-
Case Report
Spontaneous Rupture of Common Hepatic Duct in an Infant, a Rare Entity
Ranya Herzallah*,
Samer Al-Rahamneh,
Qusay Altarawneh,
Sarah Abuqubu
Issue:
Volume 11, Issue 3, September 2025
Pages:
114-118
Received:
9 May 2025
Accepted:
26 May 2025
Published:
23 June 2025
Abstract: Pediatric spontaneous biliary duct perforation (SBDP) represents a rare clinical condition. The vast majority of pediatric cases typically manifest around 6 months of age; however, the initial onset of this condition has been documented to occur as early as 25 weeks of gestation and, conversely, as late as 7 years postnatally. Despite the encouraging fact that the condition is treatable with appropriate intervention, the often non-specific nature of its associated symptoms and signs can unfortunately result in a significantly delayed diagnosis. This delay, in turn, carries the potential for the development of severe, life-threatening conditions such as biliary peritonitis and sepsis. Therefore, it is of paramount importance for clinicians to establish an early suspicion and achieve a prompt diagnosis to mitigate these risks. An exceptionally uncommon variant within the spectrum of spontaneous biliary duct perforation is the spontaneous rupture of the common hepatic duct. This report presents an illustrative case of a 5-month-old male infant who experienced a spontaneous perforation of the common hepatic duct, leading to the formation of a biloma. This diagnosis was successfully established pre-operatively through the utilization of a contrasted abdominal computed topography (CT) scan. Subsequently, the patient underwent a primary surgical repair of the identified perforation site, in addition to percutaneous drainage facilitated by a biliary T-tube. The postoperative recovery period was remarkably uneventful, and the T-tube was successfully removed on the 12th postoperative day. Six weeks following discharge from the hospital, the patient exhibited entirely satisfactory progress, with a complete absence of any discernible complications.
Abstract: Pediatric spontaneous biliary duct perforation (SBDP) represents a rare clinical condition. The vast majority of pediatric cases typically manifest around 6 months of age; however, the initial onset of this condition has been documented to occur as early as 25 weeks of gestation and, conversely, as late as 7 years postnatally. Despite the encouragi...
Show More
-
Research Article
Risk Factors for Mortality in Septic Children with Acute Kidney Injury in the Pediatric Intensive Care Unit
Issue:
Volume 11, Issue 3, September 2025
Pages:
119-126
Received:
23 May 2025
Accepted:
9 June 2025
Published:
4 July 2025
Abstract: Acute Kidney Injury (AKI) and sepsis are major causes of morbidity and mortality in pediatric intensive care units (PICUs), especially when they occur concurrently. Despite advancements in critical care, the identification of risk factors remains essential to improve survival outcomes in children. To determine the risk factors associated with mortality in children diagnosed as sepsis with treated in the PICU. This was an observational analytic study with a case-control design, conducted in the PICU of Prof. Dr. I. G. N. G. Ngoerah Hospital from 2022 to 2024. Pediatric patients aged 1 month to <18 years with diagnoses of AKI and sepsis were included. Variables analyzed included nutritional status, duration of PICU stay, requirement of mechanical ventilation, involvement of a pediatric nephrologist, history of nephrotoxic drug use, and the number of nephrotoxic drugs used. Bivariate and multivariate analyses were performed using logistic regression. Total of 126 patients were analyzed. Bivariate analysis showed a significant relationship between mortality and the need for mechanical ventilation (OR 6.2; p 0.001) and the absence of pediatric nephrology care (OR 2.1; p = 0.047). In multivariate analysis, the need for mechanical ventilation (OR 16.5; 95% CI 3.5-77.2; p = 0.001) and pediatric nephrology care (OR 6.7; 95% CI 1.6-28.0; p = 0.009) were independently associated with mortality. The need for mechanical ventilation and the lack of pediatric nephrology consultation are significant risk factors for mortality in septic children with AKI treated in the PICU.
Abstract: Acute Kidney Injury (AKI) and sepsis are major causes of morbidity and mortality in pediatric intensive care units (PICUs), especially when they occur concurrently. Despite advancements in critical care, the identification of risk factors remains essential to improve survival outcomes in children. To determine the risk factors associated with morta...
Show More
-
Case Report
Dunbar Syndrome: Unusual Cause of Chronic Abdominal Pain in Children
Gihad Alsaeed*
,
Subhi Samm,
Mohamed khabier,
Waiel Habib,
Mohamed Alsaeed,
Rana Nader Himmat
Issue:
Volume 11, Issue 3, September 2025
Pages:
127-133
Received:
30 May 2025
Accepted:
18 June 2025
Published:
16 July 2025
DOI:
10.11648/j.ajp.20251103.13
Downloads:
Views:
Abstract: Childhood chronic abdominal pain is a diagnostic challenge, with a variety of functional and organic etiologies. Whilst the majority of cases are diagnosed as either functional or dysfunctional, it is imperative that an individual diagnostic assessment is conducted in order to exclude organic causes, thus facilitating a successful management strategy. In instances where alarm-Features are present, it is recommended that investigations be conducted into rare and unusual causes, provided that initial investigations have not yielded a diagnosis. One such rare Entity is Dunbar syndrome, a vascular condition characterized by chronic abdominal pain, which typically manifests during late childhood. This curable cause appears to be more prevalent than what previously hypothesized to be 1.7% in children. We present the case of a 16-year-old female patient has been suffering from severe, unexplained chronic abdominal pain and weight loss for several months. Despite extensive investigations and exploratory laparoscopy, no clear explanation for the patient's symptoms has been found. Our approach was a combination of teamwork, a stepwise approach, and selective investigations. This collaborative effort enabled the successful diagnosis and surgical therapy. We aim to enhance the management of childhood chronic abdominal pain by adapting a cost effective stepwise approach and to raise awareness of Dunbar syndrome.
