Right ventricular hypertrophy (RVH) is a rare finding in the neonatal age. Multiple pathological conditions are associated with the development of RVH, such as metabolic diseases, hereditary disorders and premature closure of the ductus arteriosus during the intrauterine life. Transient isolated RVH may be due to perinatal factors such as perinatal distress and corticosteroid treatment of preterm neonates with bronchopulmonary dysplasia. We report a case of a term neonate, appropriate for gestational age presenting transient hypertrophy of the right ventricle, who was diagnosed with echocardiography applied by neonatologists on the first day of life.

Introduction/Purpose: Congenital cryptorchidism and retractile testis represent the most commonly presented abnormalities of the male genitourinary system. Orchiopexy is the surgical treatment for both conditions and can be performed either via the conventional two-incision surgical approach or via a singular scrotal incision. The present study firstly investigated the complications associated with each orchiopexy approach in a single-center pediatric surgical department and secondly compared the surgical outcomes in children with congenital cryptorchidism or retractile testes. Methodology: A retrospective analysis was conducted in pediatric patients with either congenital cryptorchidism or retractile testes who underwent orchiopexy from 2015 to 2019. Data collected during the study included diagnosis, surgical technique and both short- and long-term complications. Patient stratification was performed in accordance with the type of orchiopexy and the diagnosis UDT vs. RT and inguinal orchidopexy vs. scrotal orchidopexy. Results: A total of 362 children underwent 443 orchiopexies of which 227 were inguinal and 216 were scrotal. Complications were reported in 16 (3.6%) surgeries and from which 14 (3.16%) were presented in for postoperative complications. Short-term complications were presented in four (0.9%) cases and consisted of wound dehiscence. Long-term complications were recorded in 12 (2.7%) cases, including recurrence in six (1.3%) testes, testicular atrophy in three (0.6%) cases and presentation of hydrocele or inguinal hernia in two (0.4%) and one (0.2%) patient, respectively. Notably, 13 orchidopexies with preoperative diagnosis of congenital cryptorchidism, were linked with complications (p = 0.01), 12 of which underwent with two-incision technique (p = 0.07). Conclusions: The findings of the study suggest that a preoperative diagnosis of congenital cryptorchidism is a possible risk factor for postoperative complications. With regard to the surgical technique performed, the single-incision scrotal orchiopexy appears to be a much safer and more effective approach palpable undescended testes, compared to the two-incision approach. For the high-lying testes, although the single-scrotal technique provides good results, more prospective studies with selected impalpable undescended testes are needed to strengthen the existing literature.

Background: Chorioamnionitis (CA) is a major pathological cause of preterm labor and is associated with both short- and long-term adverse outcomes in neonates, including early-onset sepsis (EOS) and late-onset sepsis (LOS). Neonatal sepsis remains a significant contributor to morbidity and mortality in neonatal intensive care units (NICUs). Aim: This study aimed to evaluate the association between maternal chorioamnionitis and the incidence of early-onset and late-onset neonatal sepsis in preterm neonates born at <32 weeks’ gestation. Furthermore, the study investigated maternal and neonatal factors affecting the presentation of sepsis. Methods: A retrospective cohort study was conducted on the medical records of preterm neonates born between 2020 and 2022. Inclusion criteria were gestational age < 32 weeks, available microbiological or histological examination for chorioamnionitis, and complete maternal medical records. Infants were categorized into two groups based on the presence (CA group) or absence (non-CA group) of histological and/or microbial chorioamnionitis. Descriptive statistical analyses were performed, including calculation of frequencies and percentages for categorical variables and means with standard deviations and ranges for continuous variables. Results: A total of 189 neonates were included, with a mean birth weight of 1286 ± 405 g and a mean gestational age of 29.2 ± 2.1 weeks. The CA group consisted of 55 neonates (29.1%), while 134 (70.9%) were in the non-CA group. Early-onset sepsis (EOS) occurred in 23 neonates (12.2%), with a significantly higher incidence in the CA group compared to the non-CA group (21% vs. 8%, p = 0.014). Late-onset sepsis (LOS) developed in 66 neonates (34.9%), but no significant difference in incidence was observed between the two groups (p = 0.402). Parsimonious logistic regression analysis identified maternal chorioamnionitis as an independent predictor of EOS (Odds Ratio 2.07, 95% CI 1.85–5.08; p = 0.009). Conclusions: Intrauterine infection and inflammation caused by chorioamnionitis are linked to an increased risk of early-onset sepsis in neonates born before 32 weeks’ gestation. However, chorioamnionitis does not appear to significantly influence the incidence of late-onset sepsis, which appears to be more closely associated with postnatal factors.

