Quiste epiploico complicado tras una herniorrafia en un lactante / Complicated omental cyst after a herniorrhaphy in an infant

Los quistes de omento son tumoraciones abdominales benignas y excepcionales. En este artículo se describe el caso de un lactante varón intervenido de una hernia inguinal izquierda con epiplón incluido en el sacoherniario. En dicho epiplón, se evidenció un pequeño quiste que se resecó. El postoperatorio inmediato transcurrió sin incidencias hasta que el paciente acudió al hospital siete días después con síntomas y signos de abdomen agudo. Las pruebas de imagen realizadas, así como los hallazgos operatorios, revelaron un quiste de omento complicado. El paciente fue intervenido y el quiste resecado. El diagnóstico histopatológico de la pieza reveló un tumor pseudoinflamatorio. El postoperatorio fue satisfactorio y, desde el alta, el paciente permanece asintomático. En conclusión, es importante explorar el contenido del saco herniario durante una herniorrafia inguinal. Ante el hallazgo de un quiste epiploico en el interior del saco debería valorarse la posibilidad de que existan más lesiones intraabdominales

Omental cysts are uncommon benign masses localized in the abdomen. This article describes the case of a male infant who underwent surgery due to a left inguinal hernia. During the operation a small omental cyst was found inside the sac that was resected. The first postoperative days were uneventful but the infant came back to hospital seven days after. Subsequent imaging and operative findings revealed a complicated mental cyst. This cyst was removed and the histopathology report described an inflammatory pseudo tumor. The postoperative evolution was satisfactory and the patient has remained asymptomatic since he was discharged from hospital. In conclusion, it is important to explore the contents of the hernia sac during inguinal hernia repair. The finding of a small o mental cystinside the sac should encourage to study other potential intraabdominal lesions

[Complicated omental cyst after a herniorrhaphy in an infant]. / Quiste epiploico complicado tras una herniorrafia en un lactante.

Omental cysts are uncommon benign masses localized in the abdomen. This article describes the case of a male infant who underwent surgery due to a left inguinal hernia. During the operation a small omental cyst was found inside the sac that was resected. The first postoperative days were uneventful but the infant came back to hospital seven days after. Subsequent imaging and operative findings revealed a complicated omental cyst. This cyst was removed and the histopathology report described an inflammatory pseudotumor. The postoperative evolution was satisfactory and the patient has remained asymptomatic since he was discharged from hospital. In conclusion, it is important to explore the contents of the hernial sac during inguinal hernia repair. The finding of a small omental cyst inside the sac should encourage to study other potential intraabdominal lesions.

[Long gap esophageal atresia: Schärli versus Foker]. / Atresia esofágica long-gap. Schärli versus Foker.

PURPOSE. To submit the short and long term results of long-gap esophageal atresia (EA) with two surgical techniques. METHODS. We carried out a retrospective study of long-gap type EA without fistula (n=8) and with fistula (n=2) over the last 18 years, comparing the outcome of the Schärli technique (1992) with that of the Foker technique (1997). RESULTS. We included 10 patients with long gap EA. Mean birth weight was 2,418 grams. 30% had associated diseases (VACTERL, Down Syndrome, DiGeorge Syndrome). Gastrostomy or jejunostomy was initially placed in 7 patients. Schärli technique was performed in 4 patients (mean age: 3.3 months), and Foker technique in 6 patients (median age: 23.5 days of life). Complications were: a) Schärli: dehiscence (25%), stenosis (75%), one patient died from his heart disease (25%), colonic herniation through diaphragmatic hiatus (25%). The mean number of stricture dilatations was 7 sessions (S.D. 9.2). a) Foker: dehiscence (83.3%), stenosis (83.3%), gastroesophageal reflux (GER) (83.3%), fistula (16.7%). Mean number of dilatations was 13.7 sessions (S.D. 12.8). All patients operated on with Schärli technique (6-18 years, median follow-up 12 years) were asymptomatic at the time of the study, although one of them had grade III esophagitis in the last biopsy. As for the Foker's, 5 had undergone antireflux surgery and only one was asymptomatic. The rest had complications that were still being treated (stenosis and development of fistulae). CONCLUSION. Treatment of long gap EA remains a surgical challenge. In our experience patients developed fewer complications with the Schärli technique. Nevertheless, it is difficult to make a comparison with such a limited number of patients.

