Search

Gastrointestinal duplications are rare congenital abnormalities known to occur at any level of the alimentary tract from the mouth to the anus. The cause of intestinal duplication has not been established. Several theories have been put forward to explain different types of duplications. Some of these duplications are large sized and giant, and only 4 cases have been reported.A 4-year-old girl was referred to our hospital with a history of abdominal pain, abdominal distension, and diarrhea mixed with black blood for 20 days. Technetium-99m scintigraphy identified heterotopic gastric mucosa at the middle and lower abdominal region. Enteric duplication was suspected.Operatively, duplication was found to be located at the ileum with abnormal hypertrophy in shape, 50 cm of the ileum was resected, and an ileoileal end-to-end anastomosis was made. Stomach-like mucosa and some ring structures were identified instead of the normal intestinal mucosa when opening this ileal duplication. Microscopically, most of mucosa showed gastric corpusfundic glands.This is an unusual case of enteric duplication. Ultrasonography, computed tomography and technetium-99m scintigraphy are helpful in the diagnosis of duplication.

Eosinophilic granuloma is characterized by single or multiple skeletal lesions occurring predominantly in children, adolescents, and young adults, it accounts for 70% of Langerhans cell histiocytosis. The common sites are the skull, mandible, ribs, spines, and long bones particularly the femur and the humerus. Thoracic rib involvement is rarely seen. It was often regarded as malignant soft tissue tumor. We report an unusual case of eosinophilic granuloma in a female child presented with a solitary lesion at the thoracic rib.

Castleman disease is a rare benign lymph node hyperplasia usually presenting as an asymptomatic mediastinal mass in children. It can present at any extrathoracic site where there is lymphoid tissue. The sites include retroperitoneum, mesentery, axilla, and pelvis. Mesenteric Castleman disease is very rare in children.

The present study investigated the effects of acutely administered dihydroetorphine on mitogen-stimulated lymphocyte proliferation and lymphokine production in mice. These immune functions were significantly suppressed by dihydroetorphine at 24 microg/kg and 128 microg/kg in a dose-dependent fashion. This study further examined the involvement of micro-opioid receptors and alpha-adrenoceptors in the immunomodulatory effects of dihydroetorphine. The micro-opioid receptor antagonist, naloxone (4 mg/kg), and alpha-adrenoceptor antagonist, phentolamine (10 mg/kg), but not the beta-adrenoceptor antagonist, propranolol (10 mg/kg), effectively blocked dihydroetorphine-induced suppression of splenic lymphocyte proliferation and lymphokine production. These results demonstrate that dihydroetorphine has significant immunosuppressive effects in mice and the mechanisms of these effects may lie in its interactions with opioid receptors and adrenergic pathways.

Background The aim of this study was to evaluate the results of ultrasound (US)-guided hydrostatic reduction (UGSED) of intussusceptions in pediatric patients by saline enema. Methods Five thousand two hundred eighteen pediatric patients with intussusceptions treated by UGSED from October 1985 to October 2002 were reviewed retrospectively. Results The success rate of reduction in 5218 patients was 95.5%. Two hundred thirty-seven patients (4.5%) underwent surgery. Colonic perforation occurred in 9 patients (0.17%). Two infants suffered from milk aspiration because of vomiting during the hydrostatic enema reduction. There was no mortality. Conclusions UGSED of intussusceptions avoids radiation exposure. It is reliable and safe. It has high success rate and minimal complications. It is a perfect method for the nonoperative treatment of pediatric intussusception and can be widely used as routine therapy.

A 4-year-old girl was admitted with a history of abdominal pain for 10 days. Abdominal US showed a large solid mass with homogeneously increased echogenicity. Contrastenhanced CT showed a large, well-defined multilocular mass of largely fat density with enhancing septa occupying most of the abdominal cavity (Fig. 1). Microscopically, the tumor was made up of lobules of mature and immature fat cells and typical lipoblasts with large, atypical and vacuolated nuclei, confirming the diagnosis of a mesenteric lipoblastoma (Fig. 2). Lipoblastoma arising in the mesentery is extremely rare. Although preoperative imaging might be useful to assess the extent of disease and aid in planning surgical resection, it is of little help in differentiating lipomatous tumors [1, 2].