Abstract: Childhood chronic abdominal pain is a diagnostic challenge, with a variety of functional and organic etiologies. Whilst the majority of cases are diagnosed as either functional or dysfunctional, it is imperative that an individual diagnostic assessment is conducted in order to exclude organic causes, thus facilitating a successful management strate...
Show More
-
Research Article
Effectiveness of Methylphenidate Plus Integrated Training in Children with Comorbid SLD and ADHD: A Retrospective Pre–Post Intervention Study
Guo Haiwen,
Luo Lirong*
Issue:
Volume 11, Issue 3, September 2025
Pages:
134-140
Received:
12 June 2025
Accepted:
1 July 2025
Published:
18 July 2025
DOI:
10.11648/j.ajp.20251103.14
Downloads:
Views:
Abstract: Objective: This study aimed to evaluate the effects of methylphenidate controlled-release tablets combined with cognitive and sensory integration training on learning and behavioral outcomes in children with comorbid SLD and ADHD. Methods: A total of 55 children diagnosed with both SLD and ADHD were retrospectively included from a pediatric outpatient clinic in Guangzhou between June 2020 and December 2023. This single-group retrospective design allowed for within-subject comparisons before and after the intervention. All participants received a six-month intervention comprising daily oral methylphenidate and regular sessions of cognitive and sensory integration training. Cognitive and behavioral functioning were systematically assessed at two time points—pre- and post-intervention—using three standardized tools: the Children’s Learning Disability Characteristics Assessment Scale, the SNAP-IV scale, and the Conners’ Child Behavior Scale. This pre-post comparative framework enabled the evaluation of intervention-related changes across multiple domains. Results: Post-intervention, total and subscale scores across all three instruments were significantly reduced compared to baseline (P < 0.01), indicating marked improvements in attention, learning ability, and behavioral regulation. The most substantial gains were observed in attention control, visual perception, and hyperactivity/impulsivity symptoms. Conclusion: The combination of pharmacological treatment and structured non-pharmacological training produced significant improvements in both cognitive-perceptual and behavioral outcomes. This integrated approach may offer synergistic therapeutic benefits for children with co-occurring SLD and ADHD and provides promising clinical evidence to inform future large-scale, multidisciplinary intervention protocols.
Abstract: Objective: This study aimed to evaluate the effects of methylphenidate controlled-release tablets combined with cognitive and sensory integration training on learning and behavioral outcomes in children with comorbid SLD and ADHD. Methods: A total of 55 children diagnosed with both SLD and ADHD were retrospectively included from a pediatric outpati...
Show More
-
Review Article
Evolution of Artificial Intelligence Is a Revolution in Medical Science
Issue:
Volume 11, Issue 3, September 2025
Pages:
141-149
Received:
12 June 2025
Accepted:
1 July 2025
Published:
18 July 2025
DOI:
10.11648/j.ajp.20251103.15
Downloads:
Views:
Abstract: Artificial Intelligence (AI) is a prime instance of a technological breakthrough that has widespread medical applicability at present as well as future. This technology has multi-dimensional progression. Modern medical service became vibrant with the use of this technology. AI has its rich history of development which has been contributed by genius people around the globe. History of AI is important to realize its potentiality by analyzing its past, which helps in forecasting future. AI is becoming popular in different arena of medical science. It is now applied in cardiovascular diseases, Pulmonary Medicine, Endocrinology, Nephrology, Gastroenterology, Neurology, Dermatology, Ophthalmology, Pathology, Oncology, Radiology, Surgery and also in Telemedicine. Algorithms like Aidoc’s detect pulmonary embolism in chest CT scans with 85% sensitivity and 99% specificity. AI based (deep-learning model) mammography and skin cancer diagnosis performs at or above human specialist level. It is the need of time to train medical man power in this field. Enhancing the skill of medical professional in this regard will develop a new generation of doctors to fulfill the need of future. It should be noted that the ethical dilemmas, privacy, data protection, informed consent, social gaps, medical consultation, empathy, and sympathy are various challenges in using AI. We should be aware that its negative aspects might not outweigh its benefit. Introduction of AI and machine learning in medicine helped health professionals to improve the quality of care. It has the potential to improve even more in near future and beyond.
Abstract: Artificial Intelligence (AI) is a prime instance of a technological breakthrough that has widespread medical applicability at present as well as future. This technology has multi-dimensional progression. Modern medical service became vibrant with the use of this technology. AI has its rich history of development which has been contributed by genius...
Show More
