ABSTRACT
We present the case of an 8-year-old boy accidentally diagnosed of a splenic tumor by ultrasound and computed tomography scan of the abdomen. The patient was treated surgically with a conservative surgical technique (wedge resection and splenorraphy). The histologic study revealed a hamartoma and by immunohistologic study a clear differentiation with the splenic capillary hemangioma could be made.
Subject(s)
Hamartoma/surgery , Splenic Diseases/surgery , Biopsy , Child , Diagnosis, Differential , Hamartoma/metabolism , Hamartoma/pathology , Hemangioma, Capillary/pathology , Humans , Immunohistochemistry , Male , Spleen/metabolism , Spleen/pathology , Splenectomy , Splenic Diseases/metabolism , Splenic Diseases/pathology , Splenic Neoplasms/pathologyABSTRACT
The authors present 40 cases of Meckel's diverticulum in pediatric patients (average age 6.8 years old). 31 of these (77.5%) were discovered casually in surgery and the other nine (22.5%) presented specific symptoms (three intestinal intussusceptions, three perforations, one hemorrhage, a wet umbilicus and an intestinal obstruction). In this group, seven abdominal radionuclide scan were practiced with 99mTc, resulting in two positive diagnosis (28.5%). All patients were treated with short ileal resection. The histopathological study revealed in nine cases (22.5%) the presence of gastric ectopic mucosa and, in one of them, pancreatic tissue was also found. The only morbidity was a postoperative intestinal obstruction that occurred several months later and that required surgery. The mortality was zero and the average hospital stay was 8.6 days.
Subject(s)
Meckel Diverticulum/surgery , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Intestinal Obstruction/etiology , Male , Meckel Diverticulum/diagnosis , Postoperative Complications , RecurrenceABSTRACT
This report presents a pediatric case of right colic angiodysplasia and perhaps jejunoileal with lethal evolution by the great intensity of bleeding. Are discussed the different etiopathogenesis and the difficulties for the clinicopathological diagnosis and the actual trend towards a conservative treatment (electrocoagulation versus intestinal resection).
Subject(s)
Arteriovenous Malformations/complications , Colon/blood supply , Gastrointestinal Hemorrhage/etiology , Arteriovenous Malformations/diagnostic imaging , Child , Colectomy , Female , Humans , RadiographyABSTRACT
The present report analyzes two cases of homozygotic familiar hypercholesterolemia. An actualization on the etiopathogenesis, the poor short term prognosis and the bad results obtained with the conservative therapy are discussed. The different surgical approaches excluding liver transplantation are reviewed. Both cases underwent staged portocaval shunts and ileal exclusions afterwards. Short and intermediate results are exposed.
Subject(s)
Hyperlipoproteinemia Type II/surgery , Portacaval Shunt, Surgical , Cholesterol/blood , Female , Humans , Hyperlipoproteinemia Type II/blood , Infant , Male , Time FactorsSubject(s)
Ileal Diseases/pathology , Jejunal Diseases/pathology , Adolescent , Child, Preschool , Female , Humans , Ulcer/pathologySubject(s)
Pancreatic Cyst/congenital , Adolescent , Humans , Male , Pancreatic Cyst/diagnosis , Pancreatic Cyst/pathologyABSTRACT
Thirty-one patients with ages ranging from 4 to 16 years (average 10.3 years) with portal intrahepatic hypertensión 15 and extrahepatic hypertensión 15 are presented. Decompressive surgery on an electrive basis was carried out in all patients but one in whom it was applied as a prophylactic procedure. Twelve portocaval and five splenorrenal shunts were performed in the first group while twelve mesentericocaval and five splenorrenal shunts were carried out on the second one. The overall postoperative mortality was 12.90% (three patients from the first group and one from the second one). Anastomotic thrombosis was 19.35% (one patient from the first group and five from the second one). Recurrent hemorrhage was 3.22% (one patient in the second group). Neither encephalopathy nor long-term mortality has been noticed on survivors of both groups that were followed up from three months to fifteen years. Comments are made emphasizing the importance of surgical technical aspects as well as the surgical control of the anastomotic permeability in order to achieve better results that will make possible to increase the number of indications and their precocity.
Subject(s)
Hypertension, Portal/surgery , Adolescent , Child , Child, Preschool , Evaluation Studies as Topic , Female , Humans , Male , Mesenteric Veins/surgery , Portacaval Shunt, Surgical , Postoperative Complications , Splenorenal Shunt, Surgical , Vascular Surgical Procedures , Vena Cava, Inferior/surgeryABSTRACT
A series of 40 children (average age 8,7 years) with hepatic hydatic disease is presented. The clinical diagnosis was based on palpation of the tumour and/or hepatomegaly in 95% (38 patients). Other symptoms such as pain, fever and jaundice were less frequent (47,5%, 22,50% and 12,50%, respectively). Other diagnostic tests yielded the following results: the Casoni skin test was positive in 68,57%, the investigation of antibodies in 40% and the Weinberg reaction in 38,70%. The ultrasonography which was carried out only on the last two patients was definitive. The scintigraphy carried out on 30 patients was positive in 93,33%. Due to the polymorphism of the disease all surgical proposals are considered to be initially acceptable. However, the high rate of bile involvement resulting from our experience (55%) has induced us to favour the Lagrot surgical technique with routine surgical colangiography in 16 patients in order to achieve short postoperative periods (10,3 days) and 6,25% of morbidity (one case of biliary fistula). Following all surgical procedures, there was no mortality. No recurrence has been found within a follow-up time ranging from 1 to 14 years.
Subject(s)
Echinococcosis, Hepatic/diagnosis , Adolescent , Child , Child, Preschool , Echinococcosis, Hepatic/surgery , Female , Humans , Male , Methods , Postoperative ComplicationsABSTRACT
A series of fourteen colon esophagoplasties carried out in children suffering from different pathologies (seven caustic stenosis, five of the peptic type and two atresias) is reported. The intestinal segments used were the terminal ileum right colon in seven cases and the transverse left colon in the other seven. A decreasing number of indications has been observed. The main technical aspects are commented. The results of this technique have been rewarding: a reduced morbidity with no mortality and excellent long-term function were obtained in twelve patients.
Subject(s)
Colon/transplantation , Esophagoplasty , Adolescent , Burns, Chemical/surgery , Child , Child, Preschool , Esophageal Diseases/surgery , Female , Humans , Infant , Male , Postoperative ComplicationsABSTRACT
We emphasize the present change of surgical attitude towards splenic injuries from radical surgery to conservative techniques. The research results from experimenting upon 12 dogs with splenorrhaphies, segmentary resections and partial heterotopic autotransplantations are presented. Splenorrhaphy clinical application was tried in 12 children followed by satisfactory results, without morbi-mortality. We considered scintigraphy with 99m technetium-sulfide colloid to be the best method known for early diagnosis of spleen injury. Likewise, we suggest the possibility of partial heterotopic autotransplantation in cases with necessary splenectomy.
