[Laryngotracheoesophageal cleft]. / Hendidura laringotraqueoesofágica.

Laryngotracheoesophageal cleft is a rare congenital anomaly that should be considered in the differential diagnosis of any neonatal respiratory distress aggravated by feeding. Diagnosis is difficult, but can be made by roentgenographic and endoscopic techniques. Roentgenographic evidence of abnormal positioning of nasogastric tubes should arouse suspicion. Repeated bronchoscopy may be necessary to identify the defect. Immediate surgical repair is indicated. Incorporation of part of the esophageal wall into the repair may enhance success. Tracheostomy has been required in all survivors. The embryologic pathogenesis of the anomaly is discussed and it is concluded that the defect is found more often than is reported. We present the fifty-fourth case, the first associated to hypospadias in the world, and the first case in the Mexican literature. This child presented severe respiratory distress. Death occurred on the tenth neonatal day.

Hendidura laringotraqueoesofagica. / Laryngotracheoesophageal cleft

La hendidura laringotraqueoesofagica es una malformacion congenita rara que debe ser considerada en el diagnostico diferencial de cualquier sindrome de dificultad respiratoria neonatal que se agrave con la alimentacion.El diagnostico es dificil, pero puede lograrse con la ayuda de procedimientos radiograficos y endoscopicos. En el estudio radiografico, la posicion anormal de la sonda nasogastrica debe despertar la sospecha. Pueden ser necesarias broncoscopias repetidas para la identificacion del defecto.La reparacion inmediata es mandatoria. La incorporacion de una parte de la pared esofagica en la linea de sutura puede aumentar las posibilidades de exito. La traqueotomia ha sido una maniobra necesaria en todos los pacientes que han sobrevivido. Se discute la embriologia del defecto y ser mas comun de lo referido en la literatura. Presentamos el caso numero 54, el primero asociado reportado en Mexico. Este paciente presento signos graves de insuficiencia respiratoria y la muerte ocurrio al decimo dia de vida

[Torsion of the uterine tubes]. / Torsión de trompa uterina.

Gynecologic pathology in premenarchal girls is infrequent, although torsion of adnexa is a pathology well recognized. Very little has been written on torsion of previously healthy adnexa. Since the diagnosis can be difficult and confussing due to its resemblance with many other pathologic conditions, it is purpose of this paper to report a case the treated in our hospital. The importance of an early diagnosis is stressed in order to avoid loss of the adnexa and a brief review of the literature is made. To our knowledge, this is the first case reported in Mexico.

[An unusual complication of a tricobezoar]. / Complicación poco usual de un tricobezoar.

A cause of low intestinal obstruction due to intestinal trichobezoar is presented. This is a very uncommon entity, specially when there is no simultaneous gastric component. The first description was made by Bertram in 1965, and a few cases have been reported in the literature ever since. Such an obstruction appears in approximately 10% of all the cases of trichobezoar, being more frequent in the female, with a peak incidente at 10 to 19 years of age. There is only one case reported in Mexico. The term Bezoar means antidote and has been classified according to the material with which it is formed. It can be frequently observed in patients with psychiatric disorders. Diagnosis is made under clinical and radiological grounds; treatment is by means of enterostomy or intestinal resection.

[Acute abdominal complications of ventriculoperitoneal shunts]. / Complicaciones abdominales graves de las derivaciones ventriculoperitoneales.

A review of critical abdominal complications is made in 150 patients operated on for hydrocephalus in the surgical and neurosurgical services of the Hospital Infantil Legaria through the years 1975--1976. We found 3 colonic perforations (cecum, transverse and rectum), one abdominal perforation, one through the umbilicus, one in vagina, 1 case of plastic peritonitis and two with ascitis. In the majority of cases, such complications were satisfactorily solved; sometimes by extraction of the derivative systems, and some others by primary closure of the lesions. We only had one death. In a larger percentage, other complications were observed, being in order of frequency the following: distal catheter obstruction, proximal obstruction, infection and abdominal wall cysts. We analysed the association with spina bifida (meningocele o myelomeningocele), frequency related to age, sex, etiology and type of shunt. We reviewed the literature and suggest general measures tending to avoid such complications.