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BACKGROUND The presence of heterotopic tissue in Meckel's diverticulum (MD) increases the incidence of future complications. Based on this concept, this study aimed to detect clinical and morphological parameters able to predict the probability of heterotopy in incidentally discovered uncomplicated MD and to develop a risk-based classification tool. METHODS The clinical records of 146 patients who underwent MD resection were reviewed. MD complications (bleeding, inflammation, perforation or involvement in pathological processes such as intussusception) and MD dimensions (width, length and the product width × length) were evaluated in association with heterotopy. Regression analysis was used to explore the discrete effect of clinically relevant parameters, which were subsequently combined in a Classification and Regression Tree. RESULTS The probability of heterotopy was higher in complicated MDs. The width of the base of the MD and the product width × length were also significant predictors of heterotopy. A stepwise combination (Classification and Regression Tree model) of (i) uncomplicated macroscopic presentation, (ii) width

Perforation of the vermiform appendix in a septic neonate with an Amyands hernia resulted in the formation of a scrotal enterocutaneous fistula. In conclusion from this exceptional complication, active parental awareness for any neonatal scrotal swelling is required, and an early operative policy for the neonatal inguinal hernia is significant.

A double jejunoileal fistula was diagnosed intraoperatively 10 months since a 4-year-old boy had swallowed an object consisted of multiple magnetic items. Magnet ingestion presents characteristics that are misdiagnosing, critical time-consuming, dangerous, and occasionally fatal. The particularities and pitfalls of ingested magnetic items are outlined.

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SummaryPerforation of the vermiform appendix in a septic neonate with an Amyand's hernia resulted in the formation of a scrotal enterocutaneous fistula. In conclusion from this exceptional complication, active parental awareness for any neonatal scrotal swelling is required, and an early operative policy for the neonatal inguinal hernia is significant.

OBJECTIVE: Minimally invasive operations, such as laparoscopic cholecystectomy and adrenalectomy, result in a more rapid recovery of normal function, less physiological disturbances and less stress to the organism than similar open operations. The purpose of this study was to determine the stress response associated with minimally invasive abdominal surgery compared to conventional small or large incision laparotomy. METHODS: We compared the responses of the stress hormones cortisol and the catecholamines adrenaline and noradrenaline to elective conventional and laparoscopic cholecystectomy and unilateral adrenalectomy in male pigs. Blood samples were taken from all animals at the same time, one day before surgery, at the beginning of the operation, every 15 minutes during surgery and on the first postoperative morning. RESULTS: Plasma adrenaline and noradrenaline concentrations were significantly lower in both cholecystectomies (p

Umbilical hernia is a common benign condition which resolves spontaneously during the first five years of life. However, in certain cases there are some characteristics which may be indicative of a different prognostic approach, as they increase the possibility of complications. The two cases of umbilical hernia that we describe here were treated operatively and revealed the presence of strangulated and adhered omentum, respectively. Reflecting on the adhesive properties of the omentum, we hypothesized that this may occur more often than it is believed, especially in those cases that are described as recurrent symptomatic herniations. In such cases, there should be increased alert for the possibility of complications during the period of the conservative expectance for resolution.

Foreign body self-insertion into the urethra is an uncommon paraphilia. Variety in object form, motivation, clinical presentation, complications, and treatment options is a rule. In childhood it is very rare, and it is attributed to curiosity or mental disorders so far. However, the internet impact on daily life of all age groups has created a new category of sexual behavior in childhood and adolescence, the “internet induced paraphilia.” Such is the case of an electrical cable inserted in the urethra of a 12-year-old boy reported here, which is representative of this kind of impact.

Congenital midline cervical cleft is a very uncommon malformation of the anterior neck, with less than 100 cases reported in medical literature. Herein we present a case of a female neonate with this anomaly. A detailed description of the macroscopic and microscopic characteristics is performed. As it is derived from the natural history of the lesion, prompt clinical diagnosis, and operative treatment during early infancy predispose to a better aesthetic and functional prognosis.