[Posterior mediastinum infantile hemangioma in an 11 months infant, an unusual finding. A case report and review of the literature]. / Hemangioma infantil del mediastino posterior en un lactante de 11 meses, un hallazgo inusual. Reporte de un caso y revisión de la literatura.

Mediastinal infantile hemangioma has not been reported so far (as far as we are aware), using accurate diagnostic methods. MRI scans are essential for a correct characterization and assessment of the extension. Moreover, Endothelial cell glucose transporter 1 (GLUT1) isoform protein represents an extremely important diagnostic tool to differentiate Infantile Hemangioma from other vascular neoplasms. With regards to management, surgery appears to be the treatment of choice, although it is important to highlight that it is a rare disease and more studies are needed to establish a proper diagnostic and therapeutic protocol. The prognosis seems to be favorable, with not known cases of recurrence or progression to malignancy.

Los hemangiomas infantiles suponen los tumores más comunes en la época de la infancia. Su localización principal se sitúa en la piel, seguida del hígado. Los hemangiomas mediastínicos no han sido descritos hasta la fecha utilizando los métodos diagnósticos actuales adecuados. La resonancia magnética es esencial para una correcta caracterización y evaluación de la extensión. El estudio es histológico siendo el transportador celular de glucosa tipo 1 (GLUT-1) una importantísima herramienta diagnóstica para diferenciar el hemangioma infantil de otras neoplasias vasculares. En lo que al manejo respecta, la cirugía con excisión completa de la masa parece el tratamiento de elección. Es importante resaltar la rareza de esta enfermedad y la necesidad de realizar más estudios para establecer un adecuado protocolo diagnóstico-terapéutico. El pronóstico parece ser favorable, sin constar casos de recurrencia o progresión hacia la malignidad.

Hemangioma infantil del mediastino posterior en un lactante de 11 meses, un hallazgo inusual. Reporte de un caso y revisión de la literatura / Posterior mediastinum infantile hemangioma in an 11 months infant, an unusual finding. A case report and review of the literature

Los hemangiomas infantiles suponen los tumores más comunes en la época de la infancia. Su localización principal se sitúa en la piel, seguida del hígado. Los hemangiomas mediastínicos no han sido descritos hasta la fecha utilizando los métodos diagnósticos actuales adecuados. La resonancia magnética es esencial para una correcta caracterización y evaluación de la extensión. El estudio es histológico siendo el transportador celular de glucosa tipo 1 (GLUT-1) una importantísima herramienta diagnóstica para diferenciar el hemangioma infantil de otras neoplasias vasculares. En lo que al manejo respecta, la cirugía con excisión completa de la masa parece el tratamiento de elección. Es importante resaltar la rareza de esta enfermedad y la necesidad de realizar más estudios para establecer un adecuado protocolo diagnóstico-terapéutico. El pronóstico parece ser favorable, sin constar casos de recurrencia o progresión hacia la malignidad

Mediastinal infantile hemangioma has not been reported so far (as far as we are aware), using accurate diagnostic methods. MRI scans are essential for a correct characterization and assessment of the extension. Moreover, Endothelial cell glucose transporter 1 (GLUT1) isoform protein represents an extremely important diagnostic tool to differentiate Infantile Hemangioma from other vascular neoplasms. With regards to management, surgery appears to be the treatment of choice, although it is important to highlight that it is a rare disease and more studies are needed to establish a proper diagnostic and therapeutic protocol. The prognosis seems to be favorable, with not known cases of recurrence or progression to malignancy

[Mesenteric panniculitis: experience in our center]. / Paniculitis mesentérica: experiencia en nuestro centro.

Although several etiological factors have been associated with mesenteric panniculitis, the exact etiology in some cases remains unknown. Herein, we present a retrospective analysis of 8 patients affected with this disorder performed between May 2000 and December 2006. In our series the mean age at which patients presented was 63 years. The majority of the patients were male (with a male: female ratio of 3:1). The most common clinical manifestations were abdominal pain (n = 4) and asthenia (n = 4). Three cases presented with obstructive symptoms and three had a history of abdominal surgery. Notably, seven had a background of tobacco use (five smokers and two ex-smokers) and one patient developed follicular lymphoma. A literature research was carried out to analyze our results and formulate a new hypothesis. In our opinion, we believe that the study of causal factors such as tobacco and its components is required due to the strong association found in this study.

