[Esophageal perforation in premature newborn infants. Presentation of 8 cases]. / Perforación de esófago en recién nacidos prematuros. Presentación de ocho casos.

We report eight newborn with esophageal perforation. They were preterm infants and received mechanical ventilation for respiratory problem. Six were associated with pneumothorax, three of they show aberrant way of an orogastric tube, and another three show milk fluid in the pleural tube installed for pneumothorax. The management was fasting during ten days, parenteral nutrition, wide spectrum antibiotics, and prevention of complications; surgery treatment is not the first of all recommended at present.

[Risk factors in neonatal necrotizing enterocolitis]. / Factores de riesgo en la enterocolitis necrosante neonatal.

In this case controls prospective study, risk factors for necrotizing enterocolitis from a neonatal intensive care unit, were investigated. In 34 cases and 69 controls, were found; the fetal distress, Apgar score < or = 5 at one minute, < or = 6 at five minutes, gestational age < or = 34 weeks and birth weight < or = 1500 g, like risk factors for necrotizing enterocolitis. The investigation of a new risk factor, abdominal distention with plentiful intestinal gas documented in X ray at initial hours of life, by energetic reanimation at birth, showed that it is not a risk factor.

[Cloverleaf skull. Presentation of three cases]. / Cráneo en "hoja de trébol". Presentación de tres pacientes.

Three patients who presented cloverleaf skull are described. The first one associated with tanatophoric dwarfism, the second case was an isolate anomaly and the third one was associated with facial fissures. The three patients showed the outstanding diversity of the clinic manifestations encountered in this entity. The findings at central nervous system level, by computarized tomographic and ultrasonographic studies, are described. The relevance of genetic counselling is emphasized.

Preoperative ultrasonographic diagnosis of a parathyroid adenoma in a child.

The case of a young boy with primary hyperparathyroidism due to an adenoma is reported. The tumor was localized by ultrasonography, and a close correlation between the image and the surgical findings was found. Since primary hyperparathyroidism in children under 15 years of age is frequently due to adenomata larger than 1.5 cm it is suggested that ultrasonography of the neck should be included in the work-up of every children suspected to have this pathology.

Neumoperitoneo secundario a neumotorax en un recien nacido. / Pneumoperitoneum secondary to pneumothorax in a newborn infant

El objetivo de esta comunicacion es el de discribir un neonato con la asociacion de neumoperitoneo (NP) de origen pulmonar coincidiendo con atresia de duodeno, asi como la revision de la fisiopatogenia los elementos del diagnostico y el tratamiento del mismo. El NP se penso que era secundario a ruptura de viscera hueca debido a que se produjo disminucion radiologica del aire en camara gastrica, asi como por la presencia de la atresia duodenal, que impidio evaluar la ausencia de niveles hidroaereos en intestino y liquido libre en peritoneo, datos que corresponden a perforacion intestinal. El NP fue secundario a neumotorax con probable diseccion del aire por las vainas perivasculares de la aorta o la cava con paso en el hiato difragmatico al peritoneo. Finalmente, se senalan los elementos para el diagnostico preciso, asi como la terapeutica

Complicaciones de cateterismo venoso.La radiologia y el ultrasonido en el diagnostico y evolucion de un caso. / Complications of venous catheterism.Radiology and the ultrasound in the diagnosis and evolution of a case

Se presenta el caso clinico de un lactante femenino de 9 meses de edad, que se complica por la instalacion de cateter venoso en femoral izquierda que produce laceracion del vaso con extravasacion de liquidos a cavidades peritoneal y retroperitoneal.Se describe el desarrollo de los acontecimientos posteriores con la contribucion de la radiologia y utrasonografia en la evolucion del caso hasta su solucion final

Hiperparatiroidismo primario en ninos Informe de dos casos y revision de la literatura. / Primary hyperthyroidism in childreen. Report of 2 cases and review of the literature

Se informa acerca de dos pacientes menores de 15 anos con hiperparatiroidismo primario de caracteristicas clinicas poco frecuentes: uno sufria tumores en el femur derecho y hemicara izquierda asociados a desnutricion grave y el otro artritis importante de ambas rodillas y poca repercusion osea. En este ultimo se localizo un adenoma paratiroideo por medio de la ultrasonografia. Se revisaron 67 casos publicados hasta 1981, 40 en ninos y 27 en ninas; 57 tenian adenomas y 10 hiperparasia-glandular. Los sintomas y signos referidos con mayor frecuencia en el nino son: fatigabilidad, anorexia, vomito, perdida de peso, detencion del crecimiento, osteoporosis y artritis, mientras que en los adultos, las manifestaciones clinicas se relacionan con litiasis de vias urinarias, trastornos oseos, ulcera peptica y pancreatitis. En ninos, la etiologia mas frecuente es un adenoma paratiroideo, con dimensiones mayores a 1.5 cms, histologicamente compuesto de celulas principales. Se Sugiere que el estudio ultrasonografico de cuello sea utilizado habitualmente para la localizacion del tumor

