RESUMO
Gastroschisis is a severe congenital malformation of the abdominal wall, with relative low incidence. The authors are analysing different therapeutic methods, in a group of 17 cases, hospitalised and operated in Department of Pediatric Surgery, Emergency Hospital of Craiova. They are underlining the importance of the ultrasound prenatal diagnosis of the malformation, close related to different therapeutic methods applied in this period of time and also are advising secondary closure of the abdominal wall, using a synthetic material (Silo-bag) for temporary coverage of the intestine developed outside the peritoneal cavity. This method helped with the decreasing of mortality in gastroschisis but with high costs of treatment.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Gastrosquise/cirurgia , Bandagens , Diagnóstico Diferencial , Gastrosquise/diagnóstico , Humanos , Recém-Nascido , Estudos Retrospectivos , Romênia , Elastômeros de Silicone , Resultado do TratamentoRESUMO
HIV infection is a very actual disease widespread all over the world (40 million people), including up to 10 thousand Romanian, are infected with HIV; there are 950 HIV-infected patients in Oltenia, 450 of them are in our county (Dolj area), 80% of the HIV-infected persons are children. The authors are studying a group of 17 cases of HIV-infected children with surgical problems (Acute appendicitis, acute cholecystitis, pulmonary and kidney abscess, lymphadenophlegmons, abdominal tumours), which have been transferred to our department from the Infectious Diseases Clinic, between 1995-2004. The medical records of all patients were reviewed: strategies of management, particularity of antiretroviral therapy of children, and also strategies of prevention the perioperative HIV transmission. The most frequent cases were the lymphadenophleg mons (40%) and chronic abdominal pain (25%). The acute abdominal pathology consisted in 2 cases of acute appendicitis and 1 case of acute cholecystitis, which were successfully treated. The HIV infection remains in actuality, because there is not an efficient antiretroviral therapy. Surgeons planning treatment must consider the risks of the patient against the potential benefits of surgery.