Paniculitis mesentérica: experiencia en nuestro centro / Mesenteric panniculitis: experience in our center

A pesar de que se han reconocido distintos factores precipitantes en la paniculitis mesentérica, su etiología en determinados casos es incierta. Presentamos un análisis retrospectivo de 8 pacientes afectados de paniculitis mesentérica en un periodo comprendido entre mayo 2000 hasta diciembre 2006. En nuestra serie la edad media de presentación fue 63 años, siendo la mayoría de pacientes varones (proporción 3:1). Las manifestaciones clínicas más frecuentes fueron el dolor abdominal (n = 4) y la astenia (n = 4). Tres casos se presentaron como cuadro de obstrucción y tres casos presentaron antecedentes de cirugía abdominal. El antecedente más común fue el tabaquismo (5 casos eran fumadores activos y 2 exfumadores) y hubo un paciente que desarrolló un linfoma folicular en el seguimiento. Revisamos la literatura para analizar nuestros resultados y formular una hipótesis. En nuestra opinión, pensamos que debe ser analizada de forma más exhaustiva la relación entre el tabaco y sus componentes con la aparición de la enfermedad debido a la fuerte asociación encontrada en este estudio

Although several etiological factors have been associated with mesenteric panniculitis, the exact etiology in some cases remains unknown. Herein, we present a retrospective analysis of 8 patients affected with this disorder performed between May 2000 and December 2006. In our series the mean age at which patients presented was 63 years. The majority of the patients were male (with a male: female ratio of 3:1). The most common clinical manifestations were abdominal pain (n = 4) and asthenia (n = 4). Three cases presented with obstructive symptoms and three had a history of abdominal surgery. Notably, seven had a background of tobacco use (five smokers and two ex-smokers) and one patient developed follicular lymphoma. A literature research was carried out to analyze our results and formulate a new hypothesis. In our opinion, we believe that the study of causal factors such as tobacco and its components is required due to the strong association found in this study

[Wandering spleen torsion]. / Bazo ectópico torsionado.

The ectopic spleen characterizes for absence of its suspensory ligaments and a long pedicle that are predisposed to complicate it for a torsion with commitment of the venous drainage at first and arterial at a later time himself, producing increase of its volume and infarct. This anomalous situation, it can be had to a congenital malformation of the development of its suspensory elements and fall toward the inferior abdomen or else to an inferior growth of the mesodermic yolk of that this organ originates itself. The suitable treatment is the laparoscopic splenopexy, but when it exists infarction, it is no possible avoid the splenectomy.

Bazo ectópico torsionado / Wandering spleen torsion

El bazo ectópico se caracteriza por ausencia de sus ligamentos suspensorios y un pedículo largo, que le predisponen a complicarse por una torsión, con compromiso del drenaje venoso en un principio y posteriormente arterial, produciendo aumento de su volumen e infarto. Esta situación anómala puede ser debida a una malformación congénita del desarrollo de sus elementos suspensorios y caída hacia el abdomen inferior, o bien a un crecimiento inferior de la yema mesodérmica de la que se origina este órgano. El tratamiento idóneo es la esplenopexia vía laparoscópica, pero cuando existe infarto no podemos evitar la esplenectomía (AU)

The ectopic spleen characterizes for absence of its suspensory ligaments and a long pedicle that are predisposed to complicate it for a torsion with commitment of the venous drainage at first and arterial at a later time himself, producing increase of its volume and infarct. This anomalous situation, it can be had to a congenital malformation of the development of its suspensory elements and fall toward the inferior abdomen or else to an inferior growth of the mesodermic yolk of that this organ originates itself. The suitable treatment is the laparoscopic splenopexy, but when it exists infarction, it is no possible avoid the splenectomy (AU)

[Epidermoid splenic cyst--state of the art]. / Quiste esplénico epidermoide. Estado actual del problema.

In order to understand the features of splenic epidermoid cysts and their possible associated complications, four cases of splenic epidermoid cyst are presented in this report, two in children, one of them appeared in a child affected by a EBV and BH sepsis complicated with splenic abscesses due to scratch cat disease. The other two cases were adults. According to our histophatological findings, the pathogenesis may be related to a citodiferentation from mesothelium to squamous metaplasia. Our current knowledge about the role of spleen on immunological activity, mainly against capsulated germs, and the increase risk of overwhelming postesplenectomy septicemia have contributed to our conservative attitude about splenic surgery. We believe that management during the neonatal period should be conservative because cysts tend to disappear in most cases. In older children with a small cyst our recommendation is punction-aspiration and sclerotherapy, with ultrasound follow-up control.

