ABSTRACT
The authors present a rare case of closed abdominal trauma in a five year old girl resulting from a washtub fall on her causing three lacerations in the middle third of the esophagus, identified 48 hours after the trauma. The stitcher surgical treatment of the lacerations associated with gastrostomy and lengthy parenteral nutrition did not prevent the recurrence of the esophagus-pleural fistula, and an esophagectomy plus cervical esophagostomy was required. After a 10-month follow-up, the digestive passage was reconstructed by an esophagocoloplasty. At present, after 5 years of follow-up, the patient is cured. The authors discuss the causes of esophagus rupture in children and its etiopathogeny. They propose that preservativement the esophagus is the best initial treatment, in spite of the foot that this procedure was ineffective in the present case.
Subject(s)
Esophagus/injuries , Wounds, Nonpenetrating/complications , Child, Preschool , Female , Humans , Rupture , Thoracotomy , Wounds, Nonpenetrating/surgeryABSTRACT
Menino de 4 anos de idade, portador de estenose congenita da regiao supra-hepatica da veia cava inferior, associada a cirrose hepatica precoce, apresentava hepato e esplenonegalia, ascite e circulacao venosa colateral abdominal como principais sinais clinicos. A angiografia da veia cava inferior mostrou lesao obstrutiva com reducao concentrica por diafragma membranoso. A remocao cirurgica da membrana foi realizada por abordagem da veia cava, atraves de atriotomia direita, com auxilio de circulacao extracorporea. No periodo pos-operatorio, apresentou derrame pericardico seroso importante e ascite recorrente tratados com puncao evacuadora, albumina humana e diureticos. Tres meses apos a operacao, o paciente encontrava-se assintomatico.Destaca-se a importancia de diagnosticar e tratar precocemente esta rara anomalia congenita, que pode provocar lesao hepatica irreversivel