ABSTRACT
BACKGROUND: The presence of fistulous communications between the small bowel and the skin continues to be one of the most perplexing and challenging problems facing the surgeon today. Their occurrence is a major catastophe of surgical practice because are frequently a result of technical failure or errors in surgical judgement. MATERIAL, METHOD AND RESULTS: Thirty four patients with high-output enterocutaneous fistulae arising from the small intestine are reported. Fourteen were due to appendicitis and sixteen were infants. Fistula resection were performed in six patients. Spontaneous fistula closure occurred in twenty-eight. Six died. The treatment program included parenteral nutritition thorugh central venous line, local care and antibiotics. CONCLUSIONS: In recent years, more aggressive therapy accompanied by the development of high caloric parenteral alimentation shows promise of reducing the mortality and morbidity rates associated with these fistulas.
Subject(s)
Cutaneous Fistula , Intestinal Fistula , Intestine, Small , Adolescent , Child , Child, Preschool , Cutaneous Fistula/etiology , Cutaneous Fistula/mortality , Cutaneous Fistula/therapy , Female , Humans , Infant , Infant, Newborn , Intestinal Fistula/etiology , Intestinal Fistula/mortality , Intestinal Fistula/therapy , Male , MexicoSubject(s)
Child Abuse , Multiple Trauma/etiology , Child, Preschool , Female , Humans , Injury Severity ScoreABSTRACT
Peutz-Jeghers syndrome (PJS) is a familial condition characterized by the presence of pigmented mucocutaneous spots and intestinal polyposis. Intussusception is the most frequent abdominal complication, but it is very rare. In our country, this is the second known report. In this article we present four cases of PJS associated with intussusception. All the patients were female and all underwent a surgical procedure. The intussusception was located in the ileum and colon. There are no more than 20 reported cases in the world where these two entities are associated. Children with PJS have a high risk of suffering from ileo-ileal or jejuno-ileal intussusception that will frequently require a special surgical procedure.
Subject(s)
Ileal Diseases/etiology , Ileal Diseases/surgery , Ileocecal Valve , Intussusception/etiology , Intussusception/surgery , Jejunal Diseases/etiology , Jejunal Diseases/surgery , Peutz-Jeghers Syndrome/complications , Adolescent , Child , Child, Preschool , Female , Humans , Ileal Diseases/diagnostic imaging , Ileostomy , Intussusception/diagnostic imaging , Jejunal Diseases/diagnostic imaging , Laparotomy , Male , Radiography, Abdominal , Treatment OutcomeABSTRACT
INTRODUCTION: The disaster of a testicular torsion leading to the possible loss of a gonad within a few hours is a well known occurrence and it is discouraging. Clinical examples emphasizing torsion of the testis as the most important differential diagnosis in children with acute scrotal pain and swelling, as well as the need for early exploration, have been reported with increasing frequency. MATERIAL AND METHODS: Seventy cases of clinically diagnosed unilateral torsion of the testis have been admitted to our pediatric surgical unit over a period of 8 years. There were 46 cases between 13 and 15 years of age; 34 were admitted after 24 ho and 25 after 3 days of multilating disease. Left side was involved in 46 cases and 61 testicles were removed. CONCLUSIONS: In order to avoid initiation procedures, early diagnosis is very important.
