Christmas disease and pyloromyotomy

A 4-week-old infant developed a life-threatening haemorrhage following pyloromyotomy. Subsequent investigations revealed unsuspected Christmas disease (Haemophilia B). This case emphasises the importance of considering a diagnosis of haemophilia in a child with unexplained bleeding, even in the absence of a positive family history.     

A Christmas Dialysis Vignette

Every Christmas, a card with a touchingly wry message from thepatient arrives, reminding me of a ‘near miss’. A few months before he retired my senior colleague, who hadlooked after her and her father, introduced her to me hintingthat a very careful approach would be needed. She has adult polycystic kidney disease. Problems had startedearly—at the age of 21 she had developed a left renalabscess, which     

A Christmas tree in the larynx

A 2 year-old boy presented with acute upper airway obstruction following a 15-month history of noisy breathing and hoarseness. An urgent laryngotracheal bronchoscopy was performed following inhalational induction of anesthesia. Using a fiberoptic bronchoscope, visualization of the larynx through a laryngeal mask airway revealed a flat plastic Christmas tree embedded within granulomatous cords causing almost complete obstruction and requiring tracheostomy prior to extraction. Twelve days later, the tracheostomy was successfully decannulated with the child's voice beginning to normalize. The family remembered the decoration from Christmas celebrations 2 years prior and recalled a coughing episode that predated the onset of hoarseness.