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  • Author: Vesna Cvetanovska x
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Congenital Hydronephrosis: Disease or Condition?


The aim of this paper is to address the dilemmas of the paediatric surgeon when facing an isolated, unilateral, congenital hydronephrosis and discuss the strategic options for the management of this condition.

Congenital hydronephrosis, the most commonly diagnosed uropathy in children, is usually a benign and self-resolving condition. Nonobstructive hydronephrosis does not require operative treatment, while timely treatment is imperative for obstructive hydronephrosis before significant renal damage ensues. Managing congenital hydronephrosis is a challenging task.

Thirty-two children with unilateral, isolated hydronephrosis and nonobstructed renography curves were followed up for 3 years.

On the initial evaluation according to the grade of hydronephrosis: 22.6% were grade I, 54.8% grade II and 22.6% grade III. After 12 months of follow-up: 30% were grade I, 51.5% grade II and 18.5% grade III, respectively. After the three-year follow-up, there were no hydroneproses greater than grade II. The mean value of the separate GFR of the affected kidney at initial evaluation was 42.83%, and 40.33% after three years. In three children the treatment was converted from conservative to surgical. Nonobstructive, congenital hydronephrosis is a benign condition not requiring any medical treatment, but aggressive observation is indicated.

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Dislocated Extension – Type Supracondylar Humerus Fractures in Children: Single Centre Experience


Aim: The aim of this study is to show our experience in cases of dislocated extension type - supracondylar humeral fractures and evaluate the results of their treatment in the period from 2000 to 2010 with a follow up of a maximum six months.

Material and Methods: A retrospective analysis of the clinical cases for the period 2000 - 2010 was done. Children from 4 to 14 years of age with supracondylar fractures of the humerus - extension type are included. The total number of patients treated at the Clinic for Pediatric Surgery was 230.

Results: The results of the treatment were evaluated after the last control examination six months later. We noticed postoperative neurological damage in 10 cases (4.85%). In 14 patients (6.8%) we noticed long term deformities such as cubitus varus or cubitus valgus. Infection at the entering place of the needles occurred in 4 patients (1.94%), which did not indicate premature extraction of the needles and conversion of the treatment.

Conclusion: As a conclusion, we can stress that our outcomes in treatment of dislocated suparacondylar fractures of the humerus in children meet the world standards.

Open access
Pediatric enigma in ICU – late treatment of severe sepsis: a case report


A surgery of ritual circumcision in healthy young boys is usually a safe procedure. However, an outbreak of severe sepsis a few hours after surgery in patients who underwent this minor procedure is described and analyzed in this report. We describe the clinical course and discuss the causes of the sepsis and septic shock. Contamination of propofol, the intravenous anesthetic agent, was suspected as a probable cause. However, the most important question that had appeared from this case is the prognostic outcome regarding the delayed treatment of severe sepsis

Open access