ABSTRACT
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Subject(s)
Humans , Male , Pyoderma Gangrenosum/diagnosis , Carcinoma, Squamous Cell , Prednisone/administration & dosage , Pyoderma Gangrenosum/diagnostic imaging , Pyoderma Gangrenosum/drug therapy , Diagnosis, Differential , Skin Ulcer , Ultrasonography , Tomography, Spiral ComputedABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Chin/injuries , Primary Health Care , Anti-Bacterial Agents/therapeutic use , Erythema/diagnosis , Erythema/drug therapy , Superinfection/complications , Arthrodermataceae , Administration, Topical , Diagnosis, Differential , Superinfection/drug therapyABSTRACT
No disponible
Subject(s)
Humans , Female , Child , Nevus, Pigmented/complications , Eczema/diagnosis , Hypopigmentation/diagnosis , Erythema/diagnosis , Pruritus/etiologyABSTRACT
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Subject(s)
Humans , Female , Aged, 80 and over , Xanthomatosis/diagnosis , Breast Neoplasms/complications , Diagnosis, Differential , Postoperative Complications , Chemoradiotherapy/adverse effectsSubject(s)
Chin/injuries , Inflammation/diagnosis , Tinea/diagnosis , Diagnosis, Differential , Humans , Inflammation/pathology , Male , Middle Aged , Tinea/pathologySubject(s)
Breast Neoplasms/radiotherapy , Neoplasms, Radiation-Induced/etiology , Radiotherapy, Adjuvant/adverse effects , Xanthomatosis/etiology , Aged, 80 and over , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Biopsy , Breast Neoplasms/drug therapy , Breast Neoplasms/surgery , Combined Modality Therapy , Diagnosis, Differential , Female , Humans , Mastectomy , Mastitis/diagnosis , Neoplasm Recurrence, Local/diagnosisABSTRACT
La dermatitis anular liquenoide de la infancia es una entidad de etiología desconocida que forma parte del grupo de las dermatosis liquenoides. Afecta sobre todo a niños y adolescentes, mostrando unas características clinicopatológicas definidas que permiten su diagnóstico. Presentamos 2 nuevos casos de dermatitis liquenoide anular de la infancia en 2 niñas de 4 y 2 años y medio, respectivamente, que presentan las características clínicas clásicas de esta entidad. A diferencia del resto de casos publicados el examen histopatológico mostró un infiltrado inflamatorio liquenoide situado principalmente en el techo de las papilas dérmicas, y no en la punta de las crestas epidérmicas. En ambos casos las lesiones regresaron espontáneamente sin necesidad de tratamiento
Annular lichenoid dermatitis of youth is a lichenoid dermatosis of unknown etiology. It mostly affects children and adolescents and has well-defined clinical and histological characteristics that permit a diagnosis. We present 2 new cases of annular lichenoid dermatitis of youth with classical clinical features in 2 girls, aged 2 and 4 years. The histologic findings, however, differed from those reported in the literature in that the lichenoid inflammatory infiltrate was located primarily at the top of the dermal papillae and not at the tips of the rete ridges. In both cases, the lesions regressed spontaneously without treatment
Subject(s)
Humans , Female , Infant , Lichenoid Eruptions/diagnosis , Mycosis Fungoides/diagnosis , Biopsy , Diagnosis, Differential , Dermatomycoses/diagnosisABSTRACT
Annular lichenoid dermatitis of youth is a lichenoid dermatosis of unknown etiology. It mostly affects children and adolescents and has well-defined clinical and histological characteristics that permit a diagnosis. We present 2 new cases of annular lichenoid dermatitis of youth with classical clinical features in 2 girls, aged 2 and 4 years. The histologic findings, however, differed from those reported in the literature in that the lichenoid inflammatory infiltrate was located primarily at the top of the dermal papillae and not at the tips of the rete ridges. In both cases, the lesions regressed spontaneously without treatment.
