Qué hacer con el recién nacido obstruido / What to do with an obstructed newborn

La obstrucción intestinal es la urgencia abdominal más frecuente en el recién nacido. Su manejo es un desafío tanto para el clínico como para el radiólogo. La presentación clínica no es específica y tanto el diagnóstico como el manejo posterior se apoyan en los estudios de imagen. Los métodos tradicionales para estudiar al recién nacido obstruido han sido la radiografía simple de abdomen y los estudios con contraste del tracto gastrointestinal. La ecografía ha demostrado su utilidad en la obstrucción intestinal, evitando en determinados casos el uso de radiación ionizante, por lo que debería quedar incluida en las estrategias de diagnóstico, como una técnica de estudio inicial. Mediante la combinación adecuada de estas técnicas se podrá llegar al diagnóstico de forma rápida y precisa, orientando el manejo terapéutico del paciente y disminuyendo las complicaciones (AU)

Bowel obstruction is the most common abdominal emergency in newborns. Managing bowel obstruction is a challenge for both clinicians and radiologists. The clinical presentation is nonspecific, and both the diagnosis and subsequent management are based on imaging studies. The traditional approach to studying obstructed newborns consists of plain-film abdominal X-rays and contrast-based studies of the gastrointestinal tract. Ultrasonography has proven useful in bowel obstruction, thus avoiding the use of ionizing radiation in certain cases, so diagnostic strategies should include it as a first-line technique. Using an appropriate combination of these techniques, it is possible to reach an accurate diagnosis quickly, orienting treatment and decreasing complications (AU)

What to do with an obstructed newborn. / Qué hacer con el recién nacido obstruido.

Bowel obstruction is the most common abdominal emergency in newborns. Managing bowel obstruction is a challenge for both clinicians and radiologists. The clinical presentation is nonspecific, and both the diagnosis and subsequent management are based on imaging studies. The traditional approach to studying obstructed newborns consists of plain-film abdominal X-rays and contrast-based studies of the gastrointestinal tract. Ultrasonography has proven useful in bowel obstruction, thus avoiding the use of ionizing radiation in certain cases, so diagnostic strategies should include it as a first-line technique. Using an appropriate combination of these techniques, it is possible to reach an accurate diagnosis quickly, orienting treatment and decreasing complications.

Síndrome de aorta media: presentación de tres casos pediátricos / Middle aortic syndrome: a report of three pediatric cases

El síndrome de aorta media (SAM) consiste en una estenosis de la aorta abdominal generalmente con inclusión de las arterias renales y viscerales. Es un síndrome muy infrecuente (0,5-2%), aunque una causa importante de hipertensión arterial (HTA) en niños y adolescentes. Se cree que su origen embriológico se debe a un fallo en la fusión de las dos aortas dorsales y la etiología es idiopática en un alto porcentaje. Su localización es interrenal en el 54% de los casos. Clínicamente cursa con HTA, sintomática o no. A la exploración puede apreciarse soplo abdominal, pulsos femorales disminuidos o ausentes y diferencia de TA entre miembros superiores e inferiores. La angiografía es considerada la técnica de elección aunque las técnicas angiográficas no invasivas mediante RM y TC se encuentran al mismo nivel diagnóstico. La ecografía es la primera técnica de despistaje. El tratamiento médico consiste en la combinación de diferentes antihipertensivos. El tratamiento quirúrgico puede ser curativo(AU)

The middle aortic syndrome (MAS) is caused by stenosis of the abdominal aorta, often accompanied by concomitant stenosis of the renal or visceral arteries. Although MAS is uncommon (0.5-2%), it is an important cause of hypertension in children and adolescents. It is thought to originate in a failure of the two dorsal aortas to fuse during embryological development, and a high percentage of cases are idiopathic. MAS affects the segment of the aorta between the renal arteries in 54% of cases. Clinically, it courses with symptomatic or asymptomatic arterial hypertension. On physical examination, findings include an abdominal bruit, diminished or absent femoral pulses, and a difference between the arterial pressure of the upper and lower limbs. Angiography is the technique of choice, although noninvasive MR angiography and CT angiography have similar diagnostic accuracy. Ultrasonography is the primary screening technique. Medical treatment consists of a combination of different antihypertensives. Surgical treatment can be curative(AU)

[Middle aortic syndrome: a report of three pediatric cases]. / Síndrome de aorta media: presentación de tres casos pediátricos.

The middle aortic syndrome (MAS) is caused by stenosis of the abdominal aorta, often accompanied by concomitant stenosis of the renal or visceral arteries. Although MAS is uncommon (0.5-2%), it is an important cause of hypertension in children and adolescents. It is thought to originate in a failure of the two dorsal aortas to fuse during embryological development, and a high percentage of cases are idiopathic. MAS affects the segment of the aorta between the renal arteries in 54% of cases. Clinically, it courses with symptomatic or asymptomatic arterial hypertension. On physical examination, findings include an abdominal bruit, diminished or absent femoral pulses, and a difference between the arterial pressure of the upper and lower limbs. Angiography is the technique of choice, although noninvasive MR angiography and CT angiography have similar diagnostic accuracy. Ultrasonography is the primary screening technique. Medical treatment consists of a combination of different antihypertensives. Surgical treatment can be curative.