I’ve had these exact thoughts myself! Thank you for sharing! I’ve never understood the logic in throwing away gastric content no matter what colour. (In contrast , I’d say an atresia goes with green vomits and not just green aspirates)
Twin, w31+4, SGA 994g. Short time on ventilator/RDS and later CPAP. Now on HFNC. Now 6 weeks old.
Since roughly 2 weeks age this girl has a patch of hypertrichosis in her scalp. This is surrounded by an area of slightly less hair. The patch has crusta-like borders so it feels like a scab. The dermatologist speculated a month ago of it being caused by the CPAP. It looks the same now after a month and I´m not familiar with wounds that has excessive hair growth in them?
I´ve looked up "nevoid hypertrichosis" as an alternative diagnosis but of course a reaction after a wound is much more common...
I have the parents consent to post the pics here
Any ideas?
I wonder if there are any more common states where you would find reversed pre- and postductal saturations? We see it sometimes and those children do not have serious congenital heart defects such as TGA. Right now I´m looking at one baby with 95% foot 86% right hand.
Any experience on this?
Thanks for the pictures! I’ve seen the bottom picture before and that is the only picture of ”ectropion uveae” that looks similar to my findings, although a very mild variant.
Mostly it looks like the upper pictures although not that extreme and not extending radially outwards onto the iris but only inwards, into the pupil.
Bumping this one... a very benign condition but for those interested
Had antoher patient with these findings and I did som more digging on the topic....
It looks like it could be "Iris Flocculus/flocculi"
I teamed up with the opthalmologist today to see that they would see what I saw and she did. They usually call it "epithelial cyst of the iris" and if it´s only on the margin of the pupil they dont check it further. If it´s bigger (like this one covering a third of the caudal part of the pupil) they have follow up checks.
There are two Pictures showing iris flocculi in the link below
In Figure 2 - A and B
http://www.google.se/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&ved=2ahUKEwiKs4mUj5_fAhWjAxAIHVV5BB0Q5TV6BAgBEAs&url=http%3A%2F%2Fwww.apjo.org%2FApjo%2FdownPDF%2Fid%2F462.html&psig=AOvVaw2CHiN8-FCSrDAlRPpuCl_R&ust=1544869834309802
I also found an old article from 1998 where they describe the phenomenon "Flocculus neonatorum" - a self resolving benign nodular flocculus of the Iris in the newborn.
https://journals.sagepub.com/doi/abs/10.1177/000992289803700509?journalCode=cpja and they estimate it to be as common as 1 out of 30 newborns so I´m surprised that so few examiners recognise these findings
Finally I can sleep peacefully
An interested ENT specialist does ours within 1-2 days.
As for the criterias for intervention we tend to go with:
A subjective assessment of tounge tie-degree + continued feeding difficulties (even after midwife has observed and given breast feeding technique advice) and/or maternal painful nipples and/or poor weight gain.
Honestly I think of it as mostly trial and error based on the factors above.
We don´t use a scoring system. Those of you who do - does it help you in your decision and is this Hazelbaker scoring tool validated?
Pediatric Week 2018 in Västerås, Sweden
23-26 April @ Aros congress center
The neonatal part includes a Keynote lecture by Professor Lex Doyle, Australien, and the BPD-specialist Dr Edward Shepherd, US.
View the preliminary program at www.barnveckan.se
and follow on Instagram: barnveckan2018