[The thymothoracic index and its usefulness in the diagnosis of newborn infants with respiratory distress syndrome]. / Indice timotorácico y su utilidad en el diagnóstico del recién nacido con síndrome de dificultad respiratoria.

In order to evaluate the use of the thymothoracic index (TTI) in the diagnosis of the respiratory distress syndrome (RDS), 51 newborn infants were studied and divided into two groups: group A included 30 patients with RDS and group B, 21 infants with lung pathology other than RDS. The diagnosis in both groups was based on clinical, radiological and anatomopathological grounds. The TTI is obtained by dividing the diameter of the cardiothymic shadow at the carina level between the chest diameter at the costophrenic angles, using a simple chest radiography. In both groups, the height, weight and gestational age were similar; the only difference was the time when the X-Ray was taken; in group A the average time was 11.5 hours after birth and group B, 17.1 hours. The TTI was greater in group A (0.44 +/- 0.09) than in group B (0.30 +/- 0.08) with a significant difference. In conclusion the TTI is a simple and practical method that can be useful in the diagnosis of RDS.

Indice timotoracico y su utilidad en el diagnostico del recien nacido con sindrome de dificultad respiratoria. / Thymothoracic index and its usefulness in the newborn infant with respiratory distress syndrome

Con el fin de evaluar la utilidad del indice timotoracico (ITT) en el diagnostico del sindrome de dificultad respiratoria (SDR) se estudiaron a 51 neonatos que se dividieron en dos grupos, el A formado por 30 pacientes con SDR y el B por 21 ninos con otra patologia pulmonar que no fuera SDR. El diagnostico tanto del SDR como de las otras patologias pulmonares se establecio en base a caracteristicas clinicas, radiologicas y anatomopatologicas. El ITT se obtuvo en una radiografia de torax al dividir el diametro de la silueta cardiotimica a nivel de la carina, entre el diametro del torax a nivel de los angulos costofrenicos. Al comparar ambos grupos, resultaron similares en edad gestacional, peso y talla, no asi en el momento de la toma de la radiografia de torax que fue en promedio a las 11.15 horas de vida para el grupo A y a las 17.1 horas en el B. El ITT fue mayor en el grupo A (0.44 mais ou menos 0.09) que en el B (0.30 mais ou menos 0.08) con diferencia significativa. Se concluye que el ITT es un metodo sencillo y practico que puede ser util en el diagnostico de SDR

[Osteomyelitis in the newborn]. / Osteomielitis en el recién nacido.

The study included 17 cases of osteomyelitis in the newborn period, admitted through a period of 10 years. Males showed a rate of 1.8:1 over females. The possible port of entry was established in 11 cases. The most important clinical signs were: edema, erythema, hypomotility and fluctuation. In one third of the cases, systemic infection signs were eident and in 4 cases, confirmation resulted from blood cultures positive to gram-negative germs. The germ most frequently isolated in the secretion was S. aureus, followed by Klebsiella. The analysis included the pathogenesis that explains the high percentage of articular participation (65%) and the presence of multiple foci which, together with other characteristics, make osteomyelitis at this age, different from that seen during other stages of life in terms of diagnosis, management and prognosis.

[Anatomo-radiological correlation of shock lung in pediatrics]. / Correlación anatomorradiológica del pulmón de choque en pediatría.

We reviewed three post-mortem studies of pediatric patients who died with the diagnosis of shock lung. We try to correlate the thorax X Ray studies obtained during clinical shock, with the anatomopathological findings. We established the basis for the anatomopathological and radiological diagnosis, and its comparation with the adult studies. No correlation could be establish with this a prospective study to try recognize this entity during life with serial X Ray studies, like was performed in adults.

[Massive air embolism in a newborn infant treated with a positive-pressure respirator]. / Embolia gaseosa masiva en un recién nacido tratado con respirador de presión positiva

We report a case of gas embolism secondary to the use of positive end respriatory pressure in a newborn with ideopathic respiratory syndrome. The anatomicopathological findings lead to the hypothesis that the gas migrates from the broken alveoli through the lymphatic vessels to the venous circulation.