Subject(s)
Lichenoid Eruptions/pathology , Child, Preschool , Female , HumansABSTRACT
No disponible
Subject(s)
Adult , Female , Humans , Breast Diseases/chemically induced , Breast Diseases/complications , Breast Neoplasms/complications , Breast Neoplasms/surgery , Dermis/anatomy & histology , Dermis/pathology , Dermis , Mammaplasty/instrumentation , Breast/surgery , Hyperpigmentation/surgery , Breast/injuries , Mammaplasty/methods , Hyperpigmentation/complications , Cicatrix/complications , Cicatrix/surgery , Magnetic Resonance Imaging/methods , Fibrosis/complications , Fibrosis/surgery , Fibrosis , Mastitis/complicationsSubject(s)
Breast Implants/adverse effects , Mastitis/diagnostic imaging , Silicones/adverse effects , Adult , Diagnosis, Differential , Erythema Induratum/diagnosis , Female , Hidradenitis Suppurativa/diagnosis , Humans , Mammaplasty , Mastectomy , Mastitis/chemically induced , Mastitis/diagnosis , Mastitis/surgeryABSTRACT
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Carcinoma, Squamous Cell/surgery , Nose/surgery , Nose Neoplasms/surgery , Plastic Surgery Procedures/methods , Surgical Flaps , Esthetics , Suture TechniquesABSTRACT
BACKGROUND: The purpose of our study was to evaluate the results and complications of laparoscopic cholecystectomy in a case series of 110 infants. METHODS: Over a 5-year period (1993-98), we performed laparoscopic cholecystectomy in 110 pediatric patients. Surgery was performed at different institutions by three different surgeons. The patient population was composed of 69 girls and 41 boys; their ages ranged from 1 to 16 years (median, 8.5). All of the 110 children had symptomatic cholelithiasis, which was confirmed at ultrasound examination. An associated pathology was present in 27 patients (sickle cell disease in 17 cases, hereditary spherocytosis in seven cases, thalassemia in three); the other 83 infants were affected by idiopathic cholelithiasis. In 107 patients, the operation was performed using four ports; in three patients, it was done using five ports. In three patients, we also performed a concomitant splenectomy. RESULTS: Median duration of simple cholecystectomy was 45 min (range, 25-75) and hospital stay ranged from 1 to 10 days (median, 2). Only 15 children required drainage. We had 17 complications in our series (15.5%), including a gallbladder perforation during dissection in 11 patients, a fall of stones into the abdominal cavity during extraction in one patient, and a trocar orifice infection in the postoperative period in five patients. At a maximum follow-up of five years (range, 1-5), all patients were doing well. CONCLUSION: Laparoscopic cholecystectomy in children seems to be as effective as open surgery in cases of symptomatic cholelithiasis. In pediatric patients more than in adults, an accurate and precise dissection and a sound knowledge of possible congenital biliary abnormalities are essential to avoid any kind of complication.
Subject(s)
Cholecystectomy, Laparoscopic/adverse effects , Cholecystectomy, Laparoscopic/statistics & numerical data , Adolescent , Child , Child, Preschool , Drainage/statistics & numerical data , Female , Follow-Up Studies , Gallbladder/injuries , Humans , Incidence , Infant , Length of Stay , Male , Splenectomy/statistics & numerical data , Surgical Wound Infection/epidemiology , Surgical Wound Infection/etiology , Wounds, Penetrating/epidemiology , Wounds, Penetrating/etiologyABSTRACT
BACKGROUND: The aim of this study was to evaluate the results and complications of laparoscopic varicocelectomy in children. METHODS: Over a 36-month period, 211 children underwent laparoscopic treatment of varicocele. Their ages ranged between 6 and 17 years; the varicocele was located on the left side in 209 cases (99.1%) and was bilateral in 2 (0.9%). In 195 patients the laparoscopic transperitoneal approach was used and in 16 retroperitoneoscopy was used. Thirty children (14.2%) underwent ligation of the veins alone, and 181 (85.8%) underwent ligation of testicular veins and artery. In 15 (7.1%) cases an additional procedure was applied during the same operation. RESULTS: Average operating time was 30 minutes and hospitalization about 24 hours. At an average follow-up of 26 months, there were 19 (9%) postoperative complications: 14 children had a left hydrocele, 3 children a scrotal emphysema, and 2 an umbilical granuloma. There were 5 recurrences of varicocele in our series: 2 (2 of 30, 6.6%) after the Ivanissevitch procedure, and 3 (3 of 181, 1.6%) after Palomo's. Testicular atrophy did not occur in any patient of this series. CONCLUSIONS: This preliminary experience shows that the results of the laparoscopic approach are comparable to those of the open approach. The ligation of testicular veins and artery is preferable to the ligation of the testicular veins alone. Hydrocele seems to be the most frequent postoperative complication and a potential problem, especially in children operated on with the Palomo procedure.
