ABSTRACT
Congenital lung malformations (CLMs) include a group of different disorders. With widespread use of antenatal ultrasonography (aUS) and increased use of pre-natal magnetic resonance imaging (MRI), CLMs are increasingly detected, nevertheless the best postnatal imaging approach is not yet well defined: newborns usually undergo several chest X-rays and eventually computed tomography to confirm the diagnosis. In this case series, we show lung ultrasound features of three different cases of congenital lung malformations, describing prenatal and postnatal images comparing different imaging techniques.
Subject(s)
Lung Diseases , Lung , Female , Humans , Infant , Infant, Newborn , Lung/abnormalities , Lung/diagnostic imaging , Lung Diseases/congenital , Lung Diseases/diagnostic imaging , Male , Pregnancy , Prenatal Diagnosis , Ultrasonography, PrenatalABSTRACT
INTRODUCTION: Congenital diaphragmatic hernia (CDH) presenting after 30 days of life is unusual and has a variant pattern of presentation. PRESENTATION OF CASE: We present a death case occurred to a 34-days-old infant. The infant arrived to our emergency department in cardiac arrest after having suffered from intermittent acute abdominal pain. Autopsy confirmed the presence of a right CDH, with herniation of the right lobe of the liver into the thorax. DISCUSSION: Most of the cases of CDH are diagnosed prenatally or in the neonatal period. However, some patients do not develop symptoms until after the neonatal period. The relevance of our case is the co-existence of right CDH and important hypotrophy of the right lobe of the liver. CONCLUSIONS: Evidence of this phenomenon represents an absolute novelty in the extant scientific literature. Even if rare, we suggest to suspect the presence of CDH in fetus with disparity in right and left liver lobe at prenatal ultrasound.
ABSTRACT
FNH is a rare and benign tumor of the liver. It is not a conventional indication for liver transplantation, and no transplant for FNH in a child has been reported to date. Multifocal FNH growing in adolescent age to a widespread tumor invading the whole liver and associated with severe refractory pruritus was an unusual indication for transplantation in a 13-yr-old girl. The operation and the follow-up were uneventful, allowing full recovery and disappearance of pruritus.
Subject(s)
Focal Nodular Hyperplasia/complications , Focal Nodular Hyperplasia/therapy , Liver Transplantation/methods , Pruritus/therapy , Adolescent , Child , Female , Humans , Liver/abnormalities , Liver/pathology , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
Having illustrated the importance of extending surgical treatment into day hospital situations, the paper underlines the need for anesthetics with short-term effects. Two groups of 30 patients were included in the study and underwent anesthesia in day hospital using Propofol or Tiopentone-Enflurane. The results reveal comparable respiratory and hemodynamic effects for the two techniques, but Propofol is more reliable in terms of the lesser side-effects caused and above all the speed of the patient's psycho-physical recovery.
Subject(s)
Ambulatory Surgical Procedures , Anesthesia, General , Anesthesia, Intravenous , Propofol , Adolescent , Adult , Aged , Anesthesia Recovery Period , Enflurane , Female , Humans , Male , Middle Aged , ThiopentalABSTRACT
Bilateral retroperitoneal lymphadenectomy is usually indicated for non-seminomatous testis tumour at stage IIA and IIB. For seminoma is generally used radiotherapy, although some Authors prefer the surgical approach. Radical retroperitoneal lymphadenectomy must be bilateral, because metastatic cell can often spread to the contralateral lymph nodes. Lymphadenectomy is used not only for therapy, but also for staging: thus clinical evaluation and other diagnostic techniques are not always correct (30% of understaging). Permanent sexual disfunction can follow radical surgery, due to extensive retroperitoneal dissection and exeresis of lumbar sympathetic nerves; so it is proposed, for stage I tumors, a monolateral or limited retroperitoneal lymphadenectomy. Eight patients with non-seminomatous testicular tumours are reported by the authors; 2 (stage I) were treated with monolateral, 4 (stage IIA and IIB) with bilateral retroperitoneal lymphadenectomy; in 2 patients (stage IIC and IID) chemotherapy was followed by debulking surgery. Relapses were observed between 3 and 19 months. Sexual dysfunctions after surgery were present in 5 patients (69%); in all of these a bilateral retroperitoneal lymphadenectomy was performed.
Subject(s)
Dysgerminoma/surgery , Lymph Node Excision , Teratoma/surgery , Testicular Neoplasms/surgery , Adolescent , Adult , Follow-Up Studies , Humans , Male , Postoperative Complications , Time FactorsABSTRACT
Total gastrectomy is the elective therapy for gastric cancer, but anastomotic dehiscences often improve the results of this surgery, performed in patients with malnutrition due to the neoplasy. The authors present a group of 27 patients treated with total gastrectomy and a routine postoperative TPN; the incidence of dehiscences and postoperative complications is very low. The preoperative evaluation of surgical risk and the choice of pre- and/or postoperative, parenteral and/or enteral nutritional therapy, are discussed.
