RESUMO
The case of a 680 g premature baby who developed massive spontaneous liver haemorrhage during laparotomy for necrotizing enterocolitis is reported. The infant survived due to rapid and massive fluid administration, including transfusion of large volumes of blood and blood products, in combination with high dose inotropic support and the surgical use of packing with thrombostatic sponges. Good venous access, including two central venous lines, turned out to be very useful.
Assuntos
Anestesia Geral , Enterocolite Necrosante/cirurgia , Hemorragia/etiologia , Doenças do Prematuro/cirurgia , Recém-Nascido Prematuro , Cuidados Intraoperatórios , Complicações Intraoperatórias/terapia , Laparotomia , Hepatopatias/etiologia , Transfusão de Sangue , Cardiotônicos/uso terapêutico , Cateterismo Venoso Central/instrumentação , Cateterismo Periférico/instrumentação , Feminino , Hidratação , Hemorragia/terapia , Hemostasia Cirúrgica/instrumentação , Hemostasia Cirúrgica/métodos , Humanos , Recém-Nascido , Hepatopatias/terapia , Tampões de Gaze CirúrgicosRESUMO
The calcium excretion was investigated in 31 children who were immobilised because of fracture of the femur. Children over the age of 5 years treated with Kirschner wire extension showed a statistically significant rise of calcium excretion as compared with a control group but this reverted rapidly after mobilisation. Younger patients treated by overhead traction showed a decreased calcium excretion. The Calcium Excretion Quotient (CEQ) based on the calcium excretion in the early morning specimens of urine and the specific gravity were used to determine hypercalcemia. Dietary management or drug treatment is not necessary in this situation.
Assuntos
Cálcio/urina , Fixação de Fratura/efeitos adversos , Criança , Pré-Escolar , Fraturas do Fêmur/metabolismo , Fraturas do Fêmur/cirurgia , Humanos , Masculino , Fatores de TempoRESUMO
Pseudoatresia of the oesophagus seems to occur more frequently than assumed from the cases actually diagnosed. With reference to an appropriate case its traumatic origin is discussed and is considered to be closely connected with anatomical facts and special circumstances arising in newborn infants. Clinical symptoms, therapy and prophylaxis are pointed out. Common oesophageal atresia is the most important condition to be ruled out in the differential diagnosis.
