[Meckel's diverticulum in childhood. The authors' own experience]. / Diverticolo di Meckel in età pediatrica. Esperienza personale.

Meckel's diverticulum occurs in approximately 2 percent of the population and may present at any age. Although Meckel's diverticulum may produce an intestinal obstruction or perforation, simulating an appendicitis, hemorrhage is its most important clinical presentation. From 1989 to 1994, Meckel's diverticulum was discovered in ten children at laparotomy. Three cases were asymptomatic, representing an incidental finding at laparotomy. Of the seven symptomatic patients, four presented with bowel obstruction (intussusception), three had rectal bleeding one of whom had diverticulitis. Contrast studies--in gastrointestinal hemorrhage--were not helpful in establishing the diagnosis; colonoscopy and gastroscopy ruled out other causes of bleeding. Five of seven symptomatic patients had an intestinal resection while two a diverticulectomy after assessment that the ulcer did not require resection. No postoperative morbidity and mortality is reported in either groups. A Meckel's diverticulum found incidentally at laparotomy should be always resected as the risk of complication is high and that of resection low.

[Cardiovascular complications of Kawasaki disease: clinical cases]. / Complicanze cardiovascolari nella malattia di Kawasaki: casistica clinica.

The Authors report the cases of Kawasaki disease (K.D.) observed between July 1988 and october 1991 in OO.RR.'s Pediatric Division of Foggia. The diagnosis was made according to the C.D.C.'s Atlanta diagnostic guidelines. All children were treated (whithin the first 10 days of onset of illness) with intravenous immune-globuline (500 mg/kg/die for 5 days) and with Asa and Dypiridamol for two months after they were without temperature. The patients with coronaric sequelae repeated after 4 weeks a second cycle of intravenous immuno-globuline therapy and continued Asa and Dypiridamol therapy until two months after disappearance of coronary arterial abnormalities. All patients performed ECG at 3-15-30 days and at 180-360 days from the onset of illness. A mono-bidimensional ecocardiogram was performed twice a week in the first month, bi-monthly in the next months and after 180-360 days from the onset of illness. One of the 8 children developed coronary aneurysms, which regressed echocardiographycally during the first 6 months after the acute illness. While the etiology and pathogenesis of K.D. remain incompletely understood, the clinical spectrum of the disorder and its long-term prognosis and treatment are becoming increasingly well defined. Coronary artery aneurysms developed in 15-25% of cases, with a mortality for coronary artery thrombosis of 1-2% of cases. Intravenous immuno-globuline infusion given in the early phases of the disorder reduce the incidence of coronary artery aneurysms therefore an early diagnosis is important to prevent coronary artery abnormalities.

[Symptomatic renal candidiasis with multiple mycetomas: a case report]. / Candidiasi renale sintomatica con micetomi multipli: descrizione di un caso.

Candida albicans is the most prevalent and pathogenic fungal infection of the urinary tract. Although fungal urinary tract infection occur less frequently than bacterial infections, their incidence has increased during the last decades. Parenteral nutrition, corticosteroids, immunosuppressive drugs and prolonged antibiotic therapy are often predisposing factors. We report a case of renal pelvic fungus balls in a 6-month old female who developed candidal infection after surgical treatment for bilateral vesico-ureteric reflux; the renal candidiasis was treated successfully with fluconazole.

[Respiratory function involvement in intestinal chronic inflammatory disease: description of a case]. / Compromissione della funzionalità respiratoria in corso di malattia infiammatoria cronica dell'intestino: descrizione di un caso.

In the process of chronic intestinal inflammatory diseases the involvement of other organs and apparatuses is frequent. The respiratory apparatus, however, is not so frequently concerned as other organs, especially with regard to the paediatric age. The rarity of clinical evidences concerning the respiratory apparatus contrasts with the anomalies of the lung functionality tests described in literature. A fifteen year old boy is taken into consideration. He was first examined at the age of nine, when his symptomatology (slight fever and abdominal pain) was regarded as a chronic intestine inflammatory disease and it was treated with salazopyrina and cortisone. Compilations supervened later on, such as ilium arthritis, psoriasis-like dermatitis, perineal abscess. Five years after the beginning of the intestine disease the lungs were also involved and there was evidence of dyspnoea, especially when the patient was under stress. The clinical picture was confirmed by the reduction of the parameters of the respiratory functionality in the sense of an insufficiency of obstructive and restrictive kind. The pulmonary compilation was treated with disodium cromoglycate; such treatment was stopped, after the appearance of headache. After more than a year since the supervening of the lung complication the patient is being kept under periodic control to evaluate his pulmonary functionality. The indexes are constantly altered in the sense of a reduction of FEV 1, of FVC, of FEF 25-75 and of PEF, while the ventilatory and perfusional pulmonary scintigraphy has not shown relevant anomalies.

[Clinico-instrumental diagnosis of adrenal hematoma]. / Diagnosi clinico-strumentale dell'ematoma surrenalico.

The authors relate about 3 cases of newborn babies with adrenal haemorrhage. The only clinical sign found was the palpation of the lowered kidney. The diagnosis was made after an abdominal ultrasonography which turned out to be the decisive instrumental analysis.