ABSTRACT
In children with anorectal malformations (ARMs), it is essential to have a diagnostic imaging method that helps with the evaluation of the internal anatomy. In patients with a persistent cloaca, an ARM variant, in which the measurement of the urethral channel and common channel determines surgical management, there are multiple options for imaging. Magnetic resonance imaging (MRI) is an excellent method for this purpose, from which accurate measurements of channel length can be obtained. Additionally, the use of volumetric/isotropic sequences allows multiplanar reformatting. We present our experience with pelvic MRI and intracavitary non-paramagnetic contrast (MR genitography). This method uses volumetric T2-weighted images and the instillation of saline solution as a contrast agent to distinguish the common channel, length of the urethra, anatomy of the vagina, and presence and location of the rectal fistula. We believe this technique to be particularly useful for those working in settings with limited MRI resources.
Subject(s)
Anorectal Malformations , Female , Humans , Child , Animals , Anorectal Malformations/diagnostic imaging , Anorectal Malformations/surgery , Latin America , Hospitals, Pediatric , Magnetic Resonance Imaging/methods , Magnetic Resonance Spectroscopy , Rectum/diagnostic imaging , Rectum/abnormalities , Cloaca/diagnostic imaging , Cloaca/abnormalitiesABSTRACT
An infected aortic aneurysm is a process with high mortality rate. Survival is dependent on an early diagnosis and surgical management. This case report details a rare presentation of aortitis with persistent methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia, which initially presented as retroperitoneal fibrosis and was ultimately fatal.
ABSTRACT
Acute pancreatitis is a known complication of choledochal cysts. It is associated with changes in the biliopancreatic junction and with intra-cystic gallstones. We describe a case of pancreatitis and biliary obstruction caused by choledochal cyst type IVa complicated with obstruction by biliary stones in a 2 year old infant.
Subject(s)
Choledochal Cyst/diagnosis , Gallstones/diagnosis , Pancreatitis/etiology , Acute Disease , Child, Preschool , Choledochal Cyst/complications , Gallstones/complications , Humans , Pancreatitis/diagnosisABSTRACT
La pancreatitis aguda es una complicación evolutiva de los quistes de colédoco, se asocia a alteraciones de la unión biliopancreática y litiasis intra-quística. Se describe un caso de pancreatitis y obstrucción de vía biliar por quiste de colédoco tipo IVa complicado por cálculos enclavados, en infante de 2 años...
Acute pancreatitis is a known complication of choledochal cysts. It is associated with changes in the biliopancreatic junction and with intra-cystic gallstones. We describe a case of pancreatitis and biliary obstruction caused by choledochal cyst type Iva complicated with obstruction by biliary stones in a 2 year old infant...
Subject(s)
Humans , Male , Child, Preschool , Lithiasis , Pancreatitis , Choledochal CystABSTRACT
PURPOSE: Top analize the clinic results of the implantation of a multidisciplinary protocol to maintain permeability of the arteriovenous hemodialysis grafts (AVG). METHOD: Prospective recording of all interventions (radiological and surgical) on AVG dysfunction in the 1999-2007 period. The AVG stenosis were always treated by percutaneous angioplasty (PA) except stenosis recurrence in less than three months or persistence after PA. The AVG thromboses were always treated by surgical thrombectomy plus PTFE bridge if necessary. Complications, primary and secondary AVG patency were reviewed. RESULTS: Ninety six dysfunction AVG were collected for study. All of them were 6x40 mm standard wall PTFE (Gore-Tex®). Thirty six of them were humero-basilic antebraquial loop and sixty were humero-axillary upper arm curve configuration. During the study, 52 PTFE bridges, 109 surgical thrombectomies, 131 PA, and 15 stents were needed to maintain FAVP permeability. Primay patency was 73.68%, 60.21% and 37.52% at one, two and three years respectively. Secondary patency was 89.49%, 84.07% and 66.84% at one, two and three years respectively. We avoid a central venous catheter (CVC) in the 80% of intervention for thrombosis dysfunction. No surgical or radiological related deaths occurred. Median hospital admission related with AVG thrombosis was 0.03/patient/year. CONCLUSION: The application of a combined protocol for the treatment of AVG dysfunction and thrombosis, according to DOQI recomendations obtains good results in AVG patency in our experience.