Background/Objectives: Retractile testis has traditionally been considered a benign physiological variant, managed conservatively with observation until puberty. However, recent evidence suggests that retractility may predispose individuals to acquired cryptorchidism and complications such as torsion, testicular atrophy, and impaired fertility. This review aims to synthesize the current literature on the clinical features, natural history, complications, and management of retractile testes, and to evaluate whether conservative management remains appropriate. Methods: A structured narrative review was performed. PubMed (MEDLINE), Embase, Scopus, and the Cochrane Library were searched from database inception to 15 December 2025, and screening was reported using a PRISMA-style flow diagram. To our knowledge, this is the first review focusing exclusively on the retractile testis in the pediatric population, with a primary emphasis on management and treatment. Results: Prevalence among school-aged boys ranges from 1.2% to 3.9%. Reported progression rates to acquired cryptorchidism and orchiopexy vary widely, from 2% to 50%, with risk factors including inelastic spermatic cord, ipsilateral hernia, and younger age at presentation. Histological and sonographic studies demonstrate reduced testicular volume, seminiferous tubule degeneration, and impaired spermatogenesis, paralleling congenital cryptorchidism. Short-term complications include acute torsion, with abnormal gubernacular attachment and patent processus vaginalis frequently observed intraoperatively. Evidence for malignancy risk remains inconclusive. Conclusions: The available evidence, drawn largely from retrospective and observational studies, suggests possible associations between retractility and short- and long-term outcomes such as acute torsion, testicular atrophy, and impaired fertility, whereas an independent link with testicular malignancy remains unproven. This evidence is not yet sufficient to establish causation, and current professional-society guidelines continue to favor surveillance for the true retractile testis, reserving orchiopexy for documented ascent or other defined indications. Pending prospective data, these findings support structured, guideline-consistent follow-up, so that boys in whom ascent or atrophy develops are identified promptly.

BACKGROUND:Retractile testes have long been considered a normal variant, yet emerging evidence questions this assumption. Given the central role of the cremaster muscle in testicular position, this study aimed to compare the histological and immunohistochemical characteristics of the human cremaster muscle in boys with retractile testes (RT) and undescended testes (UDT), using patients with inguinal hernia (IH) and normally descended testes as controls. METHODS:Forty boys undergoing surgery between March 2021 and April 2023 were enrolled: 22 with retractile testis, 7 with congenital cryptorchidism, and 11 controls with inguinal hernia. Intraoperative biopsies of the cremaster muscle were evaluated using hematoxylin-eosin staining and digital morphometry. Immunohistochemistry for myosin heavy chain (MyHC)-embryonic and antibody CD34 was performed. Statistical analysis assessed differences in muscle fiber diameters, morphology, MyHC-embryonic expression, and intramuscular capillary density among groups and across age subgroups. RESULTS:Retractile and undescended testes demonstrated similar muscle fiber morphology, characterized by significantly smaller minimum and maximum muscle fiber diameters compared with controls (p < 0.001). Atrophic fibers were frequent in retractile testes (16/22), less common in cryptorchidism (2/7), and absent in controls. Both the retractile testis and the UDT group exhibited significantly higher MyHC-embryonic expression than controls (p = 0.038 and p = 0.0016 respectively). CD34 staining revealed markedly increased intrafascicular capillary density in retractile testes compared with both other groups (p < 0.001). CONCLUSIONS:Cremaster muscle in retractile testes demonstrates histological and immunohistochemical patterns closely resembling congenital cryptorchidism - a clearly defined pathological condition-rather than normal controls. At the same time, findings suggest that the retractile testis is a distinct clinical entity, with probable ongoing muscle remodeling and possible regenerative activity, rather than a physiological variant. These results combined advocate for closer monitoring of the young patients with clinical re-evaluations, while raising the question of whether earlier surgical intervention prior to puberty warrant further investigation.

