[New aspects of gallbladder pathology in children]. / Nuevos aspectos de la patologia de la vesicula biliar en niños.

We have reviewed in a retrospective study 38 children treated in our Hospital, during the last seven years, because of non congenital gall-bladder disease. The diagnosis established were cholelithiasis 58 for 100, hydrops 26 for 100, acalculous cholecystitis 13 for 100 and hemobilia in one child. Cholelithiasis was more frequent in females at a rate of 2/1. Just the opposite incidence was found for acalculous gall-bladder pathology. Mean age at time of first hospitalization was 7.6 years for the cholelithiasis group and 6.6 years for the rest. Symptoms in order of frequency were abdominal pain, vomiting and fever. Abdominal sonography has been basic in establishing to correct diagnosis in practically all cases. Our most interesting finding has been the clinical manifestations of patients with "Hydrops", consisting of abdominal pain which disappears spontaneously after 24 to 48 hours. The diagnosis has been established only after performing abdominal sonographic studies in children with abdominal pain of unclear etiology.

[Modified Kasai technique for the treatment of biliary atresia]. / Una modificación de la técnica de Kasai para el tratamiento de la atresia biliar.

Kasai's procedure has changed significantly the prognosis of biliary atresia. However, ascending cholangitis is a relatively frequent postoperative complication with high morbidity and mortality rates. We have developed a modification of that technic consisting in the isolation of a segment of jejunum-with its blood supply carefully preserved, after fashioning an antireflux valve in its distal end. This segment of bowel, less than 10 cm. in length, is anastomosed to the porta hepatis proximally and to the duodenum distally. Using this technic, we have operated upon three infants with biliary atresia and a child with extended rabdosarcoma of the biliary tree. After a follow up of 10 to 17 months with an average of 12.5 months, all children remain free of cholangitis and two of them are anicteric.