ABSTRACT
Alrededor del 20 por ciento de los tumores diagnosticados en pediatría corresponden a masas intraabdominales y de ellos, el 20 por ciento son tumores malignos, por lo que un alto índice de sospecha asociado a un diagnóstico precoz pueden incidir positivamente en el pronóstico de los pacientes. El objetivo de este trabajo fue realizar una revisión actualizada de la literatura disponible sobre el estudio de una masa abdominal en pediatría, enfocado principalmente en la epidemiología y orientación diagnóstica que debería seguir el médico al enfrentarse a un paciente con este hallazgo. La forma de presentación clínica de una masa abdominal es variable. En un número importante de pacientes será de forma asintomática, lo que dificulta el diagnóstico precoz, por lo que es necesario mantener un alto índice de sospecha frente esta patología. Como herramientas para la evaluación de una masa abdominal contamos cada vez más con exámenes radiológicos, marcadores tumorales e histología, sin embargo, los exámenes deben realizarse orientados a comprobar la sospecha diagnóstica que obtengamos de una completa anamnesis y examen físico.
About 20 percent of the tumors diagnosed in pediatric patients correspond to intraabdominal masses. These can correspond to both benign and malignant pathology. Moreover, 20 percent of solid malignant tumors are located in the abdomen, so a high index of suspicion associated with an early diagnosis can positively affect the prognosis of these patients. The clinical presentation of an abdominal mass is variable. A significant number of patients will be asymptomatic, which makes early diagnosis difficult. This is why it is necessary to maintain a high index of suspicion in this pathology. As tools for the evaluation of an abdominal mass, we are increasingly counting on radiological examinations, tumor markers and histology. However, the examinations must be carried out in order to verify the diagnostic suspicion that we obtain from a complete anamnesis and physical examination. The objective of this work was to perform an updated review of the available literature on the study of abdominal mass in pediatrics, focused mainly on the epidemiology and diagnostic orientation that should be followed by the physician when confronting a patient with this finding.
Subject(s)
Humans , Child , Abdominal Neoplasms/diagnosis , Abdominal Neoplasms/epidemiology , Biomarkers, Tumor , Diagnosis, Differential , PalpationABSTRACT
BACKGROUND: Clinical importance of sexual abuse in children has rapidly expanded in recent years, but despite of it, the lack of medical signs in the vast majority of sexual abuse cases, makes it difficult to assess. Given that, owing to our prior experience in endosonography (EUS) of the anal canal in child with anorectal malformations, we wanted to test EUS as a diagnostic method of sexual abuse in a child. PURPOSE: The purpose of our study is to present our experience in the use of anorectal EUS among children with suspected sexual abuse. MATERIALS/METHODS: We present 40 consecutive patients (34 boys and 6 girls, age: 10months-13years) recruited from April 2010 to December 2012, with suspected sexual abuse those made a transrectal EUS. RESULTS: The procedure was well-tolerated in all patients without complications. Rectoanal EUS findings were normal in 27 patients and showed a partial interruption in the external anal sphincter in 8, scars in 2, double rail image in 2, and rectal wall hematoma in 1. CONCLUSIONS: The interpretation of findings in children depends of historical, physical, and laboratory findings. We believe that anal EUS is another aid in the constellation of clinical factors that could help in diagnostic of sexual abuse.
Subject(s)
Anal Canal/diagnostic imaging , Child Abuse, Sexual/diagnosis , Endosonography , Rectum/diagnostic imaging , Adolescent , Anal Canal/injuries , Anal Canal/pathology , Child , Child, Preschool , Female , Humans , Infant , Male , Rectum/injuries , Rectum/pathologyABSTRACT
Las quemaduras en los niños son un problema frecuente de salud pública . Presentan mortalidad asociada y morbilidad tanto aguda como a largo plazo pudiendo ocasionar tanto secuelas funcionales como estéticas. Estas a su vez pueden provocar trastornos psicológicos, sociales-familiares y laborales. A pesar de las campañas preventivas, las quemaduras continúan siendo prevalentes durante la infancia. El conocimiento de esta patología desde el punto de vista fisiopatológico y diagnóstico adecuado (determinar el agente causal, la extensión y la profundidad), permite optimizar el manejo inicial del niño quemado. De esta manera al tratar de forma adecuada y oportuna se evita la profundización de las quemaduras, las infecciones y complicaciones, logrando una mejoría más temprana y con menos secuelas.
Pediatric burns are a relevant public health problem, not only because of its mortality rate but for the esthetic and functional sequelaes that cause psychological and social dysfunction. It remains a prevalent accident during childhood, despite prevention campaings. The knowledge of the physiopathology and its adecuate diagnosis (determining the causal agent, the extent and depth), leads to a good initial management of burned children, improving the prognosis, reducing mortality and morbidity minimizing sequelae in order to provide a normal upbringing.
Subject(s)
Humans , Child , Burns/diagnosis , Burns/therapy , Prehospital Care , Burns/etiology , Burns/physiopathology , Transportation of Patients , Triage , Severity of Illness IndexABSTRACT
El estudio por imágenes mediante ultrasonografía transrectal es una herramienta poco invasiva que ayuda en el diagnóstico diferencial de las enfermedades inflamatorias intestinales.
Subject(s)
Humans , Endosonography , Inflammatory Bowel Diseases , Colitis, Ulcerative , Diagnosis, Differential , Crohn DiseaseABSTRACT
Las enfermedades inflamatorias intestinales como colitis ulcerosa y enfermedad de Crohn en niños se manifiestan por síntomas como dolor abdominal, diarrea, rectorragia y se acompañan de retraso del crecimiento y síntomas psicológicos.