Polycystic kidney disease (PKD) is a clinical condition characterized by the presence of renal cysts and kidney enlargement. When it presents during the neonatal period, it can lead to progressive renal damage and eventually result in end-stage renal failure. Peritoneal dialysis (PD) can be particularly challenging in the neonatal intensive care unit due to the infant's thin abdominal wall and the often unsuitable size and shape of available catheters. As a result, the use of such catheters in infants is associated with high mortality and significant complications, including leakage, peritonitis, and hemoperitoneum. Here, we report our initial experience with Tenckhoff catheter placement and its management over 72 days in a premature newborn diagnosed with autosomal recessive polycystic kidney disease. To the best of our knowledge, this is among the few reported cases where PD was successfully maintained with a Tenckhoff catheter for such an extended duration. Despite the challenges posed by low body weight and a thin abdominal wall, PD remains a relatively effective and feasible treatment option for neonates with renal failure.

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract and may present with complications such as bleeding, obstruction, or inflammation. Massive lower gastrointestinal bleeding in adolescents is rare and may be life-threatening. Ischemic colitis is extremely uncommon in this age group and has not been previously described as a complication of gastrointestinal hemorrhage, following resection of a bleeding Meckel's diverticulum. We report a case of an adolescent boy who presented with persistent ileus due to ischemic colitis, following extensive hemorrhage of the Meckel's diverticulum.

PURPOSE:Congenital cryptorchidism or undescended testes (UDT) is one of the most common congenital abnormalities in newborns. Current guidelines recommend that surgical management should be scheduled by the 12th month and no later than the 18th month of the child's life. This is the first study to evaluate the age of diagnosis and surgical treatment of children with UDT in Greece, as well as the compliance with current guidelines worldwide. METHODS:A retrospective analysis of patients with UDT who underwent orchidopexy from 2015 to 2019 was conducted. Patient age at diagnosis and orchidopexy and the meantime between were recorded. Patients were separated into groups, based on the diagnosis age: group A, diagnosis until the 11th month; group B, diagnosis between the 12th and 18th month; and group C, diagnosis at >18th month. RESULTS:We identified 217 children who were diagnosed with UDT and underwent orchidopexy in our department. The majority of the patients (47.4%) had right-sided UDT, while 25.3% of them had UDT on both sides. There were 89 (41%) children in group A, 20 (9.2%) in group B, and 108 (49.8%) males in group C. The median age at diagnosis was 18 months (range: 1-164 months), while for groups A, B, and C, the median age at diagnosis was five, 15, and 71.5 months, respectively. The median age at orchidopexy was 23 months (range: 6-166 months), and for each aforementioned group, it was 11, 16.5, and 74 months. The median waiting time for the orchidopexy was 84 days (range: 1-692 days), and for each group, it was 157, 42, and 56 days, respectively. The delay between diagnosis and surgery was significantly greater for group A compared to groups B and C (p A versus B = 0.01 and p A versus C< 0.0001), while there was no difference in the delay between groups B and C (p > 0.05). CONCLUSIONS:Patient age at diagnosis and applied orchidopexy was within the recommended range for almost half of the patients. The rest of them had delayed diagnosis and surgery due to delayed referral. In delayed cases, the time from diagnosis to treatment was significantly shorter. Early surgical referral leading to prompt treatment will increase compliance with the guidelines and improve the quality and the outcomes of the provided health-care services.