Objectives Wilms tumor (WT) is one of the most common solid tumors in children. It also is the most frequent tumor found in the kidneys. In 5% of cases, it affects both kidneys simultaneously. Extrarenal WTs are extremely rare. The diagnosis of extrarenal WT is almost always made after surgical intervention. The tumor can be located in the retroperitoneum, uterus, cervix, testes, skin, and even the thorax. Methods We report on a 3-year-old girl with an extrarenal WT located in the presacral region. Results The exact mechanism whereby a WT occurs in extrarenal tissues is unknown. The presence of ectopic metanephric blastema cells or the WT gene causing transformation of extrarenal primitive mesonephric or pronephric remnants into WT have both been considered in the embryogenesis. Although imaging examinations are helpful in the definition of retroperitoneal tumors, no characteristic findings are available to diagnose an extrarenal WT before surgery. Conclusions As a rule, the diagnosis of extrarenal WT is made after surgery. Surgical excision is the treatment of choice and the same general therapeutic rules should be followed as when the kidney has been affected. The use of Stage III guidelines for chemotherapy and radiotherapy are appropriate for these patients.

To estimate the clinical and pathological features of pancreatic solid cystic papillary tumor (SCPT) in children.From 2000 to 2005, 8 cases with SCPT of the pancreas were analyzed retrospectively. All cases but one were females. Average age was 12.8 years. By case review, we discussed the clinical and pathological features of SCPT in children.The chief complains were abdominal pain and palpable mass. There were 3 cases in the head, 1 case in the body, and 4 cases in the tail of pancreas. The procedures employed included local resection (1 case), distal pancreatectomy (5 cases), pancreaticoduodenectomy (1 case), and biopsy (1 case). Histological examination showed solid with cystic areas and papillary protrusions in the 8 cases; as for immunohistochemical examinations, the positive rate was 100% for alpha-antitrypsin (AACT), 87.5% for vinmentin, and 62.5% for neuron-specific enolase (NSE). The patients were followed up for 2 months to 4 years but one was lost by follow-up and all were alive postoperatively. SCPT in 2 cases relapsed.Occurring predominantly in young females, SCPT is usually curable by surgical resection with a favorable prognosis.

To investigate the diagnosis and therapy of mediastinal enterogenous cysts in children.Clinical data of 17 cases with mediastinal enterogenous cysts within 19 years in our hospital were retrospectively analyzed.One case was intramural esophageal cyst and 16 cases were enteric cysts, two among which were complicated with abdominal enteric duplications. Most cases presented with symptoms of respiratory distress. Twelve cases were complicated with vertebral anomalies. Ultrasound of 12 cases and magnetic resonance imaging of 4 cases were helpful in confirming the cystic nature of these lesions. Eight cases had technetium-99m pertechnetate scintigraphy of posterior mediastinum.Most patients present with symptoms of respiratory distress, complicated with vertebral anomalies. Ultrasonography and magnetic resonance imaging may be helpful in confirming the cystic nature of these lesions. Technetium-99m pertechnetate scintigraphy is the most effective method for differentiation of the disease from other mediastinal cysts.

Solid cystic papillary tumor (SCPT) of the pancreas in children is rare with limited references of its clinical features and treatment. Therefore, to estimate the clinicopathologic features of SCPT of the pancreas in children is necessary.Clinical data of 8 children with pathologically confirmed SCPT of the pancreas, treated from 2000 to 2005 with surgery, were analyzed retrospectively. The clinicopathologic features were analyzed with literature review.All patients were girls but one, with the average age of 12.8 years. The chief complaints were burbulence, abdominal pain, and palpable mass. The tumors were mainly located in the head or tail of the pancreas. Of the 8 patients, 1 received local resection, 5 received distal pancreatectomy, 1 received pancreatico-duodenectomy, and 1 received only biopsy. Seven patients were followed-up for 2 months to 4 years and were still alive; 2 patients suffered recurrence. All cases showed solid with cystic areas and papillary protrusions. Immunohistochemically, the positive rates were 100% for alpha-antitrypsin, 87.5% for vinmentin, and 62.5% for neuron-specific enolase.SCPT of the pancreas occurs predominantly in young girls, and its pathogenesis is still unknown. Surgical resection is usually curative, and the prognosis is good.

The immunomodulatory effects of dihydroetorphine were systematically investigated in subchronically treated mice. In a dose-dependent fashion, dihydroetorphine (total doses at 444.5, 889 and 1778 μg/kg) lowered the increase of body weight, decreased the weight of the spleen and thymus, weakened the delayed-type hypersensitivity, reduced the generation of antibody-forming cells, inhibited splenic lymphocyte proliferation induced by concanavalin A and lipopolysaccharide, suppressed the production of interleukin-2 in the supernatant of splenocytes induced by concanavalin A, and depleted the ratio of CD4 + and CD8 + subpopulations. Moreover, the physical dependence on dihydroetorphine was also evaluated to confirm that the immunosuppression was concomitant with the addiction to the drug. These results demonstrate that subchronic treatment with dihydroetorphine dose dependently suppresses both humoral and cell-mediated immune function, and that the immunosuppressive effects of dihydroetorphine are much more potent than those of morphine.