Development of the vermiform appendix inchildren from different age ranges

There is no precise anatomical trace that limits the vermiform appendix of the cecum in the newborn and in the child in the first years of life. The appendix presents a conical form, with an enlarged base and a narrow apex. The objective of the present work was to identify certain anatomical parameters, and to relate them chronologically to the different age groups in order to define when exactly the base of implantation of this organ in the cecum resembles the adult’s anatomy. Sixty-seven (67) ileocecal transition pieces were grouped according to the different age groups: Group A (18 pieces of newborns at term) – Group B (14 pieces of six months-old children) – Group C (13 pieces of 12 month-old children) – Group D (11 pieces of 24 month-old children) and Group E (11 pieces of adults). The point of contact of the ileum anti-mesenteric edge in the cecum was identified and the distance between this and the edges, right (d.r.e.i) and left (d.l.e.i.), of the appendix implantation was assessed. The results were demonstrated through the crossing of variables in the different age groups and the statistical significance level was considered for p < 0.05. From the sixty-seven (67) pieces, forty-seven (70.1%) were obtained from males and twenty (29.9%) from females. The average extension of the vermiform appendix length was 5.3 cm. The retro ileum position was predominant in the first year of life (groups A, B and C). The average of the variables according to the age group (groups A, B, C, D and E) was: D.L.E.I. = 0.0-0.0-0.5-2.0-2.5 cm respectively. D.R.E.I. = 1.1-1.0-1.3-2.3-2.8 cm respectively. DIAMETER of the BASE = 1.0-0.8-0.4-0.3-0.5 cm respectively. The crossing of the average values of the distances from the left margin of the appendix base to the ileum (d.l.e.i.) was performed in groups A, B, C and D with the average value in group E (adult)...

From the foot-mouth reflex to the hand-mouth reflex: a continuum of responses to appendicular compression

We studied the mouth opening response to appendicular compression in two groups of children. This study performed with the intention of testing the semiologic role of the act of mouth opening following stimulation of various regions, based on the hand mouth reflex of Babkin. Group I was formed by 33 normal children who underwent monthly follow up assessments since birth; and group II consisted of 50 children older than 6 months of age, known to have a neurologic deficit and a neuro-psychomotor development equivalent to that of a child in the first trimester of life. We observed that the normal mouth opening response in group I was more pronounced following compression of the hand and forearm when compared to compression of the arm (p<0.001). This response could persist for as long as the first 6 months of life. We were not able to elicit a mouth opening response following compression of the lower limb in this group. Among children from group II, we observed mouth opening responses to stimulation of all limb segments. Within the upper limb, the response was more pronounced following compression of the hand in comparison to the forearm (p<0.01), and forearm in comparison to the proximal arm (p<0.01). Stimulation of the foot was more effective in eliciting a mouth opening response when compared to equivalent stimulation of the lower leg (p<0.05). However, there was no statistical difference when responses to stimulation of the lower leg and thigh were compared. The presence of the previously unreported foot-mouth response may serve as an indicator of central nervous system compromise and could be associated with a poorer prognosis. We believe that our observations of the specific foot-mouth response patterns may serve as a marker of early neuro-psychomotor development dysfunction during childhood.

Apéndice cecal

Del apéndice cecal se detallan sus características anatómicas, funciones, tamaño y ubicación. La apendicitis aguda constituye la causa más frecuente de abdomen agudo, la misma se debe sospechar en cualquier paciente que se queje de dolor abdominal o presente síntomas que sugieren al cirujano, irritación peritoneal. Se describen las apendicitis aguda obstructiva, no obstructivas, efectos de la perforación, diagnóstico, formas especiales de apendicitis agudas, tratamiento, otras afecciones como los tumores mucoceles malignos, argentafinomas, adenocarcinomas, tuberculosis y traumatismos