Blunt trauma is a common injury in children; however, blunt abdominal aortic trauma is extremely rare and is accompanied by high rates of morbidity and mortality. We report our initial experience with the endovascular management of an abdominal aortic rupture in a 12 -year -old boy after he was involved in a motor vehicle accident. The patient was a backseat-restrained passenger. Upon admission, he had a Glasgow Coma Scale of 15, was hemodynamically stable, and complained of abdominal pain. The computed tomography revealed a rupture in the abdominal aorta along with a distally extending pseudoaneurysm, free fluid in the peritoneal cavity, and a large retroperitoneal hematoma. The rest associated injuries were a Grade III splenic injury, a retroclival epidural hematoma in the first cervical vertebra level, a right clavicle fracture, a bilateral minor pneumothorax, along with bilateral pulmonary lacerations and contusions in the thoracic vertebrae. Given the extent of the intraabdominal injuries and the risk for open laparotomy, the decision to proceed with endovascular stenting instead of open surgical repair was made. The patient tolerated the procedure well and an angiography confirmed the result. The postoperative period was uneventful and the associated injuries were treated conservatively without complications. Although blunt abdominal aortic trauma is extremely rare in children, endovascular management seems to be a new and feasible therapeutic approach.

Preeclampsia is a human-specific hypertensive disorder of gestation. It is associated with short-term adverse effects in the fetus and long-term complications in the neonate, mainly due to disrupted blood flow during critical periods of intrauterine development. An ischemic event in the uterus can affect many systems of the fetus, including a small bowel involvement. We present a case of a preterm, small for gestational age neonate with severe intrauterine growth restriction, small bowel stenosis, and volvulus without malrotation, born to a mother with severe preeclampsia.

Inflammatory bowel disease (IBD) is an inflammatory clinical entity with many extraintestinal symptoms, including urinary tract manifestations. However, the bilateral ureteral obstruction is extremely rare. We report a case of bilateral ureteral obstruction in a 12-year-old male patient with ulcerative colitis (UC). Ultrasonography in the context of sudden anuria revealed bilateral ureterovesical junction (UVJ) obstruction, and the following cystoscopy verified the presence of fragile calculi in both edematous ureteral orifices. The literature data on UC in the pediatric population are scarce. Sudden deteriorating oliguria in an UC patient may result from secondary obstructive uropathy. Immediate diagnosis and treatment are essential to prevent acute kidney injury.

Abstract PURPOSE: Congenital cryptorchidism and retractile testes are two of the commonest abnormalities of the genitourinary system in boys. Orchidopexy is the final surgical treatment for both clinical conditions. It can be applied either with the traditional two-incision inguinal approach, or with the single-scrotal incision technique. This study aimed to investigate the complications of each orchidopexy procedure in a pediatric surgery department, and then to compare the traditional two-incision with the single incision technique in children diagnosed with cryptorchidism or retractile testes. METHODS: A retrospective analysis of patients with congenital cryptorchidism or retractile testes who underwent orchidopexy from 2015 to 2019 was conducted. Diagnosis, patients’ details, the applied orchidopexy technique, the short-term complications and the long-term complications were recorded. Patients were separated based on the applied orchidopexy either two-incision inguinal approach or single-incision scrotal orchidopexy, and a descriptive statistical analysis followed. RESULTS: We identified 362 children who underwent 443 orchidopexies. The 227 of them were inguinal orchidopexies and the 216 were scrotal orchidopexies. Sixteen orchidopexies (3.6%) applied in fourteen patients (3.8%) had complications. The short-term complications were in four cases (0.9%) and included wound dehiscence. The long-term complications regarding the rest twelve cases (2.7%) included: the recurrence of cryptorchidism for 6 testes (1.3%), the testicular atrophy for 3 patients (0.6%), the presentation of hydrocele and inguinal hernia for 2 (0.4%) and 1 (0.2%) patient respectively. For the 13 out of the 16 orchidopexies the preoperative diagnosis was congenital cryptorchidism, p=0.01, and 12 of them were performed with the two-incision inguinal technique, p=0.07. CONCLUSIONS: The diagnosis of cryptorchidism associates with the orchidopexy complications. Specifically, the preoperative diagnosis of congenital cryptorchidism is a possible risk factor of complications in comparison with the retractile testis diagnosis. Regarding the surgical technique, the single scrotal orchidopexy is a safe management for the palpable undescended testes, in comparison to the two-incision, inguinal orchidopexy. Concerning the high-lying cases of undescended testes, although the single scrotal technique provides also good results and low complication rate, more prospective studies with selected impalpable UDT cases are needed to compete the existing literature.