Subject(s)
Laparoscopy/adverse effects , Laparoscopy/methods , Varicocele/surgery , Adolescent , Arteries/surgery , Child , Emphysema/etiology , Follow-Up Studies , Granuloma/etiology , Humans , Ligation/adverse effects , Ligation/methods , Male , Phlebography , Recurrence , Testicular Hydrocele/etiology , Testis/blood supply , Time Factors , Treatment Outcome , Varicocele/diagnosis , Veins/surgeryABSTRACT
BACKGROUND: Several surgical procedures have been described for the management of nonpalpable testis. Following a vast experience with a complete laparoscopic two-stage Fowler-Stephens procedure, we report our experience with laparoscopic orchiopexy performed without dividing the spermatic vessels. METHODS: Over a 24-month period, 70 boys with nonpalpable testes (72 overall) underwent laparoscopic diagnostic exploration. Twenty patients (27.8%) of this series who showed an intraabdominal testis underwent laparoscopic orchiopexy without sectioning the spermatic vessels. In seven cases, the testis was just proximal to the internal inguinal ring; in 13, it was in the high intraabdominal position. The technique consisted in sectioning the gubernaculum (when present), opening the peritoneum laterally to the spermatic vessels, and mobilizing the testicular vessels and the vas deferens in a retroperitoneal position for 8-10 cm. The testis was then brought down into the scrotum through the internal inguinal ring (11 cases), if this was open, or through a neo-inguinal ring (nine cases) created medially to the epigastric vessels. In every case, we closed the inguinal ring at the end of the operation using one or two detached sutures. RESULTS: Operating time ranged between 40 and 75 min (median, 55). All the testes were successfully brought down into the scrotum. We had only one (5%) intraoperative complication. In the second patient treated with this procedure, there was an iatrogenic rupture of the spermatic vessels due to excessive traction. CONCLUSION: On the basis of our experience, we believe that laparoscopic orchiopexy without division of the spermatic vessels should be the treatment of choice in the management of nonpalpable testes, because it does not affect normal testicular vascularization and is minimally invasive. A blunt dissection and a delicate manipulation of the testis without excessive traction are the best ways to avoid any kind of complication.
Subject(s)
Cryptorchidism/surgery , Laparoscopy/methods , Child , Child, Preschool , Humans , MaleABSTRACT
PURPOSE: We report preliminary results of a multicenter study of the Italian Society of Video Surgery in Infancy on the laparoscopic treatment of pediatric varicocele. MATERIALS AND METHODS: A total of 161 children 6 to 16 years old (median age 12.5) underwent laparoscopic treatment of varicocele at 6 pediatric surgery divisions. Varicocele was on the left side in 159 cases (98.7%) and bilateral in 2 (1.3%). Two boys had recurrent left varicocele. All children were treated with laparoscopy, including ligation of the spermatic veins only in 28 (17.3%), and ligation of the testicular veins and artery in 133 (82.7%). In 10 boys (6.2%) an additional procedure was done simultaneously, including closure of an apparently patent peritoneal vaginal duct on the right side in 7 and resection of epiploic adhesions between the intestinal loops and abdominal wall from previous appendectomy in the remaining 3. RESULTS: Average operative time was 30 minutes and hospitalization was about 24 hours. At followup there were 13 minor complications (8%), including left hydrocele in 9 children who underwent the Palomo technique, minor scrotal emphysema in 2 and umbilical granuloma in 2. In our series varicocele recurred in 1 boy (3.5%) who underwent ligation of the spermatic veins only and in 3 (2.2%) treated with the Palomo technique. CONCLUSIONS: Our preliminary experience shows that the results of the laparoscopic approach are comparable to those of the open approach. However, the important advantages of laparoscopy over the open approach are its minimal invasiveness and precision of intervention. Moreover, laparoscopy allows treatment of other intra-abdominal pathological conditions using the same anesthesia, as in 10 patients in our series. We believe that ligating the testicular veins and artery is preferable to ligating the testicular veins only, even if the incidence of hydrocele is not negligible after the Palomo procedure.
