Patología del ombligo / Pathology navel

El cordón umbilical, tan vital en la vida intrauterina, no tiene una función fisiológica en el ser humano después del nacimiento. Entre los primeros 10-20 días de vida del recién nacido requiere de cuidados que el pediatra y personal de salud que realiza los controles debe indicar a la madre para asegurar que el proceso de desecación y eliminación del cordón se complete de forma apropiada. Sin embargo, aun cuando la madre haya seguido correctamente las indicaciones, existen posibilidades de que la evolución clínica no sea la normal y la cicatrización se retarde o complique. Las posibilidades que el clínico debe sospechar son bastante variadas dentro de un espectro que va desde patologías leves hasta aquellas más complejas que incluyen alteraciones del desarrollo intrauterino con resultado de malformaciones congénitas. El propósito de este artículo es revisar la literatura publicada al respecto y actualizar aspectos clínicos importantes que el pediatra o médico que atiende niños debe conocer para orientar correctamente el diagnóstico y oportunidad terapéutica.

The umbilical cord, is a vital structure in utero, but it has no one physiological function in humans after birth. Among the first 10-20 days old newborn baby requires care pediatrician and health staff should learn to the mother how she must be care to make the drying process and complete removal of the cord can be appropriate. However, even if the mother has correctly followed the instructions, there are chances that the clinical course than the normal healing is delayed or complicated. The chances that the clinician should suspect are quite varied within a spectrum from mild to the most complex pathologies including disturbances of intrauterine development resulting in congenital malformations. The purpose of this article is to review the published literature and update important clinical aspects pediatrician or physician who treats children should learn to correctly orient the diagnosis and therapeutic opportunity.

Congenital umbilical appendix

We report a case of a 3 years old female with umbilical appendix presenting with a fistula. Initial examination, which was done by a midwife, missed a congenital appendix protruding through the umbilicus. Ligation of this cord resulted in fistula formation. The patient was successfully managed by doing an appendectomy. Congenital umbilical anomalies are rare, only handful of cases have been reported so far. Most umbilical neonatal anomalies described in literature are derived from the vitelline duct. In this article we describe the clinical presentation and management of an umbilicus appendix presenting with a fistula following umbilical cord ligation. We also review the embryological origin, and aetiological facors

Persistência do uraco em gato: relato de caso / Urachal persistence in a cat: case report

Relata-se o caso de um gato que apresentava persistência do uraco, cujos principais sinais clínicos, iniciados apenas aos cinco meses de idade foram micção através da cicatriz umbilical, hiperemia da área circunvizinha e presença de uma fístula no centro do umbigo. A afecção foi diagnosticada mediante exames clínico, laboratorial, ultra-sonográfico e radiográfico, especialmente pela cistografia

It is reported a case of a cat presenting persistence of the urachal. The symptoms only began at five months of age. The diagnosis was confirmed by the clinical, laboratorial, ultrasonographic and radiographic exams, especially by the cystography

Plástica na anomalia umbilical num paciente portador de síndrome de rieger / Umbilical stump plasty in a patient with rieger syndrome

Neste estudo demonstra-se a tática encontrada pelos autores no tratamento da anomalia umbilical numa paciente portadora da síndrome de Rieger. A estratégia baseia-se na delimitação fusiforme e sinuosa no sítio do umbigo original.A partir desta projeção divide-se o umbigo anômalo em quatro retalhos, descolando-os sob o plano dérmico centrifugamente. Os retalhos são aproximados ao plano do neo-umbigo, ressecados os exces- sos e suturados na parte interna do umbigo previamente delimitado. Nesta paciente obteve-se a anatomia do umbigo com sucesso. Desse modo, os autores sugerem esta abordagem em casos similares.

In this study, the authors demonstrated a strategy to correct a challenge umbilical anomaly in a 20 years- old young woman with Rieger syndrome. The approach utilized was a four flaps technique performed easily, proportioning a nice anatomic shape of the altered umbilicus. In this way, the authors suggest that this procedure could be considered to the armamentarium of the plastic surgeon.

Reconstrução de umbigo após ressecção de foco de endometriose / Umbilicus reconstruction after endometriosis scar

Várias técnicas têm sido utilizadas para reconstruir a cicatriz umbilical, mas nenhuma tem mostrado ser a ideal para todos os casos. Os autores apresen- tam um caso de reconstrução imediata de umbigo, utilizando uma técnica de simples execução, realizada após ressecção de foco de endometriose.

Various techniques have been used to reconstruct umbilical scar, however none have appeared to be the ideal for all cases. The authors present a case of imediat reconstruction of umbilicus making use of an simple technique wich was done after resection if umbilical endometriosis.

Unusual manifestations of VACTERL association.

We report a case of VACTERL association along with unusual manifestations of pseudo-exostrophy of bladder, hemifacial microsomia and an urachal cyst communicating with the bladder.

Hernia del cordón umbilical: descripción de su patología / Hernia of the umbilical cord: description of the pathology

Se presenta un caso de hernia del cordón umbilical y se describe la patología del cordón umbilical

Los grandes defectos de la pared abdominal en el niño / The main defects of the abdominal wall in the children

Se describen algunas características sobresalientes de los 2 defectos congénitos de mayor magnitud de la pared abdominal (gastrosquisis y onfalocele). Adicionalmente, se propone una ruta crítica a manejo médico-quirúrgico dividida en 3 etapas: preoperatoria, transoperatoria y postoperatoria. No es aconsejable como parte del tratamiento, dejar un defecto herniano para cierre ulterior.