Child, Preschool ; Embolism ; complications ; physiopathology ; Humans ; Male ; Mediastinal Emphysema ; etiology ; Pulmonary Atelectasis ; etiology ; Sputum ; physiology ; Subcutaneous Emphysema ; etiology

Child, Preschool ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; complications ; virology ; Male ; Mediastinal Emphysema ; etiology ; Subcutaneous Emphysema ; etiology

OBJECTIVETo investigate the clinical characteristics and treatment strategies of severe complications induced by esophageal foreign bodies.

METHODSThe clinical data of 44 patients with severe complications of esophageal foreign bodies treated from July 2004 to July 2014 were retrospectively analyzed. The type of complications was recorded.

RESULTSThe ratio of severe complications in patients with esophageal foreign bodies was 9.05% (44/486). The most common type of foreign body was animal bone, with a total of 34 cases (77.3%); Onset of the disease were 2-40 days, mostly above 6 days, accounting for 61.4%. Severe complications of esophageal foreign bodies included 16 cases (36.3%) of simple esophageal perforation or combined with esophageal regional inflammation, 14 cases (31.8%) of cervical abscess, 7 cases (15.9%) of abscess around esophagus, 3 cases (6.8%) of mediastinal abscess, one case (2.3%) of cervical subcutaneous emphysema, one case of tracheoesophageal fistula, one case (2.3%) of aortic fracture, and one case (2.3%) of subclavian artery pseudoaneurysm. Among the 44 patients with severe complications, 40 patients (90.9%) were cured and 3 patients (6.8%) died. One case didn't receieve treatment.

CONCLUSIONSOccurrence of the severe complications induced by esophageal foreign bodies is closely related to the type of foreign bodies and time before presentation. Early diagnosis and prompt treatments for esophageal foreign bodies are crucial for preventing of severe complications.

Abscess ; etiology ; Esophageal Perforation ; etiology ; Foreign Bodies ; complications ; pathology ; Humans ; Neck ; pathology ; Retrospective Studies ; Subcutaneous Emphysema ; etiology ; Tracheoesophageal Fistula ; etiology

Hearing Loss, Sudden ; therapy ; Humans ; Hyperbaric Oxygenation ; adverse effects ; Male ; Middle Aged ; Neck ; Subcutaneous Emphysema ; etiology

One case of pneumoscrotum associated with spontaneous colon perforation was reported. The patient was a 66-year-old man, presented with high temperature, mild abdominal pain and an enlarged scrotum. Physical examination revealed scrotal swelling, abdominal tenderness Case Report and muscular defense. Computed tomography (CT) of the abdomen showed swelling and pneumatosis of the left major psoas and iliopsoas muscles, and ultrasound found subcutaneous emphysema of the scrotum. Surgical investigation discovered a retroperitoneal perforation in the descending colon connected with a huge retroperitoneal vomica and scrotal sac. Spontaneous colon perforation induced pneumoscrotum is rare clinically. It may present as colon perforation, which calls for special attention.
Aged ; Colonic Diseases ; complications ; Genital Diseases, Male ; etiology ; Humans ; Intestinal Perforation ; complications ; Male ; Scrotum ; Subcutaneous Emphysema ; etiology

Pneumomediastinum and subcutaneous emphysema generally occurs following trauma to the esophagus or lung. It also occurs spontaneously in such situations of elevating intra- thoracic pressure as asthma, excessive coughing or forceful straining. We report here on the rare case of a man who experienced the signs of pneumomediastinum and subcutaneous emphysema after a prolonged bout of intractable hiccup as the initial presenting symptoms of multiple sclerosis.
Adult ; Brain/pathology ; Hiccup/*complications/etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Mediastinal Emphysema/*etiology/radiography ; Multiple Sclerosis/*complications/diagnosis ; Subcutaneous Emphysema/etiology ; Thoracic Vertebrae/pathology ; Tomography, X-Ray Computed

OBJECTIVETo analyze the diagnosis, treatment and prognosis of spontaneous pneumomediastinum (SPM) in children.

METHODA retrospective analysis of the clinical data of 18 children diagnosed with SPM in Yuying Children's Hospital Affiliated to Wenzhou Medical University from December 2007 to February 2013 was performed. Information of the sequelae and recurrence of SPM was obtained by telephone follow-up. SPM was diagnosed according to Versteegh's standard. SPM cases due to mechanical ventilation, trauma, inhaled foreign body or as a result of the underlying disease were not included. Also cases of secondary pneumothorax pneumomediastinum and neonatal mediastinal emphysema were excluded.

