Prognostic factors of mortality in newborns with necrotizing enterocolitis submitted to exploratory laparotomy.

PURPOSE: The aim of this study was to identify and assess mortality predictive factors in newborns with necrotizing enterocolitis (NEC) requiring emergency exploratory laparotomy. METHODS: A prospective study of 91 newborns with NEC submitted to exploratory laparotomy was conducted. Clinical outcomes were death and survival 60 days after surgery. Nine variables were analyzed: weight at birth, gestational age, intrauterine growth, sex, gas in the portal vein at abdominal x-ray, pneumoperitoneum, extent of the disease, operative strategies, and extension of bowel resection. Univariate and multivariate analyses were performed to identify mortality predictors. RESULTS: Mean weight at birth was 1,676 +/- 634.8 g, and mean gestational age was 34 +/- 2.8 weeks. Thirty-nine newborns (42.9%) presented intrauterine growth retardation. Operative techniques included bowel resection with enterostomy (80 patients), bowel resection with primary anastomosis (10 patients), and decompressive enterostomy (1 patient). Six deaths occurred caused by co-existing disease. NEC-related mortality rate was 46.15% (42 of 91). CONCLUSIONS: Two variables, intrauterine growth retardation, and diffuse bowel involvement, were predictive of mortality according to both univariate and multivariate analyses. Site of bowel involvement seems to be important mortality predictors in infants with NEC requiring surgery. The size of our population did not allow statistical analysis of this relationship. Further studies should focus on examining this aspect.

Tríada de Currarino / Currarin's Triad

Se presenta el caso de un neonato varón con estenosis anal, hemisacro en forma de "cimitarra" y un teratoma presacro firmemente unido al recto distal(Triada de Curraino). El tumor tenía comunicación con el canal raquídeo. Por un abordaje sagital posterior pudo resecarse completamente el tumor, cerrando la duramadre del saco dural abierto. Se realizó además un sigmoidostomía desfuncionalizante temporaria. La evolución posoperatoria fue muy satisfactoria. Con la revisión de la literatura reciente, se analizan las variantes en cada uno de los tres componentes de la Tríada de Currarino y la posible herencia dominante de esta asociación patológica

Tríada de Currarino / Currarins Triad

Se presenta el caso de un neonato varón con estenosis anal, hemisacro en forma de "cimitarra" y un teratoma presacro firmemente unido al recto distal(Triada de Curraino). El tumor tenía comunicación con el canal raquídeo. Por un abordaje sagital posterior pudo resecarse completamente el tumor, cerrando la duramadre del saco dural abierto. Se realizó además un sigmoidostomía desfuncionalizante temporaria. La evolución posoperatoria fue muy satisfactoria. Con la revisión de la literatura reciente, se analizan las variantes en cada uno de los tres componentes de la Tríada de Currarino y la posible herencia dominante de esta asociación patológica

Distopia testicular. / The undescended testis

Os autores apesentam um estudo de 200 recem-nascidos a termo, analisando a incidencia de distopia testicular e sua interrelacao com dados do recem-nascido (cor, peso, comprimento e idade gestacional) e da mae (idade, numero de gestacoes e numero de filhos). Concluiu-se que houve predominancia de distopia a direita, sendo a localizacao inguinal mais frequente do que os testiculos retrateis e os nao localizados. No presente estudo ocorreu uma incidencia mais elevada de criptorquidia do que o citado na literatura

[Esophago-gastro-duodenal endoscopic findings in patients with urticaria]. / Rilievi endoscopici esofagogastroduodenali in pazienti affetti da orticaria.

In a study carried out on 54 patients affected with urticaria the Authors try to demonstrate, by esophagogastroduodenoscopy, concomitant lesions of the gastroduodenal tract. The superior panendoscopic examination has shown gastroduodenal lesions in about 39% of cases.