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Children who have undergone splenectomy may develop impaired immunologic function and heightened risk of overwhelming postsplenectomy infection. We sought to define the long-term rate of and risk factors for postsplenectomy sepsis. We leveraged the Military Health System Data Repository, a nationally representative claims database including > 3 million children registered as dependents of members of the United States Armed Services (2005–2014). Inclusion criterion was splenectomy at age 18 years or prior. The primary outcome was hospitalization for sepsis. Among 195 children who underwent splenectomy, 7% (n = 13) were hospitalized with sepsis, with an incidence of 1.8 (95% CI = 1.0-3.1) events per 100 person-years. The median time to sepsis was 224 days (IQR = 109–606) and 38% (5/13) of events occurred within the first postsplenectomy year. The postsplenectomy mortality rate was 1% (n = 3). After adjusting for underlying diagnosis, older age at splenectomy (HR = 0.90 per year, 95% CI = 0.81–0.99) was associated with decreased hazard of sepsis. In a contemporary national cohort, the prevalence of postsplenectomy sepsis was 7% (1.8 events per 100 person-years). Although most presented during the first year after splenectomy, many (62%) sepsis events occurred later, suggesting that postsplenectomy immunologic dysfunction persists beyond one year. The immunologic consequences of asplenia must continue to be acknowledged, as postsplenectomy sepsis remains a serious concern. Prognosis study. Level III. [ABSTRACT FROM AUTHOR]

The article discusses the study on requiring chest X-ray after central venous line placement in children. Chest X-ray is reportedly used to confirm the catheter tip's location and identify complications of line placement, however the practice started at a time when the lines were placed without fluoroscopic guidance. The results revealed that chest X-ray is unnecessary after fluoroscopically guided central venous line placement,

Sanchez S, Javid P, Ricca R, Avansino J. Colocolonic intussusception in a four-yr-old with a heart transplant: A case report and review of the literature. Pediatr Transplantation 2011. © 2011 John Wiley & Sons A/S. Abstract: A rare case of a colocolonic intussusception in a pediatric cardiac transplant patient is reported along with a review of colocolonic intussusception in pediatric patients after organ transplantation. A four-yr-old girl with a history of heart transplantation shortly after birth presented with a 12-hour history of abdominal pain, vomiting, and bloody stools. Initial abdominal x-ray showed rectal edema. A rectal examination revealed a palpable intussusceptum that prompted a therapeutic contrast enema, which failed to reduce the intussusception. Surgical exploration was performed with reduction of the intussusception and resection of the terminal ileum and cecum. A pathologic lead point was not identified. [ABSTRACT FROM AUTHOR]

Abstract: Transmesenteric hernia is a rare cause of intestinal obstruction most commonly affecting the small bowel. The mesenteric defect is usually 2 to 3 cm in diameter. The authors describe 2 cases of young pediatric patients presenting with bowel obstruction resulting from a congenital mesenteric defect. The initial patient had a 30-cm-wide congenital defect in the ileal mesentery through which the sigmoid colon and some loops of small bowel had herniated. The second patient is a newborn infant who presented with symptoms and radiographic evidence of proximal bowel obstruction initially thought to be resulting from malrotation with midgut volvulus but was found at surgical exploration to have a small defect in the ileal mesentery. [Copyright &y& Elsevier]