La Pediatria Medica e Chirurgica 2018-12-11T07:46:41+01:00 Francesca Baccino Open Journal Systems <p><strong>La Pediatria Medica e Chirurgica&nbsp;</strong>(Medical and Surgical Pediatrics) publishes original papers in the field of basic science, clinical and laboratory research pertinent to medical and surgical pediatrics.</p> <p>In addition to Original Articles, <strong>La Pediatria Medica e Chirurgica&nbsp;</strong>(Medical and Surgical Pediatrics) welcomes Editorials (on invitation), Brief Reports, Letters to the Editor and Book Reviews as well. All manuscripts are critically assessed by external and/or in-house experts in accordance with the principles of peer review. Manuscripts must be written in English or Italian.</p> Hypoceruloplasminemia: an unusual biochemical finding in a girl with Hashimoto's thyroiditis and severe hypothyroidism 2018-12-11T07:46:29+01:00 Mariella Valenzise Federica Porcaro Giuseppina Zirilli Filippo De Luca Maurizio Cinquegrani Tommaso Aversa <p>Clinical picture of Hashimoto’s thyroiditis (HT) may significantly vary in pediatric age, ranging from euthyroidism to subclinical hypothyroidism or hyperthyroidism; only rarely HT presentation may be characterized by a severe hypothyroidism also in pediatric age. Here we describe a 3-year-old Caucasian girl who was admitted to our Clinic due to pericardial effusion, muscle weakness and weight gain. At clinical examination, she presented with bradycardia, pale and round face, pseudohypertrophy of calf muscles and no pitting edema of the limbs. Routine blood investigations showed high serum aspartate and alanine aminotransferase levels, low serum ceruloplasmin without clinical signs of Wilson’s disease, dyslipidemia. Thyroid function tests revealed a picture of severe hypothyroidism associated with HT. After the replacement treatment with L-T4, thyroid-stimulating hormone serum levels gradually decreased, with concomitant resolution of pericardial effusion and normalization of ceruloplasmin levels.</p> 2018-12-05T09:50:08+01:00 ##submission.copyrightStatement## Robot-assisted resection of gastric duplication cysts in a child: a detailed case report 2018-12-11T07:46:30+01:00 Riccardo Rizzo Gabriele Lisi Nino Marino Giuseppe Lauriti Dacia Di Renzo Pierluigi Lelli Chiesa <p>Gastric duplication cysts (GDCs) represent 4-9% of alimentary tract duplications. Early diagnosis and surgical excision are essential to avoid morbidity or neoplastic degeneration. Roboticassisted excision of GDCs has never been described in childhood. We report an asymptomatic male patient with 2 gastric cystic masses at ultrasonography (US)-study (diameter 25mm and 8mm), increasing in size at follow-up. At 20 months of age, magnetic- resonance-imaging-scan confirmed 2 round gastric masses (44×35mm and 16×12mm, respectively). Two months later, an elective robotic-assisted excision of GDCs was completed without complications. The patient was discharged at day 6 after procedure. Histology confirmed the diagnosis of GDCs. At a 2-year follow- up, US-study did not evidence any issue. In this first reported case of robotic-assisted cystectomy for CGD in childhood, the procedure seems safe, effective, and feasible. This approach improves the movements of the surgical instruments with better 3- D visualization in comparison with the laparoscopic approach.</p> 2018-12-04T11:16:12+01:00 ##submission.copyrightStatement## The isolated tubal torsion: an insidious pediatric and adolescent pelvic urgency 2018-12-11T07:46:31+01:00 Carmine Noviello Mercedes Romano Alfonso Papparella Andrea Ciavattini Ascanio Martino Giovanni Cobellis <p>Isolated tubal torsion (ITT) is a rare cause of acute abdominal pain. Preoperative diagnosis is difficult because of a lack of specific signs. Surgery is recommended to preserve the integrity of the tube. Seven patients of median age of 13 years (range 9 to 15) came to our observation for worsening abdominal pain, nausea and vomiting. On admission, all girls had blood tests and ultrasound. Laparoscopy was performed for diagnosis in all cases. The girls had one-month and one-year ultrasound and clinic