Atresia esofágica long-gap. Schärli versus Foker / Long gap esophageal atresia: schärli versus foker

OBJETIVOS: Presentar los resultados a corto y largo plazo de las atresias de esófago (AE) tipo long-gap con dos técnicas quirúrgicas.Material y métodos. Estudio retrospectivo de AE tipo long-gap sin fístula (n= 8) y con fístula (n= 2) de los últimos 18 años. Se compara el resultado de técnica de Schärli (1992) con la técnica de Foker (1997).Resultados.Se incluyeron 10 pacientes con AE tipo long-gap. Peso medio al nacimiento 2.418 gramos. El 30% tenían patologías asociadas (VACTERL, síndrome de Down, síndrome de DiGeorge). Se realizó gastrostomía o yeyunostomía a 7 pacientes inicialmente. Se realizó la técnica de Schärli en 4 pacientes (edad media 3,3 meses) y 6 con técnica de Foker (edad mediana 23,5 días). Las complicaciones fueron:a) Schärli: dehiscencia (25%), estenosis (75%), exitus por cardiopatía (25%), herniación colónica a través del hiato diafragmático (25%). La media de dilataciones fue de 7 sesiones (SD 9,2).b) Foker: dehiscencia (83,3%), estenosis (83,3%), reflujo gastroesofá-gico (RGE) (83,3%), fistulización (16,7%). La media de dilataciones fue de 13,7 sesiones (SD 12,8).Actualmente los enfermos intervenidos con técnica de Schärli (6-18 años, 12 años evolución media) se encuentran asintomáticos, aunque uno de ellos presenta esofagitis grado III en la última biopsia. En los pacientes en los que se realizó la técnica de Foker, 5 de ellos han sido sometidos a cirugía antirreflujo, solamente uno se encuentra asintomá-tico, el resto siguen en tratamiento de sus respectivas complicaciones.Conclusiones. El tratamiento de la AE tipo "long-gap" sigue siendo un desafío quirúrgico. Nuestra experiencia concluye que la técnica de Schärli presenta menor número de complicaciones. Aunque es difícil establecer esta comparación con un número tan limitado de pacientes

PURPOSE: To submit the short and long term results of long-gap esophageal atresia (EA) with two surgical techniques. METHODS: We carried outa retrospective study of long-gap type EA without fistula (n=8) and with fistula (n=2) over the last 18 years, comparing the outcome of the Schärli technique (1992) with that of the Foker technique (1997). RESULTS: We included 10 patients with long gap EA. Mean birth weight was 2,418 grams. 30% had associated diseases (VACTERL, Down Syndrome, DiGeorge Syndrome). Gastrostomy or jejunostomy was initially placed in 7 patients. Schärli technique was performed in 4 patients (mean age: 3.3 months), and Foker technique in 6 patients (median age: 23.5 days of life). Complications were:a) Schärli: dehiscence (25%), stenosis (75%), one patient died from his heart disease (25%), colonic herniation through diaphragmatic hiatus (25%). The mean number of stricture dilatations was 7 sessions (S.D. 9.2) a) Foker: dehiscence (83.3%), stenosis (83.3%), gastroesophageal reflux (GER) (83.3%), fistula (16.7%). Mean number of dilatations was 13.7 sessions (S.D. 12.8).All patients operated on with Schärli technique (6-18 years, me-dian follow-up 12 years) were asymptomatic at the time of the study, although one of them had grade III esophagitis in the last biopsy. As for the Foker's, 5 had undergone antireflux surgery and only one was asymptomatic. The rest had complications that were still being treated (stenosis and development of fistulae). CONCLUSION: Treatment of long gap EA remains a surgical chal-lenge. In our experience patients developed fewer complications with the Schärli technique. Nevertheless, it is difficult to make a comparison with such a limited number of patients