Introduction. In recent years, there has been a significant rise in the number of pediatric cases involving multiple magnet ingestion, resulting in increased incidence and morbidity of injuries. When a metal object and magnet are ingested, either single or multiple, they can cause serious complications such as intestinal obstruction, ischemia, necrosis, fistula, perforation, and even death. This study aims to detail the complications and treatment approaches associated with magnet ingestion in children. Materials and Methods. In our study, we conducted a retrospective analysis of all cases involving the ingestion of a magnet along with a second metal object at two training and research hospitals in our province, which admit pediatric patients, between the years of 2013 and 2023. Results. A total of 42 patients had a history of magnet ingestion, with the number of ingested magnets ranging from 1 to 41. The median magnet size was 11 mm (range: 5.5-17.5 mm) and the median time to presentation was 24 hours (range: 3-48 hours). Thirteen patients (30.9%) required either endoscopic or surgical intervention to extract the magnets or address complications. Endoscopy was performed on eight patients, while surgical intervention was required for five patients. Among those who underwent surgery, four experienced complications, including intestinal perforation, ileoileal fistula, and internal herniation. Notably, no fatalities occurred following intervention. There was no statistically significant difference in age or magnet size between the interventional and non-interventional groups. However, the length of hospital stay was significantly longer in the interventional group compared to the non-interventional group (P

Megacystis-Microcolon-Intestinal Hypoperistalsis Syndrome (MMIHS) is a rare disorder characterized by smooth muscle dysfunction impairing the intestine and bladder. This disorder is commonly associated with a fatal prognosis. Here, we present a female neonate with antenatal clues who had abdominal distension since birth and underwent multiple exploratory laparotomies, and bladder distension requiring drainage by catheterisation. Unresponsive surgical procedures for bowel decompression were carried out. She was managed with total parenteral nutrition and jejunostomy. Mutation in the smooth muscle gamma-actin (ACTG2) gene confirmed the diagnosis. A timely high index of suspicion is crucial for neonates, especially females with abdominal and urinary distension. The early multidisciplinary assesment of the patient provides appropriate treatment modalities, and improves the survival.

Objectives: Testicular torsion is a time-critical pediatric urological emergency in which delayed presentation may increase the likelihood of orchiectomy. However, preoperative estimation of the immediate intraoperative outcome remains challenging. This study aimed to develop and internally validate machine-learning models integrating ischemic timing variables and complete blood count-derived inflammatory indices to predict orchiectomy versus testicular preservation at index surgical exploration in pediatric and adolescent testicular torsion. Methods: We retrospectively analyzed 165 children and adolescents who underwent surgical exploration for confirmed testicular torsion. The primary endpoint was orchiectomy at index exploration versus testicular preservation through detorsion and/or orchiopexy. Clinical timing variables and complete blood count-derived indices, including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, white blood cell-to-monocyte ratio, monocyte-to-mean platelet volume ratio, hemoglobin-to-monocyte ratio, systemic inflammatory response index, and aggregate index of systemic inflammation, were evaluated. Five supervised machine-learning algorithms—logistic regression, random forest, XGBoost, LightGBM, and support vector machine—were assessed using nested stratified cross-validation with an outer 5-fold loop and inner 3-fold hyperparameter selection. Model performance was estimated from out-of-fold predictions. Results: Orchiectomy was performed in 37 patients (22.4%), whereas testicular preservation through detorsion and/or orchiopexy was performed in 128 patients (77.6%). Symptom duration was significantly longer in the orchiectomy group than in the preservation group (48.00 [30.00–72.00] vs. 6.00 [2.00–24.00] h, p < 0.001). Monocyte count was also higher in the orchiectomy group (0.92 [0.68–1.23] vs. 0.65 [0.50–0.93] × 10⁹/L, p < 0.001). Among the combined models, XGBoost achieved the highest numerical discrimination, with a ROC-AUC of 0.926 ± 0.066 and a bootstrap 95% confidence interval of 0.856–0.966. Feature-block and interpretability analyses identified symptom duration as the dominant predictor, followed by emergency department waiting time and selected monocyte-centered inflammatory indices. Conclusions: Immediate intraoperative orchiectomy in pediatric and adolescent testicular torsion was most strongly associated with prolonged symptom duration, while selected complete blood count-derived inflammatory indices provided complementary risk information. The combined XGBoost model showed strong internal discrimination and clinically interpretable predictor patterns. However, the model was internally validated only and requires external validation before clinical implementation.