Congenital recto-urethral fistula is the most common form of anorectal malformation found in boys. The final repair includes the ligation of the fistula and the anorectoplasty, and can be achieved either way: posterior sagitally or laparoscopically. We present a case of a term male infant diagnosed with anorectal malformation and recto-prostatic urethral fistula, that underwent a laparoscopic-assisted posterior sagittal anorectoplasty in our department.

Purpose: This study investigated the potential association between the previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive infection, as well as vaccination, and the presentation of acute appendicitis in pediatric patients. It has been three years since the World Health Organization (WHO) declared the SARS-CoV-2 pandemic, and city lockdowns and self-protective measures have been applied worldwide. In an effort to contribute to the research on the probable long-term complications of the COVID-19 infection as well as the vaccination against SARS-CoV-2, the current study was designed and investigated patients’ health records in the post-quarantine era. Methods: A retrospective analysis of patients admitted and treated surgically for acute appendicitis from January 2022 to June 2022 was conducted. Demographic and personal data, as well as the COVID-19 infection history of each child, were recorded. The patients who were negative for a previous COVID-19 infection were excluded. For the rest of the sample, the time-to-onset of acute appendicitis, the severity of appendicitis (complicated or uncomplicated), and the vaccination status of the patients were examined. Regarding the time-to-onset of appendicitis, we divided the patients into three groups: group A with a time-to-onset < 3 months, group B with a time-to-onset of 3–6 months, and group C with a time-to-onset of >6 months. Statistical analysis followed and was considered significant if p < 0.05. Results: Sixty-six children with a mean age of 10.5 years (range 1–15 years) were admitted for acute appendicitis during the determined period. After excluding 30 children that were negative for previous COVID-19 infection, we divided the patients into three groups: group A-23 children, group B-7 children, and group C-6 children. A statistically significant incidence of acute appendicitis diagnosis in <3 months after laboratory-confirmed COVID-19 infection (p < 0.01) was found. The incidence of complicated appendicitis was greater in patients with a positive SARS-CoV-2 history, with an estimated odds ratio of 1.8 (p > 0.05). The majority of the children (92%) had not received a COVID-19 vaccination. For the vaccinated children, the relative risk for complicated appendicitis was equal to 1.5 (p > 0.05). Conclusions: The results of our study demonstrate a potential positive relationship between COVID-19 infection and subsequent acute appendicitis in pediatric patients. There are also some speculations on the presentation of complicated cases of appendicitis following COVID-19 infection or vaccination, but these need to be further proven. Further data are required to better understand this potential complication of COVID-19 infection as well as the role of vaccines in the current post-vaccine era.

Arteriovenous malformations (AVMs) are common benign lesions, present at birth. Although they may occur anywhere in the body, usually they are found on the head, the neck, and the extremities. AVMs of the glans penis are very rare. Only a few have been reported in the literature, and thus, a definitive treatment does not exist. We herein report our experience of treating an AVM of the glans penis with surgical excision and plastic reconstruction of the glans, with the application of transplant tissue from the inner skin of the prepuce.