RESULTFifteen of 18 cases were boys and 3 were girls, the range of age was from 9 to 17 years. Predisposing factors included sport activities, severe cough or without a known cause. Clinical manifestations included chest pain, chest tightness, dyspnea, neck pain, back pain, foreign body sensation or pain on swallowing, throat pain of swelling. Chest CT of 18 cases showed pneumomediastinum, 8 cases displayed varied degrees of air in neck, chest; 18 cases of SPM responded well to bed rest, oxygen, antitussive and anti-infection treatment. Fifteen cases received chest CT or X-ray inspection after therapy, showing that the pneumomediastinum disappeared or significantly absorbed, 3 cases improved in clinical symptom. Among 18 patients, telephone follow-up of 14 were successful and 4 cases were lost. An average follow-up time was (24 ± 17) months. None of the cases had any serious consequences, and recurrence happened in one case.

CONCLUSIONChildren's spontaneous pneumomediastinum is a benign disease. When a child has chest pain or chest tightness, SPM should be considered after excluding the common diseases. SPM can be diagnosed in association with clinical feature and chest CT examination. Patients respond well to conservative therapy and most of them had no severe sequelae.

Adolescent ; Chest Pain ; diagnosis ; etiology ; Child ; Dyspnea ; diagnosis ; etiology ; Female ; Follow-Up Studies ; Humans ; Male ; Mediastinal Emphysema ; complications ; diagnosis ; therapy ; Oxygen Inhalation Therapy ; Prognosis ; Radiography, Thoracic ; Recurrence ; Subcutaneous Emphysema ; diagnosis ; etiology ; Tomography, X-Ray Computed

The aim of this study was to assess the feasibility and efficacy of laparoscopic myomectomy (LM) for large myomas. A subpopulation of 51 patients with myomas 8 cm or larger in diameter was selected from 155 patients who underwent LM at Kangbuk Samsung Hospital from July 2003 to November 2006. The mean age of the patients was 34.9+/-5.6 yr, mean parity was 0.6+/-0.9, and 8 patients had a previous operative history. The most common operative indication was a palpable abdominal mass (24 patients, 47%). The mean operating time was 85.6+/-38.9 min, and the mean diameter of the largest myoma was 9.3+/-1.8 cm. The mean change in hemoglobin concentration was 2.1+/-1.2 g/dL. Histopathological diagnosis included 49 patients of leiomyoma (96.1%) and 2 patients of leiomyoma with adenomyosis (3.9%). Postoperatively, a transfusion was done in 7 patients, and a case of subcutaneous emphysema was noted. None of the operations was switched to laparotomy. With the newly-developed screw and the port placement system that was modified from the Choi's 4-trocar method to obtain better surgical vision, LM of large myomas proved to be one of the efficient and feasible methods.
Adult ; Feasibility Studies ; Female ; Humans ; Laparoscopy/adverse effects/*methods ; Leiomyoma/pathology/*surgery ; Length of Stay ; Postoperative Complications/etiology ; Reproducibility of Results ; Subcutaneous Emphysema/etiology ; Treatment Outcome ; Uterine Neoplasms/pathology/*surgery

ObjectiveTo compare the clinical effect of transumbilical single-port laparoscopy combined with improved double hernia needles with that of traditional open surgery in the treatment of hydrocele in children.

METHODSWe retrospectively analyzed 35 cases (54 sides) of pediatric hydrocele treated by transumbilical single-port laparoscopy combined with improved double hernia needles (laparoscopy group). We recorded the operation time, intraoperative blood loss, hospital stay, scrotal edema, and postoperative complications and compared them with those of another 46 cases (58 sides) treated by traditional open surgery (open surgery group) during the same period.

RESULTSThe laparoscopy group showed a significantly shorter operation time, less intraoperative blood loss, milder scrotal edema, and fewer hospital days than the open surgery group (all P<0.05). However, no statistically significant difference was found in the incidence of postoperative complications between the two groups (P>0.05). Subcutaneous emphysema developed in 2 patients in the laparoscopy group, which disappeared after 1－3 days of oxygen inhalation and other symptomatic treatment, while scrotal hematoma occurred in 1 and incision fat liquefaction in 2 patients in the open surgery group 3 days postoperatively, which healed after debridement suture and daily dressing, respectively. The patients were followed up for 3－6 months, which revealed no late complications in the laparoscopy group but 1 case of unilateral recurrence and 2 cases of offside recurrence in the open surgery group, all cured by laparoscopic internal ring ligation.

CONCLUSIONSTransumbilical single-port laparoscopy combined with improved double hernia needles is superior to traditional open surgery for the treatment of pediatric hydrocele and therefore deserves clinical generalization.

Blood Loss, Surgical ; Child ; Edema ; diagnosis ; Female ; Humans ; Laparoscopy ; instrumentation ; methods ; Length of Stay ; Ligation ; Male ; Needles ; Operative Time ; Postoperative Complications ; diagnosis ; surgery ; Postoperative Period ; Recurrence ; Retrospective Studies ; Scrotum ; Subcutaneous Emphysema ; etiology ; Testicular Hydrocele ; surgery ; Umbilicus