Indian Journal of Trauma and Emergency Pediatrics

Ventriculo-peritoneal (VP) shunt is a procedure performed for diverting the cerebrospinal fluid (CSF) flow in patients with hydrocephalus. The procedure may be associated with various complications including mechanical complications (shunt block, shunt obstruction or shunt migration) and biological complications (shunt infection). CSF pseudocyst, commonly called “CSFoma” is a rare but significant
complication of VP shunt. We present a case of Crouzon syndrome (with hydrocephalus) operated for VP shunt, who developed a CSF pseudocyst within 3 months of insertion of the VP shunt. He presented
with abdominal distension and the diagnosis was confirmed by ultrasonography followed by a contrast enhanced computed tomographic (CECT) scan of the abdomen. The patient underwent therapeutic fluid tapping for the abdominal distension (as it was causing respiratory distress) followed by exteriorisation of the VP shunt till the pseudocyst resolved. The VP shunt was replaced later with a ventriculo-atrial shunt. The child has been doing well with no further complications at 4 weeks of follow-up.

Keywords: Abdominal pseudocyst; Crouzon syndrome; CSFoma; Hydrocephalus; Ventriculoperitoneal shunt.
 

Background: Protein C, Protein S and Antithrombin III are negative regulators of coagulation. Homozygous protein C deficiency is a rare inherited disorder manifesting as neonatal purpura fulminans. A two week old female baby delivered at term, developed purpuric lesions over the left thigh and progressing to other areas. Investigations showed
negligible protein C level, besides meagre protein S and antithrombin III levels. The diagnosis of inherited combined protein C, protein S and antithrombin III deficiency was made. Conclusion: Genetic analysis will help in prenatal diagnosis in future pregnancies.

Keywords: Antithrombin III; Purpura fulminans; Thrombophilia.
 

Imperforate hymen is the most common congenital malformation of the female genital tract. It can manifest in the neonatal period as hydrocolpos or at menarche as hematocolpos. The clinical manifestations of hydrocolpos include: bulging membrane at introitus, lower abdominal cystic swelling, abdominal distention, difficulty in emptying the bladder. The diagnosis of hydrocolpos is by USG and MRI. The anomalies associated with the hydrocolpos are imperforate anus, persistent urogenital sinus, cloacal dysgenesis etc. The surgical treatment can be simple hymenotomy or hymenectomy while laparotomy is indicated for the treatment of abdominal complications. Complications of hydrocolpos are hydronephrosis, chronic kidney
disease, sepsis, Pyocolpos. Delay in the diagnosis of hydrocolpos lead to development of complications and more difficult management.

Keywords: Hydrocolpos; Imperforate Hymen; Abdominal distention; Prenatal diagnosis.
 

Seizures are common in children. With the advent of newer antiepileptics efficacy as well as safety profile has increased. Although we are using conventional antiepileptics to abort an acute episode
of seizure more studies have to be conducted for assessing the safety and efficacy of newer drugs as first line antiepileptic drugs. Here we conducted a study to assess levetiracetam as first line antiepileptic.

Keywords: Levetiracetam; Statusepilepticus; First line; Efficacy.