ABSTRACT
INTRODUCTION: Spigelian hernias in childhood are extremely uncommon. The aim of this study was to analyse the pathogenetic factors of paediatric Spigelian hernias. PATIENTS AND METHOD: A retrospective review of worldwide literature for infants who had undergone surgical repair of a Spigelian hernia from 1950 to 2006. Descriptive statistical techniques were applied and percentages and means were calculated. RESULTS: There were 33 patients in whom 40 Spigelian hernias were repaired, 26 males and 7 females, with a sex ratio of 3.7/1. The mean age was 2.7 years. 7 hernias are bilateral. RISK FACTORS: anal stenosis (n = 1). Associated defects: cryptorchidism (n = 22), inguinal hernia (n = 5), umbilical hernia (n = 2). The most common hernia contents are testicle (40%), small intestine ( 27.5%) and omentum (15%). CONCLUSIONS: The mean age of Spigelian hernia in children was 2.7 years, which would suggest a congenital cause. Spigelian hernias in infants are more common in males. There were 21.2% bilateral hernias. No risk factors were detected. Combined hernias accounted for 15.1% of the total. The most frequent hernia content is the testicle (40%). Interestingly, 48.4% of those infants with Spigelian hernias had ipsilateral cryptorchidism, which may suggest a new syndrome.
Subject(s)
Cryptorchidism/surgery , Hernia/congenital , Herniorrhaphy , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Preoperative Care , Retrospective Studies , Risk FactorsABSTRACT
Introducción. La hernia de Spiegel es muy poco frecuente en la infancia. El objetivo de este trabajo es analizar los aspectos etiopatogénicos de estas hernias. Material y método. Analizamos retrospectivamente a los pacientes pediátricos con reparación quirúrgica recogidos en la literatura entre 1950 y 2006. Se aplicó estadística descriptiva con cálculo de porcentajes y medias. Resultados. Se analiza a 33 pacientes menores de16 años tratados quirúrgicamente de 40 hernias de Spiegel. La media de edad fue 2,7 años. Había 26 varones y 7 mujeres, en proporción de 3,71:1. Había 15hernias derechas, 11 izquierdas y 7 bilaterales. Factores predisponentes: estenosis de ano (n = 1). Anomalías asociadas: criptorquidia (n = 22) (10 ipsolateralesy 6 bilaterales), hernia inguinal (n = 5), hernia umbilical(n = 2). El contenido del saco más frecuente fue el testículo (el 40% de todas las hernias), seguido de intestino delgado (27,5%) y epiplón (15%).Conclusiones. La media de edad de los pacientes pediátricos con hernias de Spiegel es de 2,7 años, lo que indica una causa congénita. Las hernias de Spiegel pediátricas son más frecuentes en varones. Estas hernias son bilaterales en el 21,2% de los pacientes. Hay pocos factores predisponentes. Aparecen hernias asociadas en el 15,1%. El contenido del saco más frecuente es el testículo (40%). La asociación entre hernia de Spiegel y criptorquidia ipsolateral ocurre en el 48,4% de los pacientes, lo que puede significar un nuevo síndrome (AU)
Introduction. Spigelian hernias in childhood are extremely uncommon. The aim of this study was to analyse the pathogenetic factors of paediatric Spigelianhernias. Patients and method. A retrospective review of worldwide literature for infants who had undergone surgical repair of a Spigelian hernia from 1950 to2006. Descriptive statistical techniques were applied and percentages and means were calculated. Results. There were 33 patients in whom 40 Spigelian hernias were repaired, 26 males and 7 females, with a sex ratio of 3.7/1. The mean age was 2.7 years.7 hernias are bilateral. Risk factors: anal stenosis (n =1). Associated defects: cryptorchidism (n = 22), inguinal hernia (n = 5), umbilical hernia (n = 2). The most common hernia contents are testicle (40%), small intestine( 27.5%) and omentum (15%).Conclusions. The mean age of Spigelian hernia in children was 2.7 years, which would suggest a congenital cause. Spigelian hernias in infants are more common in males. There were 21.2% bilateral hernias. No risk factors were detected. Combined hernias accounted for 15.1% of the total. The most frequent hernia content is the testicle (40%). Interestingly, 48.4%of those infants with Spigelian hernias had ipsilateral cryptorchidism, which may suggest a new syndrome (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Hernia, Ventral/surgery , Hernia, Ventral/etiology , Hernia, Ventral/congenital , Cryptorchidism/complications , Retrospective Studies , Age Factors , Sex Factors , Hernia, Ventral/diagnosisSubject(s)
Gastrointestinal Hemorrhage/etiology , Klippel-Trenaunay-Weber Syndrome/complications , Colonoscopy , Fatal Outcome , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/surgery , Humans , Klippel-Trenaunay-Weber Syndrome/diagnosis , Klippel-Trenaunay-Weber Syndrome/surgery , Laparotomy , Male , Middle AgedABSTRACT
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Subject(s)
Male , Middle Aged , Humans , Gastrointestinal Hemorrhage/etiology , Angiomatosis/complications , Mesentery , Klippel-Trenaunay-Weber Syndrome/diagnosis , Disseminated Intravascular Coagulation/complicationsABSTRACT
La rotura del uréter es una entidad clínica poco frecuente que puede ocasionar graves consecuencias. Su causa más habitual es la iatrogenia durante una intervención quirúrgica. Otras posibles causas son las maniobras urológicas o urográficas. En nuestra paciente, como caso único publicado hasta el momento, la rotura se ocasionó por un sondaje urinario traumático, al hinchar el balón de la sonda en el interior de un uréter. Los síntomas de la rotura uretral son los de un cólico nefrítico, aunque en ocasiones puede simular un abdomen agudo. Es importante valorar la posibilidad de lesión uretral en pacientes intervenidos de cirugía abdominopélvica o sometidos maniobras urológicas que presenten esta clínica. El tratamiento es quirúrgico, aunque en algunos casos podrían considerarse medidas conservadoras (AU)
Rupture of the ureter is an infrequent event that can have serious consequences. The most frequent cause is surgical iatrogenic ureter disease. Other possible causes are urological procedures and urographic studies. In our patient, which, to our knowledge, is the first to be reported in the literature, the ureteral rupture was produced by a traumatic urinary catheterism, because the balloon was filled inside the ureter. The normal presentation is nephritic colic, although acute abdomen is also a possibility. The possibility of ureteral rupture in abdominopelvic surgery or in urological techniques should be evaluated when patients present these clinical symptoms. Treatment is surgical, although in some cases conservative measures can be used (AU)
Subject(s)
Female , Aged , Humans , Iatrogenic Disease , Ureter/injuries , Urologic Surgical Procedures/adverse effects , Rupture/etiologyABSTRACT
Rupture of the ureter is an infrequent event that can have serious consequences. The most frequent cause is surgical iatrogenic ureter disease. Other possible causes are urological procedures and urographic studies. In our patient, which, to our knowledge, is the first to be reported in the literature, the ureteral rupture was produced by a traumatic urinary catheterism, because the balloon was filled inside the ureter. The normal presentation is nephritic colic, although acute abdomen is also a possibility. The possibility of ureteral rupture in abdominopelvic surgery or in urological techniques should be evaluated when patients present these clinical symptoms. Treatment is surgical, although in some cases conservative measures can be used.
Subject(s)
Ureter/injuries , Urinary Catheterization/adverse effects , Aged , Aged, 80 and over , Female , Humans , Iatrogenic Disease , RuptureABSTRACT
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