[Evaluation of primary cicatrization of anastomosis of small intestine (experimental study in guinea pigs)]. / Evaluación de cicatrización primaria en anastomosis de intestino delgado (estudio experimental en cuyos).

The healing process carried out during the first 72 hours of the anastomotic line of the small intestine has not been satisfactorily studied. This is a time during which intestinal transit is evaluated and oral feeding is given without being really sure whether there is resistance to rupture and if the open surgical technique favors local infection. For this study, 120 guinea pigs submitted to end-to-end anastomosis were used, 30 with continuous sutures and 30 with separate stitches, who were examined 24, 48 and 72 hours after the surgery, plus another group similarly evaluated immediately after the surgery, finding that rupture resistance is greater immediately after surgery than 48 or 72 hours later and that in these, the inflammatory process is greater and a more positive number of cultures are found. The antibiotic orally and parenterally administered did not do away with the infection but did limit further complications.

[Massive pulmonary hemorrhage in surgical pathology of the newborn infant]. / La hemorragia pulmonar masiva en la patología quirúrgica del recién nacido.

Massive pulmonary hemorrhage is a complication which frequently leads to death in newborns with conditions susceptible to surgical treatment. Out of 112 postmortem studies, focal hemorrhage was found in 38 (33.9%) and massive in 34 cases (30.3%). In this series, congenital anomalies were found in digestive tract in 70.5% of the patients. Prematurity andlow weight were not important factors as was hypoxia, which was evident in 70.5% of the cases. Manifestations of respiratory insufficiency, shock, rales in lung fields, bleeding in other places different from the lung, blood leaking through upper respiratory ducts, are all clinical features of diagnostic aid. Disturbances in coagulation tests were detected, the same as drop in figures of hemoglobin, acidosis, hypoxia and hypercapnia. Gram-negative germs, with a predominance of Klebsiella, were isolated in 33 cultures. The radiographic finding with reticulogranular image was unfrequent. Among other precipitating factors of pulmonary hemorrhage, identification was made of the surgical disease by itself, surgical and anesthetic procedures, of ventilatory assistance and therapy with oxygen at high concentration for long periods of time.

[Surgical management of intestinal atresia]. / Conducta quirúrgica en atresia de intestino

The study included 33 newborns with the diagnosis of intestinal atresia after discarding those of the duodenum. According to the clinical conditions of the patient and of the malformation, surgery was carried out by derivative ileostomy or primary anastomosis. Survivorship reaches 67% for ileostomy and 65% for anastomosis which are much higher figures than those obtained before.

[Intrathoracic tumors in children]. / Tumores intratorácicos en niños

Intrathoracic tumors in pediatric ages are unfrequent. A review of 138 cases in patients under 15 years of age showed in the first place, the same as in adults, malignant neoplasms represented by pulmonary metastases. However, in those of primary localization, the histologically benign are more frequent. Out of 69 cases, such tumors came up to 78.2% and 47% of them were cystic malformations. Among malignant primary neoplasms, out of 30.4%, neuroblastoma showed 8.6%, diverse sarcomas were 8.6% and the epithelial type added up to 4.3%. The main symptoms were: frequent bronchopulmonary infections, obstructive respiratory insufficiency and vascular stasis. Radiological examinations are of great diagnostic aid, but a full clinical evaluation is always necessary. A surgical treatment removing the mass leads to radical recovery leaving limited sequelae. The comparative group of 69 cases with pulmonary metastases showed that neoplasms considered of embryonal type are practically always multiple and appear during the final stage of the disease. Surgery may be attempted when they are single and the primary has been removed; however, chemotherapy and radiotherapy are always necessary.

[Integral intravenous feeding in pediatric surgery]. / Alimentación endovenosa integral en cirugia pediátrica

Forty newborns bearing several gastrointestinal conditions (congenital malformations, intestinal bypass, postinflammatory obstruction, malabsorption and enteritis) were treated with long-term integral parenteral nutrition. A solution made up of synthetic aminoacids, emulsion of lipids, glucose, electrolytes, vitamins, plasma and whole blood was perfused through a catheter introduced into central or peripheral veins. Temporal glucosuria and anemia were observed in some cases. In all but three cases urinary alpha amino nitrogen was normal. In some infected patients leucocytosis or leucopenia was found. After treatment, all patients showed adequate nutritional conditions, manifested by increase in body weight and healing of damaged tissues.