An unusual complication of appendicitis in childhood.

Mesenteric venous thrombosis has not been reported after an appendicectomy in the pediatric literature. We report on a special and very unusual complication in a girl who presented mesenteric venous thrombosis (MVT) following an appendicectomy for gangrenous appendicitis. The early diagnosis of this entity is vital in order to start the anticoagulation treatment which could allow preservation of bowel viability. The therapy should be continued for a long time to decrease the risk of relapse.

Faecal incontinence in children with spina bifida: the best conservative treatment.

Incontinence is one of the major stigmata affecting the quality of life of the myelodysplastic patient. The appropriate management of the neuropathic bladder has led most patients to survive with good conditions. Major advances have also been made in the treatment of faecal incontinence for enabling patients to achieve their full potential, to become integrated in society and to be as independent as possible. We present the results of the Retrograde Colonic Enema (RCE) in 33 patients suffering neurogenic faecal incontinence. We believe that the RCE is one of the best conservative methods of treatment for relieving faecal incontinence originating from spina bifida and other neurological problems with intestinal dysfunction.

Mesenteric venous thrombosis after appendicectomy in a child: clinical case and review of the literature.

Mesenteric venous thrombosis (MVT) after appendicectomy has not been reported in the pediatric literature. This complication is associated with significant morbidity and mortality rates in adults. The report of this case attempts to analyze the features found in an appendicectomized child documented by radiological examination and surgery before and after starting heparin therapy. Anticoagulation treatment should be started as soon as possible and continued for a long time to decrease the risk of relapse.

Uncommon case of gastrinoma in a child.

Gastrinoma is a kind of neuroendocrine tumor very rare in children. It can be described as solitary and has been reported in the liver and in the kidney; or as part of MEN type I (tumors of parathyroids, pancreatic islets and pituitary). We report here, a solitary and huge pancreatic gastrinoma in a young girl with a Zollinger-Ellison (Z-E) syndrome, whose diagnosis was delayed by misunderstanding of the symptoms.

Gallbladder carcinoma in an achondroplastic boy.

Carcinoma of the gallbladder in an extremely rare tumor in childhood. We have found only five cases in the literature. Most of them were associated with an ethnic group - The Navajo Indians - who are known to have high incidence of gallbladder disease. We report here on the exceptional presence of this type of tumor in a child, who also had achondroplasia. This, as far as we can determine, is the first such case ever reported.

[Neonatal tracheomalacia. Study of 3 cases treated with aortopexy+]. / Traqueomalacia neonatal. Estudio de tres casos tratados con aortopexia.

Neonatal tracheomalacia is a disease in which there is a softening of the tracheal wall with lost of this consistency. This cause expiratory collapse cough and respiratory difficulty it is generally associated with Esophageal atresia and Vascular Rings. Exceptionally is a primary disease. In this paper we present three cases of neonatal tracheomalacia treated by aortopexy who is at the moment the best treatment that we have in severe cases. Soft cases will remit with conservative treatment.

[Gastroschisis: study of teratogenic factors]. / Gastrosquisis: estudio de factores teratogénicos.

The medical and surgical treatment of gastroschisis has improved in the last decades leading to better survival rates. Since in our institution there were the same cyclic variations in the incidence as in other large series in the literature, we have reviewed the epidemiological factors that can be at the origin of such variations. We studied 20 different variables in our patients in a case-control basis. Only five of them were significantly different between cases and controls. (Birth weight, gestational age, infection, drugs during the first three months of gestation and maternal age). The results point to the role of environmental factors more relevant in the etiology of gastroschisis than genetic ones.

[Surgical treatment of differentiated carcinoma of the thyroid. Retrospective study]. / Tratamiento quirúrgico del carcinoma diferenciado de tiroides. Estudio retrospectivo.

This is a review of the surgical treatment in six patients with papillary carcinoma of the thyroid. The mean age at the time of diagnosis was eight years (range four-twelve years). Clinical presentation was: all patients had a palpable thyroid tumor, palpable lymph nodes in four and one with lung metastases. The initial surgical treatment was lobectomy and modified regional lymph nodes resection. Four patients underwent a second operation for multifocal disease, palpable lymph node or thyroid tumor. The interval from initial surgical management to the detection of recurrence ranging from one month to four years. In three patients the remaining thyroid gland was removed. Radioiodine, external irradiation and chemotherapy were given during the postoperative. The median follow-up was eight years (range one-fifteen years). All patients are alive with thyroid hormone therapy by hypothyroidism. There were no hypoparathyroidism or injuries to the recurrent laryngeal nerve. The results of this study suggest that the surgical approach in papillary carcinoma of the thyroid is total thyroidectomy because reoperation were performed in four patients.