Late presentation of midgut malrotation with obstruction in a 5-year-old female: A case report

Midgut malrotations are rarely diagnosed beyond infancy. Delays in recognition and diagnosis can result in death. Here, we report the case of a 5-year-old girl who presented with a 1-year history of intermittent abdominal pain and vomiting. An abdominal computed tomography scan with contrast confirmed the diagnosis of midgut malrotation with obstruction; therefore, the Ladd procedure was performed, and the child was discharged uneventfully. Clinicians must maintain a high level of suspicion because this diagnosis is unusual in this age group

Burden of bronchiolitis post-COVID-19 pandemic in children less than 2 years old in 2021–2024: experience from a tertiary center in Saudi Arabia

Abstract Background Bronchiolitis, a common lower respiratory tract infection in children under 2, is primarily caused by respiratory syncytial virus (RSV). During the coronavirus disease (COVID-19) pandemic, respiratory infections initially decreased due to non-pharmaceutical interventions; however, patients with bronchiolitis have surged in the post-pandemic period. This study examined the burden and severity of bronchiolitis in the post-COVID era in a tertiary center in Saudi Arabia. Methods This retrospective review was conducted on pediatric patients aged < 2 years who were diagnosed with bronchiolitis at a tertiary hospital in Riyadh between September 2021 and March 2024. The collected data included demographics, comorbidities, viral polymerase chain reaction results, clinical management, disposition, and outcomes. Statistical analysis was performed using SPSS, with statistical significance at p < 0.05. Results Out of 482 patients, 56% were male, with a mean age of 6.37 months. RSV was the most common virus (53.79%) among the 132 tested patients. Oxygen therapy was administered to 93.15% of patients, with only 4.36% requiring high-flow nasal cannula and 0.41% requiring intubation. Pediatric Intensive Care Unit admission was necessary for 5.6%, with most managed with non-invasive support. Complications were infrequent; only 4.77% developed pneumonia. Conclusions The findings reflect a significant increase in patients with bronchiolitis post-COVID, consistent with the global trends. Despite this increase, most patients required minimal intervention, aligning with pre-pandemic management practices. This study highlighted the post-pandemic resurgence of bronchiolitis. While the caseload has increased, outcomes remain favorable, reinforcing the importance of supportive care and judicious resource allocation during the bronchiolitis season