ABSTRACT
PURPOSE: The authors report the postoperative follow-up results of patients who underwent posterior rectal flap anorectoplasty (PRFA), with emphasis in fecal continence. Variables considered on each patient were sex, presence of fistula, location of the fistula, severity of the defect during the correction, sacral condition, dysraphism, and age at surgery. METHODS: Continence was rated using the Peña method and defecogram. The authors studied 20 patients (17 boys and three girls). RESULTS: Postoperatively, normal continence was found in 18 patients. Of the two remaining (boys), one had grade II spotting (sacrum agenesia and uretrobulbar fistula) and the other had grade II staining; this patient had the most severe malformation requiring an abdominoperineal approach. All of the defecograms showed complete emptying of the rectum. No recurrent fistulas occurred. CONCLUSIONS: The posterior rectal flap anorectoplasty is a new technique that takes into consideration all known factors that contribute to continence. This initial report confirms that this technique results in excellent continence for patients with imperforate anus.
Subject(s)
Fecal Incontinence , Rectum/abnormalities , Rectum/surgery , Surgical Flaps , Anal Canal/abnormalities , Anus, Imperforate/surgery , Child , Child, Preschool , Female , Humans , Male , Prospective StudiesABSTRACT
The first pediatric case of hepatic hydatidosis diagnosed in Mexico is reported. Previous to surgery, the diagnosis was established, based on a cystic tumor of the liver, the X ray findings, defects in the liver uptake, eosinophilia and Casoni's positive intradermal reaction. Besides, the immunoelectrophoresis test showed specific antibodies. Clinical and epidemiological considerations, related with the pathology and treatment of hydatidic disease are made, stressing the importance to know the symtoms of the illness, in order to establish the diagnosis and treatment. Likewise, the prognosis is evaluated considering the remaining cysts of the liver and the possible seeding of the parasite into the peritoneal cavity. Pertinent literature on the subject is reviewed.
Subject(s)
Echinococcosis, Hepatic/parasitology , Child , Humans , Radionuclide ImagingABSTRACT
Two cases of sacrococcygeal teratomas that were successfully treated surgically through the abdominosacral route are reported. Besides, a series of 36 children diagnosed through a period of 30 years is reviewed and considerations are made on the importance the classification of teratomas has, to choose the best route of approach for the surgical removal of these tumors. Mention is made of symptoms that allow the diagnosis of presacral teratomas and of those that show intrapelvic or abdominal extension.
Subject(s)
Pelvic Neoplasms/surgery , Sacrococcygeal Region/surgery , Teratoma/surgery , Female , Humans , Hydronephrosis/diagnostic imaging , Infant , Infant, Newborn , Male , Retroperitoneal Neoplasms/surgery , Sacrococcygeal Region/diagnostic imaging , Teratoma/diagnostic imaging , Urography , Vena Cava, Inferior/diagnostic imagingABSTRACT
A review of 10 years (1964-1973) of patients admitted to the Hospital Infantil de Mexico with duodenal obstruction is made. There were 70 cases, 33 of which corresponded to intrinsic obstruction and 37 to the extrinsic type. The clinical picture, whether complete or incomplete obstruction is involved, is analysed and the importance of radiology is emphasized to reach an early diagnosis. The surgical management is described in accordance with the type of lesion found. Mortality in this type of pathology is still high in spite of the improvement in surgical techniques and intensive management of newborns, considering that these patients usually show low weight and a high frequency of associated malformations.
