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Background Abdominal cocoon or "encapsulating peritoneal sclerosis" (EPS) is an uncommon and rare cause of intestinal obstruction. Only a few cases have been reported in paediatric patients. Typically, EPS is described as the primary form in young adolescent girls from tropical and subtropical countries because of viral peritonitis due to retrograde menstruation or a history of peritoneal dialysis. Most patients are asymptomatic or present with abdominal pain, which is likely to occur secondary to subacute bowel obstruction. Findings at imaging, such as ultrasound, computed tomography, and magnetic resonance imaging, are often nonspecific. When diagnosed, EPS is characterized by total or partial encasement of the bowel within a thick fibrocollagenous membrane that envelopes the small intestine in the form of a cocoon because of chronic intraabdominal fibroinflammatory processes. The membrane forms a fibrous tissue sheet that covers, fixes, and finely constricts the gut, compromising its motility. Case summary We present a case of EPS in a 12-year-old boy 8 wk after primary surgery for resection of symptomatic jejunal angiodysplasia. There was no history of peritoneal dialysis or drug intake. Conclusion In this report, we sought to highlight the diagnostic, surgical, and histopathological characteristics and review the current literature on EPS in paediatric patients.

Aneurysms of the ulnar artery and its palmar arch are usually rare events, which are mostly related to repetitive trauma of the extremity. This syndrome is also known as hypothenar hammer syndrome, which presents two pathologic entities: the aneurysmal type and the thrombotic type. Whereas surgical treatment is not necessary within the thrombotic type, it is the gold standard to treat aneurysms of the palm with resection of the aneurysm and reconstruction of the vessel with either end-to-end anastomosis, venous or arterial grafts. We report a case of a young male patient with an aneurysm of the right ulnar artery at the wrist with history of repetitive trauma. Reconstruction with a venous forearm graft showed recurrence of the aneurysm after 2 years from surgery. The authors want to elaborate an algorithm for surgical treatment to make the right decision for choice of reconstruction. Level of evidence: Level IV, therapeutic study.

The fast-evolving nature of the coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented clinical, logistical, and socioeconomical challenges for health-care systems worldwide. While several studies have analyzed the impact on the presentation and management of acute appendicitis (AA) in the adult population, there is a relative paucity of similar research in pediatric patients with AA. To date, there is some evidence that the incidence of simple AA in children may have decreased during the first lockdown period in spring 2020, whereas the number of complicated AA cases remained unchanged or increased slightly. Despite a worrying trend toward delayed presentation, most pediatric patients with AA were treated expediently during this time with comparable outcomes to previous years. Hospitals must consider their individual capacity and medical resources when choosing between operative and non-operative management of children with AA. Testing for severe acute respiratory syndrome coronavirus type 2 is imperative in all pediatric patients presenting with fever and acute abdominal pain with diarrhea or vomiting, to differentiate between multisystem inflammatory syndrome and AA, thus avoiding unnecessary surgery. During the further extension of the COVID-19 crisis, parents should be encouraged to seek medical care with their children early in order that the appropriate treatment for AA can be undertaken in a timely fashion.

BACKGROUND Due to various options for tissue resection and preoperative markings, many different reports on aesthetics and patient’s satisfaction exist. To assess differences among tissue resections and risk factors, we herein analyzed satisfaction levels of patients that underwent upper blepharoplasty. METHODS A retrospective analysis during the period from January 2006 to June 2013 was conducted by reviewing patient’s electronic medical files. All patients underwent medically indicated upper blepharoplasty at our department. We classified patients relating to resected tissues; hence the categories created were skin, skin/muscle, skin/muscle/fat and skin/fat. Furthermore, an evaluation of risk factors according to the patient’s number of present medical preconditions ranging from 0 (none) to 4 was performed. Data collection was conducted by reviewing patient’s electronic medical files. Moreover, a questionnaire concerning patient’s satisfaction was forwarded. RESULTS No significant differences in patient’s satisfaction and complication rates comparing the different groups of tissue resection were noted. However, we found a significantly higher complication rate at a presence of 2 risk factors. In addition, a significantly worse scar outcome and longer recovery periods in patients with 4 risk factors were observed. CONCLUSION The extent of tissue resection has no statistically quantifiable effect on patient’s satisfaction ratings and complications. For this reason, we believe cautious resection of muscle and fat is only indicated if pathologies are present. Moreover, patients with 2 risk factors or more shall be rigorously evaluated preoperatively to avoid complicating events. An abbreviated form of this manuscript was presented at the conjoint 52nd and 45th annual meeting of the Austrian and German Society of Plastic, Aesthetic and Reconstructive Surgery, September 11th-13th 2014 in Munich, Germany.

Hintergrund: Eine verbreitete Behandlungsalternative bei verschiedensten Gründen für chronische Schmerzzustände des Handgelenkes stellt die 1966 von Wilhelm entwickelte Methode der Denervierung dar. Untersuchungen zu Veränderungen der Eigenschaften des umgebenden Gewebes liegen jedoch[zum vollständigen Text gelangen Sie über die oben angegebene URL], 48. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 55. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie, 22. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Ziel: Vergleich der klinischen und der sonomorphologischen Befunde bei Kindern mit der Verdachtsdiagnose einer akuten Appendizitis. Methode und Patienten: Retrospektive Analyse der sonographischen und intraoperativen Befunde bei dem Patientengut der Notaufnahme der Klinik für Kinder und Jugendliche[zum vollständigen Text gelangen Sie über die oben angegebene URL], Süddeutscher Kongress für Kinder- und Jugendmedizin; 65. Jahrestagung der Süddeutschen Gesellschaft für Kinder- und Jugendmedizin gemeinsam mit der Süddeutschen Gesellschaft für Kinderchirurgie und dem Berufsverband der Kinder- und Jugendärzte e.V. – Landesverband Hessen