follow up. In all cases diagnosis was delayed, median 66 hours after the onset of symptoms and laparoscopy showed necrosis of the Fallopian tube. In five girls a laparoscopic salpingectomy was performed. In the other two, an open salpingectomy was necessary because of pelvic adhesions. Histology showed a hemorrhagic infarction of the Fallopian tubes. At follow up all patients were asymptomatic with normal ovaries, but one ovarian cyst. In the differential diagnosis of acute abdominal pain in children or female adolescents the possibility of ITT should be considered for a conservative treatment. Laparoscopy allows for definitive diagnosis and treatment.</p> 2018-12-04T11:05:58+01:00 ##submission.copyrightStatement## Pseudoarthrosis of second metatarsal fracture 2018-12-11T07:46:31+01:00 Jessica Zanovello Barbara Bertani Redento Mora Gabriella Tuvo Mario Mosconi Luisella Pedrotti <p>Metatarsal fractures make up the greatest portion of foot fractures in children. Most of them are treated with closed reduction and non-weightbearing cast immobilization.Usually, these fractures heal uneventfully and delay union and pseudoarthrosis are rare. We report a case of a 10-year-old child with non-union of the second metatarsal following a traumatic fracture, caused by an accident 10 months before, and treated successfully by osteosynthesis with plate and screws. Good clinical outcome was achieved at 2 years follow-up.</p> 2018-10-19T15:24:56+02:00 ##submission.copyrightStatement## Transscrotal orchidopexy for palpable cryptorchid testis: follow-up and outcomes 2018-12-11T07:46:38+01:00 Alfonso Papparella Giovanni Cobellis Laura De Rosa Carmine Noviello <p>We retrospectively reviewed the results of transscrotal orchidopexy in the surgical management of palpable testis. From January 2014 to June 2017, 130 male children with a total of 140 palpable undescended testes (UDT) underwent transscrotal orchidopexy. The charts were retrospectively reviewed for demographic data, preoperative position and mobility of the testis, patency of the peritoneal vaginal duct (PVD), and post-operative complications. The resting position of the testis and its traction towards the scrotum were assessed before surgery and under anaesthesia. The mean age of the patients was 4.6 years. The position of the testis assessed at surgery was in most cases at the external inguinal ring (62.8%), at the neck of the scrotum (15.7%), in the inguinal canal (12.8%), or in an ectopic position (8,5%). A PVD was found in 66 testes (47.1%). Two surgical cases required an inguinal incision. In each patient, the postoperative course was unremarkable. The testicle at 1-year follow-up was in a scrotal position in 134 cases, but 6 patients required a second surgical intervention for re-ascent of the testis. No testicular atrophy or inguinal hernias were observed. Transscrotal orchidopexy is a simple and effective procedure for the treatment of palpable UDT. The incidence of complications is low and manageable, with rapid postoperative recovery and early resumption of normal activities.</p> 2018-10-03T11:59:45+02:00 ##submission.copyrightStatement## Clinical side effects after oral administration of palm oil and Alchornea cordifolia decoction in a child 2018-12-11T07:46:38+01:00 Paulo Muntu Bunga Jephté Bambi Nzita Gerry Mubungu Sophie Nyembo Mangaza Nono Joelle Seudjip Michel Ntetani Aloni <p><em>Alchornea cordifolia</em> is known to be a plant with a variety of medicinal properties and is quoted by many traditional healers to treat a variety of medicinal problems in the Democratic Republic of Congo. However, very little is known about its potential toxicity. We report the case of a 9-year-old boy referred for assessment of suspected bronchial troubles without a history of atopic disease or drug allergy who developed dyspnea, dysphagia, asthenia and lingual ulcers within 30 minutes after nasal and oral administration of decoction of palm oil associated with <em>A. cordifolia</em> leaves in water. In the present report, adverse effects of <em>A. cordifolia</em> therapy may be related to the mixtures of active compounds that they contain and can cause the symptoms observed in our patient. These findings call for caution in the use of <em>A. cordifolia</em> especially in children.