ABSTRACT
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Subject(s)
Humans , Male , Child , Hematoma/complications , Hematoma/diagnosis , Abdominal Injuries/complications , Biopsy/adverse effects , Tomography, Emission-Computed/methods , Duodenum/injuries , Duodenum , Endoscopy/adverse effects , Endoscopy, Digestive System/adverse effectsABSTRACT
Objetivos. Establecer la utilidad de la ecografía, tomografía computarizada (TC), resonancia magnética (RM) y estudios baritados en el diagnóstico de las fístulas del seno piriforme (FSP). Material y métodos. Se han revisado las historias clínicas y los estudios de imagen de cuatro pacientes de edad pediátrica diagnosticados de FSP. La primera técnica de imagen que se realizó en todos los casos fue la ecografía cervical; a tres se les realizó posteriormente TC con contraste intravenoso y a uno RM; a todos ellos, de forma diferida, se les practicó esofagograma con bario. En todos los casos hubo comprobación quirúrgica. Resultados. En los cuatro pacientes la ecografía permitió identificar la localización de las lesiones en el lado izquierdo, así como la existencia de colecciones heterogéneas en tiroides y tejido peritiroideo. Posteriormente, mediante la TC y la RM se delimitaron las lesiones abscesificadas. El esofagograma con bario demostró la existencia de la FSP en los cuatro casos. Conclusiones. La presencia de un proceso inflamatorio de repetición y de tiroiditis supuradas agudas de localización izquierda debe hacernos sospechar la existencia de FSP. Tanto la TC como la RM son útiles en el estudio de la FSP pero, en nuestra experiencia, la ecografía es la técnica de elección en su valoración inicial y seguimiento evolutivo. Tras el proceso agudo, el esofagograma con bario sigue siendo el principal método diagnóstico del trayecto fistuloso
Objectives. To establish the usefulness of ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and barium contrast swallow studies in the diagnosis of piriform sinus fistulas (PSF). Material and methods. We reviewed the clinical histories and imaging studies of four pediatric patients diagnosed with PSF. Cervical ultrasound was the first imaging study performed in all cases. Three patients subsequently underwent intravenous contrast-enhanced CT examination and one underwent MRI. Barium contrast swallow studies were performed in all patients at a later time. All cases were confirmed at surgery. Results. Ultrasound enabled the lesions to be located on the left side and showed the existence of heterogeneous collections in and around the thyroid glands in all four patients. Posterior CT and MRI studies determined the exact size of the abscessed lesions. Barium contrast swallow studies demonstrated the existence of the PSF in all four cases. Conclusions. The presence of a recurrent inflammatory process and acute suppurating thyroiditis located on the left side should raise suspicions of PSF. Both CT and MRI are useful in the study of PSF; however, in our experience, ultrasound examination is the technique of choice for initial evaluation and follow-up. After the acute process, barium swallow studies continue to be the main method for diagnosing the trajectory of the fistulous tract
Subject(s)
Humans , Vascular Fistula/diagnosis , Neck Injuries/diagnosis , Diagnostic Imaging/methods , Abscess/diagnosis , Esophageal Diseases/diagnosisABSTRACT
El reflujo gastroesofágico (RGE) es un fenómenomuy prevalente en la población infantil. El diagnósticode la enfermedad por reflujo gastroesofágico(ERGE) están ampliamente descrito. Existen numerososaspectos del RGE que todavía presentan muchasdudas a la hora de su abordaje diagnóstico yterapéutico. El ánimo de esta revisión es el de realizaruna actualización de las técnicas diagnósticas yexponer la situación actual de temas controvertidosdentro de esta patología como son el RGE en el pacientepretérmino, la enfermedad respiratoria porRGE y las indicaciones de la cirugía antireflujo
Gastroesophageal Reflux (GER) is a high prevalentcondition in children. The diagnosis of the GastroesophagealReflux Disease (GERD) is broadlydescribed. However, ther are still a lot of questionsto resolve when talking about diagnosis and therapeuticapproach. The aim of this review is to carryout an up-date of the diagnosis techniques and explainthe actual situation of controversial items relatedto GER: the role of GER in the preterm newborn,the respiratory disease associated to GER and theindications for antireflux surgery
Subject(s)
Male , Female , Infant, Newborn , Humans , Gastroesophageal Reflux/diagnosis , Gastroesophageal Reflux/physiopathology , Pneumonia, Aspiration/physiopathology , Infant, Premature , Esophagitis, Peptic/physiopathology , Gastroesophageal Reflux/therapyABSTRACT
OBJECTIVES: To establish the usefulness of ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and barium contrast swallow studies in the diagnosis of piriform sinus fistulas (PSF). MATERIAL AND METHODS: We reviewed the clinical histories and imaging studies of four pediatric patients diagnosed with PSF. Cervical ultrasound was the first imaging study performed in all cases. Three patients subsequently underwent intravenous contrast-enhanced CT examination and one underwent MRI. Barium contrast swallow studies were performed in all patients at a later time. All cases were confirmed at surgery. RESULTS: Ultrasound enabled the lesions to be located on the left side and showed the existence of heterogeneous collections in and around the thyroid glands in all four patients. Posterior CT and MRI studies determined the exact size of the abscessed lesions. Barium contrast swallow studies demonstrated the existence of the PSF in all four cases. CONCLUSIONS: The presence of a recurrent inflammatory process and acute suppurating thyroiditis located on the left side should raise suspicions of PSF. Both CT and MRI are useful in the study of PSF; however, in our experience, ultrasound examination is the technique of choice for initial evaluation and follow-up. After the acute process, barium swallow studies continue to be the main method for diagnosing the trajectory of the fistulous tract.
