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Background: Splenic cysts are one of the relatively rare conditions in pediatric surgery practice. Primary non-parasitic splenic cysts are even more scarce. Case presentation: A 13-years-old female patient presented with chronic left hypochondrial pain of 2 months duration. Abdominal ultrasonography and computed tomography revealed huge 18 cm × 14 cm × 10 cm splenic cyst. Deroofing of the cyst was done which was complicated by secondary infection. Subsequently, the patient was re-operated on and partial splenectomy done with good outcome at 6 months follow up. Conclusion: Partial splenectomy is the best management strategy for huge non-parasitic splenic cysts in children. There is also less recurrence rate of splenic cysts with preservation of splenic functions. [ABSTRACT FROM AUTHOR]

Background and objectives: Soave transanal procedure for Hirschsprung disease (HD) is most commonly performed at early age with good outcome. In our center we adopted this technique in many patients in different age groups without assisted laparoscopic abdominal approach. We herein aim to describe different technical aspects, outcome and success rate of Soave procedure among our patients. Methods: We retrospectively reviewed our series of HD patients who underwent the Soave transanal approach, for postoperative stricture, anastomotic leak, enterocolitis, and subsequent bowel functions. Patients were divided into two groups: group 1: the early neonatal group (0-1month) and group 2: the late presentation group(3-14years). Results: Among the 17 patients with HD operated in our center, 13 underwent Soave transanal resection, 1 was lost from follow up, 2 had a levelling colostomy prior to referral and 1 had ileostomy. The average length of resection was 20±10.5 cm. The mean follow-up period was 12.2 months (range 5-22 months). Seven patients were 3-14 years old. At follow-up none had fecalincontinence or constipation requiring laxatives. All patients had voluntary bowel movements. Conclusions: Our results support the fact that a single stage Soave approach without transabdominal dissection is an excellent technique for patients presenting with late HD with an excellent outcome. A multicenter prospective study with larger number of patient is essential to validate our results. [ABSTRACT FROM AUTHOR]

Background: Lipoblastoma is a rare benign mesenchymal tumour of embryonal fat that occurs almost exclusively in infants and children. This determined the epidemiological, clinical and therapeutic aspect of this disease. Materials and Methods: A total of 10 cases of pathologically proven lipoblastoma from 2003 to 2012 were reviewed. Results: There were six boys and four girls ranging in age from 7 months to 9 years. A soft-tissue mass was the main complain in nine patients. The various locations of the mass were mediastinal, thigh, buttock, inguino-scrotal, the greater omentum and the Latissimus dorsi. Lesions measured 5-15 cm. complete excision was done. The median time of follow-up was 42 months (ranges between 18 and 84 months). There were no recurrences. Conclusion: It is important to consider lipoblastoma in the diagnosis of a rapidly enlarging fatty mass in children. Complete resection is the only definitive treatment and should not be delayed when impingement on surrounding structures is imminent. There is a tendency for these lesions to recur despite presumed complete excision. Therefore, follow-up for a minimum of 5 years is recommended. [ABSTRACT FROM AUTHOR]

Background: To determined the accuracy of ultrasound in diagnosis of acute appendicitis in children keeping histopathology as gold standard., Methods: A prospective evaluations of all ultrasound for appendicitis from January 1, 2014, to June 15, 2017, was conducted at our hospital. A diagnostic protocol was implemented to reduce radiation exposure employing US as the initial imaging modality followed by CT for non-diagnostic US studies in patients with an equivocal clinical presentation. The imaging, operative findings, and pathology of 223 patients (females 80, males 143, age less than 14years) with diagnosed appendicitis were collected. The sensitivity, specificity, predictive value, and negative appendectomy rate were also analyzed. All those patients which had subjected to surgery were included to evaluate the true result of ultrasound in diagnosis of appendicitis., Results: Of the 223 pediatric appendectomies performed in this time period, a total of 192 (86%) were diagnosed by ultrasound. The histopathology of 8 was normal (3.6%), CT done in 11 and three was normal. The negative appendectomy rate was 3.6%. US were the sole imaging modality in all patients., Conclusions: In the diagnosis of acute appendicitis in children, ultrasound is useful and accurate mode, which results in a significant decrease in negative appendectomies with no increase in the number of CT scans. This has important implications in the reduction of childhood radiation exposure., Study Design: cross sectional validation.