</p> 2018-09-26T12:08:16+02:00 ##submission.copyrightStatement## Transient femoral nerve palsy in spica cast treatment for developmental dysplasia of the hip 2018-12-11T07:46:39+01:00 Luisella Pedrotti Barbara Bertani Gabriella Tuvo Redento Mora Mario Mosconi Federica De Rosa <p>A 4 months and half female child come to our attention for congenital dislocation of the left hip, previously treated in another hospital with abduction bracing, without satisfactory results. After progressive longitudinal bilateral traction, closed reduction under general anesthesia was performed and a spica cast was applied in the so-called<em> human position</em>. The patients remained in the spica cast for 6 weeks and then the plaster cast was renewed in narcosis for another 6 weeks. Once the second cast has been removed left femoral nerve palsy was detected. Orthopaedic treatment was interrupted and in 3 months the nerve completely recovered, while the hip was still stable. We followed the child regularly since then, she is now five years old, she is totally asymptomatic, X-rays shows a residual acetabular dysplasia, with no sign of avascular necrosis.</p> 2018-09-26T12:00:00+02:00 ##submission.copyrightStatement## Robotic removal of Müllerian duct remnants in pediatric patients: our experience and a review of the literature 2018-12-11T07:46:39+01:00 Mario Lima Michela Maffi Niel Di Salvo Giovanni Ruggeri Michele Libri Tommaso Gargano Hubert Lardy <p>Persistent Müllerian duct syndrome is a disorder of sexual development, which features a failure of involution of Müllerian structures. An enlarged prostatic utricle is a kind of Müllerian duct remnant (MDR) with a tubular shaped structure communicating with the prostatic urethra. Treatment is aimed at relieving symptoms when present, preserve fertility and prevent neoplastic degeneration. We describe 3 cases of successful robot assisted-removal of symptomatic MDRs. The first case came to our attention for pseudo-incontinence; the other two for recurrent urinary tract infections. The patients have not presented such symptoms anymore on follow-up. We then reviewed existent literature on authors who have recently investigated the main issues concerning MDRs and have attempted a roboticassisted approach on them. Robot-assisted laparoscopy can be considered a valid, safe and effective minimally-invasive technique for the primary treatment of prostatic utricle.</p> 2018-05-30T17:33:38+02:00 ##submission.copyrightStatement## Kearns-Sayre syndrome is genetically and phenotypically heterogeneous 2018-12-11T07:46:40+01:00 Josef Finsterer Sinda Zarrouk-Mahjoub <p>Not available.</p> 2018-05-29T11:40:49+02:00 ##submission.copyrightStatement## Torsion of huge epididymal cyst in a 16-year-old boy: case report and review of the literature 2018-12-11T07:46:41+01:00 Cosimo Bleve Maria Luisa Conighi Valeria Bucci Lorenzo Costa Salvatore Fabio Chiarenza <p>Epididymal cysts (ECs) are relatively common in adults, rare in children. Normally their treatment is conservative. They may be situated anywhere in the organ, frequently in the region of the head. Torsion of these cysts is extremely rare in both children and adults, causing acute scrotal swelling. The diagnosis is intraoperative. A 16-year-old boy was referred to our Divisional Clinic by the treating physician for scrotal swelling appeared 4 months earlier. Absence of a history of minor scrotal trauma. Ultrasonography showed a 40×50 mm fluid-filled right para-testicular mass. We performed surgery finding a large black cyst connected to the head of the epididymis with 720°-degrees rotation. Histology revealed an acquired EC. The particularity of our case is due to the absence of symptoms in association with a big EC twisted of 720° degrees. This is the only case reported in literature. All patients with EC torsion reported presented symptoms related to acute scrotum.</p> 2018-05-29T11:22:03+02:00 ##submission.copyrightStatement##