Juvenile intestinal ischemia–reperfusion (JII/R) is a pediatric surgical emergency caused by mesenteric vessel occlusion and has a high mortality rate. Malrotation can cause intestinal ischemia in infants due to midgut volvulus. It affects not only the intestine itself but also other organs, such as cardiac tissue. Therefore, searching for more effective therapeutic solutions is an essential critical need. This directed our thoughts to evaluate the role of ambrisentan (AMB) in a rat model of induced JII/R by clamping the superior mesenteric artery. Forty juvenile male Wistar albino rats (3–4 weeks old) were randomly divided into four experimental groups: control (CON) group, JII/R group, and AMB-treated groups (30, 60 mg/kg) with JII/R. Induction of JII/R results in significant changes in cardiac enzymes, oxidative stress, inflammatory, and apoptotic parameters with high expression of endothelin receptor A (ERA). Also, histopathological changes revealed extensive mucosal damage, loss of intestinal villi, dysregulated and degenerated cardiac fibers with inflammatory cell infiltration, and tissue necrosis. In contrast, AMB administration significantly reduced the elevated levels of cardiac enzymes, malondialdehyde (MDA), nuclear factor kappa B (NF-κB), ERA, and caspase-3 expression. However, AMB treatment increased immune expressions of phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt), Ki-67, and mammalian target of rapamycin (mTOR) and showed remarkable improvement in the histopathological changes. AMB could be considered as an adjuvant medical treatment for cases of JII/R.

Background: Anorectal malformations (ARMs) are congenital anomalies that affect the developing hindgut. Sacral development can be used as a prognostic factor in these patients because it parallels the development of the muscles and nerves of the perineum. This study aimed to evaluate the validity of using sacral ratio (SR) and sacral curvature (SC) as predictors for the type of ARMs. Methods: A prospective radiological observational study was conducted on 23 newborns with ARMs at Aswan University Hospitals. ARMs were classified according to the Wingspread classification into low, intermediate, and high. Sacral SR was measured in anteroposterior (AP) and lateral views and SC was measured in lateral view. Both were correlated with ARMs type. Results: High-type ARMs represented 47.8%, low and intermediate were 39.1% and 13%, respectively. Perineal fistula was the most common anomaly (30.4%). SR in both AP and lateral views was significantly lower in the high ARMs group compared to other groups ( p < 0.001). SC showed a lower mean in high ARMs but without statistically significant difference ( p = 0.115). Conclusions: SR in both AP and lateral views is a reliable marker for predicting ARMs severity. SC may provide complementary insights. Routine SR assessment is recommended in newborns with ARMs.