Abstract Purpose of Review Food protein induced allergic proctocolitis (FPIAP) is a frequently encountered non-IgE-mediated gastrointestinal disorder, affecting both breastfed and formula-fed infants. The natural history of FPIAP typically involves spontaneous resolution, often within the first year of life, even without specific dietary intervention. There are no sensitive or specific tests to diagnose FPIAP and thus diagnosis is typically made based on clinical criteria. Managing FPIAP remains challenging due to the relative paucity of objective data to inform practice. This review aims to provide a foundation for an evidence-based approach to FPIAP management. Recent Findings Recent research suggests a significant role for gut microbiota dysbiosis in FPIAP pathogenesis, with associations observed in infants with an atopic predisposition. Notably, FPIAP in infancy may correlate with an elevated risk of developing IgE-mediated food allergies later in life, indicating a potential mechanistic link between these immune responses. Summary A period of watchful waiting may be appropriate in well-appearing infants. However, for children with persistent symptoms, management centers around a cow’s milk restricted diet during lactation and/or hypoallergenic formula, guided by a registered dietitian. Strongly consider a food challenge with the dietary trigger 2-4 weeks after restriction to confirm the diagnosis and prevent unnecessary restrictions.

Abstract Purpose of the Review Chylothorax is the most common cause of neonatal pleural effusions. Although rare, neonatal chylothorax poses a significant risk for morbidity and mortality for these patients. Additionally, heterogeneity in the etiology of chylothorax and the variability in diagnostic and therapeutic techniques used by clinicians make standardization of evidence-based treatment guidelines difficult. The purpose of this review is to explore the existing and most recent literature on neonatal chylothorax to describe the diagnostic, imaging, and therapeutic modalities that are available to clinicians. Recent Findings In the majority of neonatal chylothorax cases, symptoms improve with nutritional and pharmacologic therapy alone. In recent years, there has been a transition in focus to minimally invasive imaging and interventional techniques for neonatal chylothorax resistant to conservative measures. In particular, the role of dynamic magnetic resonance lymphangiography and minimally invasive or microsurgical techniques such as thoracic duct embolization or lymphovenous anastomosis are being explored. Summary The goal of neonatal chylothorax management is to stop chyle accumulation by the most conservative and least invasive method possible. Larger, multicenter studies will be important to develop evidence-based treatment guidelines and improve outcomes in these patients.

Abstract Purpose of Review Irritable bowel syndrome (IBS) in children is a disorder of gut-brain interaction (DGBI) characterized by chronic abdominal pain related to bowel movements. This review aims to evaluate the clinical application of different therapies in pediatric IBS including current and new pharmacological and non-pharmacological treatments. Recent Findings While further pediatric data is needed in pediatrics to help optimize management, combination of pharmacologic and non-pharmacologic interventions are often used. Adult recommendations are published for the use of Linaclotide for IBS-C, tricyclic antidepressants for IBS-D. In pediatrics, CBT and hypnotherapy have been found to be successful in management of symptoms. Further evaluation is needed for the role of dietary changes and OMT. Summary Pediatric IBS may be difficult to treat and often requires both pharmacologic and non-pharmacologic management. There is no clear consensus for management of pediatric IBS and will often require implementation of adult recommendations for pediatric use. Gut directed hypnotherapy has been clearly shown to improve symptoms of IBS in children. Further studies are needed in pediatrics in the management of IBS.

Abstract Background Tubularized incised plate (TIP) urethroplasty is widely used for distal hypospadias but may be suboptimal in patients with narrow or scarred urethral plates. Grafted TIP (GTIP), incorporating a dorsal inlay graft, is an emerging alternative to improve outcomes in such cases. Objective To describe the indications, techniques, outcomes, and evolving perspectives on inlay graft use in distal hypospadias repair. Methods A narrative review was conducted using published studies, prospective trials, and network meta-analyses comparing TIP and GTIP outcomes, with attention to complication rates, functional results, and decision-making tools. Results GTIP offers superior healing and reduced complications in patients with unfavorable urethral plates. While operative time is longer, uroflowmetry and cosmetic outcomes are comparable. Technical success relies on graft type, accurate incision, and tension-free multilayer closure. Conclusion GTIP represents a valuable adaptation of TIP for selected patients with distal hypospadias. GTIP should be considered when urethral plate characteristics predict poor healing. Further prospective studies are warranted to validate its long-term outcomes.