Complications of Whipple procedure in a pediatric patient with pseudopapillary tumor of the pancreas

Pancreatic neoplasms are rare in pediatrics; the pseudopapillary tumor (PPT) of the pancreas is the most common. PPTs of the pancreas are usually located in the head of the pancreas. A pancreaticoduodenectomy or Whipple procedure is the technique of choice for the treatment of benign or malignant pancreatic tumors. Although mortality for this cause has decreased in recent years, due to the greater experience of surgeons and improved pre- and postoperative care, morbidity has remained high secondary to associated complications. These include delayed gastric emptying, intra-abdominal collections, pancreatic fistula, surgical site restenosis, and post-pancreatectomy hemorrhage. Here we describe the clinical case of a 13-year-old girl diagnosed with PPT of the pancreas who underwent an effective surgery in terms of cancer treatment, but who required a prolonged hospitalization secondary to surgical complications.

[Ring-sling complex association with pig bronchus: a pediatric case report]

The ring-sling complex is an association between pulmonary artery sling and congenital tracheal stenosis. Pulmonary artery sling is a rare form of vascular ring in congenital heart disease. The clinical case of a child with inspiratory laryngeal stridor associated with respiratory distress is presented, evaluated in another center where respiratory endoscopy was performed, observing extrinsic tracheal compression. Given the clinical suspicion of a vascular ring, CT angiography was requested, confirming the diagnosis of pulmonary artery sling. He was referred to our hospital and during the surgical intervention a new respiratory endoscopy and tracheobronchography were performed, reaching the diagnosis of congenital tracheal stenosis, right accessory bronchus (pig bronchus) and complete vascular rings, both repaired in the same surgical act.

[Marchiafava-Bignami disease]

INTRODUCTION

This paper reviews the literature about Marchiafava-Bignami disease (MBD).

DEVELOPMENT

Recognized since 1903, MBD is a rare condition mainly observed in hardened drinkers and resulting in demyelinization and necrosis of the corpus callosum and, occasionally, adjacent subcortical white matter. The symptomatology is diverse and with magnetic resonance imaging (MRI) is now possible to diagnose this disease on its early stages. The clinical course of MBD is varied and it may be acute, subacute or chronic. Although numerous etiological hypotheses have been proposed the pathophysiology of MBD remains unknown. A few cases have been described in nonalcoholics, demonstrating that ethanol alone is not responsible for the lesions. Neuropsychological deficits (interhemispheric disconnection syndrome) due to the callosal lesion are also frequently observed in MBD.

CONCLUSION

Since its initial description, a remarkable advance in our knowledge of MBD has been achieved.