RESUMO
Perineal trauma in children are rare, but they can be life-threatening and surgically challenging conditions in the absence of a standardized therapeutic approach. Colostomy remains important and plays an essential role in minimizing the frequency of perineal wound infections but has known complications. Here, we describe a case of a 7-year-old boy who was a victim of a road traffic accident polytrauma and sustained severe perineal injury. The patient was managed primarily without stoma creation and achieved complete wound healing and continence. This case highlights that selection of primary repair without colostomy must be meticulous and individualized.
Assuntos
Hérnias Diafragmáticas Congênitas/diagnóstico por imagem , Infecções Estreptocócicas/diagnóstico por imagem , Streptococcus agalactiae , Reações Falso-Negativas , Feminino , Hérnias Diafragmáticas Congênitas/complicações , Humanos , Recém-Nascido , Radiografia Torácica , Insuficiência Respiratória/diagnóstico por imagem , Insuficiência Respiratória/etiologia , Infecções Estreptocócicas/complicações , Tomografia Computadorizada por Raios XRESUMO
Giant omphalocele is difficult to manage and is associated with a poor outcome. A male newborn presented to our hospital with a giant omphalocele. We performed a staged closure of giant omphalocele using synthetic mesh to construct a silo and then mesh abdominoplasty in the neonatal period that led to a successful outcome within a reasonable period of hospital stay.
RESUMO
BACKGROUND: Long-term follow-up has substantiated the colon as a durable and highly acceptable esophageal substitute. Exposure of colonic conduit to gastric acid may lead to histopathologic changes in the form of chronic inflammation. MATERIALS/METHODS: Thirty children with esophageal replacement were studied from 2 to 12 years (mean, 5.20 years) postoperatively. All cases underwent upper gastrointestinal tract endoscopy to evaluate the gross appearance of colonic conduit mucosa, and punch biopsies were taken from upper and lower junctions of the conduit. All biopsies were submitted to histopathologic examination. RESULTS: Endoscopic findings were comparable with normal regarding the gross appearance of colonic mucosa in both upper and lower junctions (25 cases/83.3%). Some abnormalities were seen including cervical anastomosis stricture (2 cases/6.7%), redundancy (3 cases/10%), mucosal ulcer in the lower residual esophagus (1 case/3.3%), and hyperemia (3 cases/10%). Pathologic changes were minimal regarding the change in position of the colon to a thoracic organ during follow-up. Most of the cases were normal (22 cases/73.3%). Seven cases (23.4%) showed mild chronic nonspecific inflammation of the colonic mucosa, whereas only 1 case (3.3%) showed mildly active inflammation of colonic mucosa. CONCLUSION: The use of the colon for esophageal replacement showed that no significant pathologic changes affecting its function as a conduit because its mucosa showed no significant change in response to gastric acid reflux in long-term follow-up and can be further protected by an antireflux procedure.