermometer (DT) and mercury in glass thermometer (MT). Settings and Design: A prospective cross-sectional study was done in postoperative patients at a pediatric surgical center over a period of 3 months. Subjects and Methods: The forehead temperature was recorded with IRT. This was followed by recording the temperature in one armpit by DT and the other armpit by MT. Readings were promptly documented. Statistical Analysis Used: A sample t-test was done which gave the P value and mean. Linear regression analysis was carried out to find correlation coefficients. Bland–Altman test was used to access the concordance between all readings. Results: We found a strong correlation between temperature readings taken by DT (mean = −0.03, r = 0.07, slope = −0.04) and IRT (mean = 0.89, r = 0.091, slope = −0.14). However, on comparison of results with the MT, there are wider limits of agreement with the IRT (−0.31–2.09) in comparison to DT (−0.66–0.59). Conclusion: Skin contact digital thermometer are more accurate and suitable for checking body temperature as compared to infrared nonskin contact digital thermometer in postoperative pediatric patients. [ABSTRACT FROM AUTHOR]