Fibroadenoma de mama juvenil

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Firoadenoma gigante juvenil mamario en la adolescencia / Giant juvenile fibroadenoma of the breast in adolescence

Presentamos dos casos de adolescentes con un fibroadenoma gigante juvenil de mama de crecimiento rápido en un periodo de 5 meses. Ante esta masa voluminosa localizada en la mama en esas edades, hay que plantearse el diagnóstico diferencial entre un fibroadenoma gigante juvenil y un tumor filoides. El diagnóstico se realizó según los criterios clínicos, mamográficos y eco-Doppler y se confirmó mediante estudio anatomopatológico. Se debatieron las características histológicas, la citología, la histoquíinica, la citometría de flujo del fibroadenoma juvenil y el tumor filoides. El tratamiento consiste en una amplia resección de la tumoración hasta el tejido glandular normal, previendo una posible cirugía reparadora mediante la colocación de prótesis o un expansor mamario, si fuera preciso (AU)

[Comparison of prosthetic materials for abdominal wall reconstruction. Experimental study]. / Comparación entre materiales protésicos para reconstrucción de la pared abdominal. Estudio experimental.

To repair large abdominal deficiencies, either congenital of acquired, occasionally serious problems show up where obtaining the ideal material is concerned, in those cases where autological tissue in the right size can not be found. In this sense materials like silver, steel and tantalium darning have been used, as well as many other synthetic tissues and non porous materials like silastic. During this same period, prosthesis of reabsorbing materials have been developed and used. We present a experimental work in which we compare four prosthesic materials as there are Marlex, Silastic, polyglycolic acid and lyodura, from the clinical, biological and histopathological point of view, distinguishing the ideal material in definite pathologies.

[Acute perforated sigmoid diverticulitis in childhood]. / Diverticulitis aguda de sigma perforada en la infancia.

Colonic diverticulosis is a pathology of high incidence in normal population during the last decades of life. About 2-5 per 100 of patients admitted because of this disease are below 40 years old, and in this group of patients diverticulitis tends to be very aggressive with a high number of complications. We report a clinical case of acute perforation of sigmoid colon due to diverticulitis in a ten year old child who was treated surgically by means of resection of the sigma and primary end-to-end anastomosis. We did not find in the literature consulted any cases of this illness under twenty years of age.

[Urachal cyst. Current status of the problem]. / Quistes de uraco. Estado actual del problema.

Attention is focussed on urachal cysts, an uncommon disease entity recognized in 1 out of 5,000 autopsies performed in children. Two male patients, aged 47 and 30 years are described herein. Ultrasonography is considered to be necessary for diagnosing this disease. Treatment by complete removal of the cyst is advocated while others suggest the possibility of a more aggressive approach: removal combined with resection of a bladder anuria to avoid recurrence or development of a carcinoma.

[Biophysical study of resistance in arterial anastomoses. Experimental results]. / Estudio biofísico de la resistencia de anastomosis arteriales. Resultados experimentales.

Experimental study about suture materials of mean velocity absorption, in order to demonstrate their capacity to obtain a correct and sure arterial cicatrization by means of their tensile force, even though they disappear afterwards by absorption. 32 arterial anastomosis were carry out, and all of them resisted 300 mmHg of pressure, without to be broken.

[Hemorrhagic recurrence after operations of azygoportal disconnection]. / La recidiva hemorrágica tras las operaciones de desconexión acigoportal.

One of the main drawbacks attributed to azygoportal disconnection operations in the surgical treatment of bleeding esophageal varices is recurrence of hemorrhage. The present paper reviews the results obtained as regards hemorrhage recurrence in 4,975 patients who underwent azygoportal disconnection in 41 series published in the western literature in recent years. An analysis is also made of the factors that, according to different authors, could be related to the failure of these procedures to prevent eventual variceal hemorrhage.

Retroperitoneal fibrosis in a patient with Turner's syndrome.

Retroperitoneal fibrosis rarely affects children. Its clinical manifestations are protean, but if recognized early and properly treated, the prognosis is generally good. This is the report of a 14-year-old girl with Turner's syndrome and retroperitoneal fibrosis.