Search

Introduction. Studies regarding antibiotics administration during pregnancy and atopic dermatitis (AD) in children are only few. In this context, the objective of our study was to investigate the potential association between the timing of intrauterine exposure to antibiotics or prenatal antibiotic administration in general and AD occurrence in children.

Introduction: Splenic hemangiomas are benign vascular lesions with potential for severe complications such as rupture and bleeding. The optimal management of these lesions remains controversial, and appropriate management requires careful evaluation of each individual case. Usually, they are less than 2 cm in diameter and have a specific vascular pattern in Contrast-enhanced ultrasonography (CEUS). The aim of this case study is to illustrate the management of a 70 years old patient with a splenic gigantic focal lesion and to underscore the importance CEUS in describing the vascular pattern. Case Report: We present the case of a 70-year-old man with a history of ischemic nephropathy, right renal artery stenting, coronary heart disease, and systemic arteriosclerosis, who has been monitored for 3 months. Patient also had a traumatic event more than 10 years ago. At ultrasound (US) examination, there was a normal vascular pattern in the renal arteries but a huge lesion was found in the spleen. CEUS and CT scan confirmed the benign character of the lesion. Discussions : Patient US examination of the abdomen revealed no signs of restenosis at the renal arteries, with a reno-aortic index below 2, and normal acceleration time within both kidneys. Though, in the spleen, a 9.7 cm inhomogeneous lesion was found, more hyperechogenic than the normal spleen tissue, with transonic areas inside, rising the suspicion of a malignant tumor. We used a performant Esaote Mylab9 equipment that allows the microvascularization (microV) and the CEUS examination. There was a late enhancement within the lesion, and a persistence of the contrast agent more than 3 minutes after 1.6 ml of SonoVue bolus injection, that corresponds with a benign pattern. Because of a normal renal function, contrast-enhanced CT scan was performed and the diagnosis was confirmed. Splenic hemangiomas are benign tumors usually les than 2 cm in diameter, but in our case a more complex focal lesion was found. The vascular patters confirmed the hemangioma, although an organized hematoma was initially suspected. Conclusions: We emphasize that a complex splenic lesion can have a benign character, highlighting the need for a multiparametric imaging approach in patient's management. The quantification of the vascularization provided vital insights for identifying the benign pattern of the microvascularization. This integrated approach and ongoing patient assessment are essential for effective and comprehensive case management. [ABSTRACT FROM AUTHOR]

Introduction: Iron-deficiency anemia is a prevalent hematological condition in children, characterized by low hemoglobin levels often caused by inadequate iron intake or blood loss. However, there are cases where anemia persists despite adequate iron therapy, being classified as iron-refractory feriprival anemia. The objective of this case report is to highlight the crucial role of a rigorous diagnostic approach in the management of refractory iron-deficiency anemia in children, focusing on identifying the underlying cause. Case Report: We present the case of a 10-year-old boy diagnosed with autism spectrum disorder and iron deficiency anemia for approximately 2 years, who underwent oral iron therapy without any improvement. The patient presents with severe normochromic, normocytic anemia, elevated ferritin levels, as well as increased inflammatory markers (ESR, C-reactive protein). Suspicion of malabsorption arises, as the patient was tested negative for Helicobacter pylori infection and celiac disease, but elevated calprotectin levels were discovered. Subsequent findings raise suspicion of an inflammatory bowel disease. Also, antinuclear antibodies (ANA) were tested and found to be at the upper limit of normal. Following this, the patient was scheduled for a colonoscopy; however, prior to the procedure, a test for Clostridium difficile was conducted, yielding a positive result. Discussions : These findings led to the suspicion of an inflammatory bowel disease, potentially underlying the refractory iron-deficiency anemia in this patient. The importance of a meticulous diagnostic approach is highlighted, focusing on identifying the underlying cause to ensure appropriate management and prevent potential complications. Conclusions: This case exemplifies the critical role of meticulous diagnostic investigations in elucidating the complex etiology of refractory iron-deficiency anemia in pediatric patients. Despite initial therapeutic efforts targeting iron deficiency, the persistent anemia prompted a comprehensive diagnostic workup, revealing potential underlying factors such as malabsorption and inflammatory bowel disease. [ABSTRACT FROM AUTHOR]

Introduction: Small bowel volvulus(SBV) is the torsion of the small bowel and its mesentery, and it is a medical emergency. It is categorized as primary or secondary type. Primary SBV is defined as torsion of a segment of the small bowel at the mesentery basis without any evident underlying cause; secondary SBV occurs in the presence of an acquired condition, such as congenital malrotation, postoperative adhesions, and diverticular disease. Case Report: In this paper, we present the case of an 80-year-old male patient who came to the emergency department with diffuse abdominal pain, nausea, and vomiting. From the personal pathological history, we note the cholecystectomy in 2009, hypertension, and peripheral polyneuropathy. The objective examination revealed a distended abdomen, above the xipho-pubic plane, very sensitive at palpatory examination. Abdominal CT examination revealed intestinal jejunal loops depleted of semifluid content with a luminal diameter of 3 cm and only minimal aerial content, sketching 2 small hydroaeric levels; diverticulums on a small segment of the jejunum, and multiple colonic diverticulosis throughout. It was decided that the patient needed medical-surgical care. The surgical intervention began with exploratory laparotomy followed by the sectioning of the bridle that was caused by post-operatory adhesions. The adhesions contributed to the formation of SBV. Since the intestine was viable detorsion was needed. During the intervention, a compact foreign body of spherical shape was discovered in the small intestine and removed. The foreign body revealed itself after extraction as chicken bones. Discussions : The fibrous adhesions may have originated from previous surgery and/or inflammation induced by the multiple diverticulum found along the patient's bowel. The adhesion bands caused obstruction in the small bowel and promoted the unusual formation of the mass of bones that fortunately did not perforate the intestine. Clinical presentation of volvulus is usually nonspecific unless an acute small bowel obstruction occurs, which in this case was most likely caused by the foreign body. Conclusions: In summary, we presented a case of small bowel volvulus that may be categorized as the secondary type. Early surgical treatment is essential for small bowel volvulus and we should raise suspicion for small bowel volvulus when a patient displays symptoms such as upper abdominal pain, vomiting, and tenderness. [ABSTRACT FROM AUTHOR]