ABSTRACT
Paciente intervenido quirúrgicamente de estenosis hipertrófica de píloro, con reaparición de clínica después de un período asintomático. El caso obliga a su estudio hasta llegar al diagnóstico de gastritis eosinofílica. Se realiza una revisión de esta entidad: síntomas, métodos diagnósticos y tratamiento. (AU)
Subject(s)
Humans , Eosinophilia/complications , Gastritis/etiology , Pyloric Stenosis/surgery , RecurrenceABSTRACT
La incidencia del tumor de Wilms bilateral es entre el 5 y 10% de los casos de nefroblastoma. La forma metacrónica representa el 2-3%. El 96,2% de las formas metacrónicas aparecen durante los primeros 5 años tras el tumor primario. Las malformaciones asociadas son más frecuentes en las formas bilaterales. La aparición de un tumor metacrónico constituye una dificultad terapéutica. Se describe el caso de una niña de 11 años con hemihipertrofia izquierda diagnosticada de recidiva metacrónica de tumor de Wilms tras 7 años del primer diagnóstico. Recibió 5 ciclos de quimioterapia preoperatoria. Se realizó tumerectomía. Por complicación posquirúrgica se realizó nefrectomía del único riñón. La paciente se encuentra en insuficiencia renal crónica por su condición de anéfrica, dependiente de hemodiálisis. Se continuó el tratamiento posquirúrgico con carboplatino y etopósido. Actualmente se encuentra en remisión completa. Es excepcional la presentación de las formas metacrónicas del tumor de Wilms después de los primeros 5 años del tumor primitivo. Cuando aparece el tumor contralateral la quimioterapia debe mantenerse hasta conseguir la reducción del tamaño tumoral para poder preservar la función renal y evitar la diálisis. En los casos de insuficiencia renal crónica secundaria a una nefrectomía bilateral la elección de los quimioterápicos efectivos y el conocimiento de la farmacocinética y farmacodinámica de éstos hace posible continuar el tratamiento en estos pacientes con el soporte adecuado de hemodiálisis (AU)
Subject(s)
Child , Female , Humans , Neoplasms, Second Primary , Wilms Tumor , Kidney NeoplasmsABSTRACT
Wilms' tumor occurs in 5-10 % of all cases of nephroblastoma. The metachronous form represents 2-3 % of cases. Most (96.2 %) metachronous tumors appear within the first 5 years of the primary tumor. Associated malformations are more common in bilateral cases. Metachronous tumors are a therapeutic challenge. We describe the case of an 11-year-old girl with left hemihypertrophy. The diagnosis was metachronous relapse of Wilms' tumor 7 years after the first diagnosis. The patient received five courses of preoperative chemotherapy and tumorectomy was performed. Because of post-surgical complications, nephrectomy was performed on her only kidney. Since she is anephric, the patient is in chronic renal failure and is dependent on dialysis. Treatment with carboplatin and etoposide was continued after surgery and the patient is currently in complete remission. The appearance of a metachronous Wilms' tumor 5 years after that of the primary tumor is rare. When a contralateral tumour develops, chemotherapy must be given until the size of the tumor is reduced in order to preserve renal function and avoid dialysis. In patients with chronic renal failure caused by bilateral nephrectomy, ongoing treatment with dialysis support can be achieved through the choice of effective drugs and knowledge of their pharmacokinetics and pharmacodynamics.
Subject(s)
Kidney Neoplasms , Neoplasms, Second Primary , Wilms Tumor , Child , Female , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/therapy , Neoplasms, Second Primary/diagnosis , Neoplasms, Second Primary/therapy , Wilms Tumor/diagnosis , Wilms Tumor/therapyABSTRACT
A case of Apple Peel syndrome in a 1,800 g. premature female infant is reported. In a two stage approach, the dilated proximal segment of the jejunum was treated with jejunoplasty and termino-terminal anastomosis. After 55 days of total parenteral nutrition, oral feedings were instituted with good tolerance and satisfactory weight gain. Five months postoperatively, her weight is 5,500 g. and is on a standard diet for her age.
Subject(s)
Infant, Premature, Diseases/diagnostic imaging , Intestinal Atresia/diagnostic imaging , Female , Humans , Ileum/abnormalities , Ileum/diagnostic imaging , Ileum/surgery , Infant, Newborn , Infant, Premature, Diseases/surgery , Intestinal Atresia/surgery , Jejunum/abnormalities , Jejunum/diagnostic imaging , Jejunum/surgery , RadiographyABSTRACT
A group of 17 patients with different types of hemangiomas that were submitted to treatment with steroids (prednisone) is studied. The results obtained are analyzed, together with the indications for the drug, its mechanism of action and the advantages of the doses used. Although this is not a definitive solution in all cases, considering the short number of complications observed, it is believed to be a treatment that be taken into account before more aggresive measures are followed, but it should never be done routinely.
Subject(s)
Hemangioma/drug therapy , Prednisone/therapeutic use , Adolescent , Child , Child, Preschool , Drug Evaluation , Humans , Infant , Infant, Newborn , Male , Prednisone/adverse effectsABSTRACT
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.