Congenital cryptorchidism is a well-established risk factor of testicular malignancies. However, there is still remarkable variability in the measures of associations between of these two clinical entities. The current meta-analysis investigates the up-to-date risk of testicular cancer in adults with a history of surgically corrected congenital cryptorchidism until adolescence. The meta-analysis was conducted with strict criteria for the identification of the congenital cryptorchidism cases that underwent surgery before adulthood. The study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of the PubMed and the Scopus databases was conducted, using a defined strategy, from inception to February 2023. Two independent authors screened the literature and extracted the data, using inclusion and exclusion criteria. Of the 2176 articles identified, 93 articles were fully retrieved, and 6 articles met all the inclusion criteria. The Newcastle–Ottawa scale was applied for the studies’ quality assessment. The random-effects model in RevMan 5.4 program was used for the meta-analysis. Three case–control studies and three cohort studies were selected. They included 371,681 patients and 1786 incidents of testicular cancer. The pooled odds ratio (OR) was 3.99 (95

AimThis study examined if the classification systems for acute appendicitis could be applied in the emergency department as an indicator for surgical consultation, in order to reduce unnecessary paediatric surgery admission.MethodsThe Alvarado Score (ALS) and the Pediatric Appendicitis Score (PAS) were applied. The decisions for hospitalisation and treatment were made independent of the scores.ResultsIn total, 307 children with abdominal pain suggestive of acute appendicitis were included. We used a cut‐off point of 7 and divided the patients into groups; the group with score ≥ 7 points was considered the positive ALS and/or PAS group, and the group with score < 7 points was the negative ALS and/or PAS group. The same process for cut‐values set at 6 points was followed. The joint probabilities for the 7‐point‐thresholds were: ALS‐sensitivity 84%, PAS‐sensitivity 85%, ALS‐specificity 92%, PAS‐specificity 92%, ALS‐positive predictive value (PPV) 83%, PAS‐PPV 84% and 93% negative predictive value (NPV) for both scores. Considering the 6‐point‐thresholds, we estimated: 94% sensitivity for both scores, 74% ALS‐specificity, 84% PAS‐specificity, 66% ALS‐PPV, 73% PAS‐PPV, 91% ALS‐NPV and 97% PAS‐NPV.ConclusionThe scoring systems provided acceptable prediction of patients with and without appendicitis. They may be of use in the emergency department, as assistive diagnostic‐tools, in order to reduce paediatric surgery consultations, admissions and treatment costs.

Crush syndrome, also known as traumatic rhabdomyolysis, is the result of the disruption of skeletal muscle fibers with the release of intracellular contents into the bloodstream. Although trauma is the main trigger for rhabdomyolysis in adults, in the pediatric population viral infections and inherited disorders seem to be the most frequent causes. Only a few reports in the literature mention rhabdomyolysis secondary to non-accidental pediatric trauma. We herein report an unusual case of traumatic rhabdomyolysis, following significant physical abuse in an infant. Rhabdomyolysis should be suspected in children presenting with a history of excessive blunt trauma, because a prompt diagnosis and treatment prevent from the potential life-threatening consequences.

Background: Horner’s Syndrome is defined by myosis, enophthalmos, lack of sweating and eyelid ptosis, as well as vascular dilatation of one half of the face, caused by damage of the ipsilateral cervical sympathetic chain. It is known that Horner’s syndrome is an unusual complication of thyroidectomy and selective lateral neck dissection. Its exact pathophysiology is not totally explained and its treatment remains conservative. Case presentation: A 27-year-old man developed one-sided partial eyelid ptosis, enophthalmos and myosis two hours after a total thyroid gland excision and a selective lateral neck dissection for papillary carcinoma. A clinical diagnosis of Horner’s syndrome was formed. He was treated conservatively and presented with an incomplete recovery at a 2-month follow up. Conclusions: The present case report underlines the adjacent anatomical correlation between the thyroid gland, the celluloadipose tissue and the cervical sympathetic trunk throughout thyroidectomy and selective lateral neck dissection. Every surgeon should be familiar with the potential complications in order to preoperatively counsel patients, as well as avoid them during the surgical procedure.