Pleural effusion in a child with a correctly placed ventricle-peritoneal shunt.

Pleural effusions in children (PE) due to ventricle-peritoneal shunt (VPS) is very rare, with few cases reported. We present a new case of an infant with VPS who had a massive hydrothorax not associated with misplacement or migration of the distal catheter or with ascites. After the evacuation of the PE we managed the patient by adjusting the pressure of the adjustable valve (AV). Sequential thoracic ultrasounds showed a satisfactory outcome. We review the literature thoroughly and describe the possible pathophysiological mechanisms.

Parénquima testicular ectópico en la túnica albugínea / Ectopic testicular parenchyma in albugineal tunic

Presentamos un varón, operado de criptorquidia bilateral, en el que macroscópicamente ambos testículos presentaban máculas y que en el estudio histológico se observaron grupos de túbulos seminíferos, con estroma y células de Leydig, rodeados por la albugínea, aislados del resto del parénquima testicular, siendo el diagnóstico histopatológico de "ectopia del parénquima testicular". Esta anomalía puede inducir a error y realizar laparotomías innecesarias, debido a que los túbulos seminíferos están rodeados por la albugínea, sin conexión aparente con el resto del parénquima testicular, siendo necesaria su valoración a largo plazo tanto durante la pubertad como en la edad adulta (AU)

We introduce a male patient with bilateral chryptorchidism submitted to surgery; during the intervention, macroscopically round macules were seen in the outer surface of both testes. In the round macules histological study, groups of seminiferous tubules were observed, including stroma and Leydig’s intestitial cells surrounded of tunica albuginea, isolated from the rest of testicular parenchymal tissue; the diagnosis "Ectopic testicular parenchyma tissue" was confirmed by histopathological study. Due to the seminiferous tubules are surrounded by the tunica albuginea, with no apparent connection to the rest of the testicular parenchyma, a long-term assessment is required, both during puberty aswell as in adulthood; owing to that can mislead and make unnecessary laparotomies and orchiectomies in the future (AU)

[Ectopic testicular parenchyma in albugineal tunic]. / Parénquima testicular ectópico en la túnica albugínea.

We introduce a male patient with bilateral chryptorchidism submitted to surgery; during the intervention, macroscopically round macules were seen in the outer surface of both testes. In the round macules histological study, groups of seminiferous tubules were observed, including stroma and Leydig's intestitial cells surrounded of tunica albuginea, isolated from the rest of testicular parenchymal tissue; the diagnosis "Ectopic testicular parenchyma tissue" was confirmed by histopathological study. Due to the seminiferous tubules are surrounded by the tunica albuginea, with no apparent connection to the rest of the testicular parenchyma, a long-term assessment is required, both during puberty as well as in adulthood; owing to that can mislead and make unnecessary laparotomies and orchiectomies in the future.

[Intrakidney-catheter. Post pyelo-plasty complication]. / Catéter intrarrenal. Complicación post-pieloplastia.

One of the more severe urology complications are the forgetfulness of surgical instruments or materials (compress, gauzes...), with different types of complications. We present a male, operated of left hydronephosis. The post surgical catheter was retired five days after the anterograde urography, being all normal. But, in the new urography, practised six month after, a little fragment of catheter was discover, being necessary to do a new lobotomy and extraction. After revised the paediatric-urology bibliography, we note the very few articles about surgical complications, which is not the case of the adult's urologist. And this is very negative to the resident training, and also to our patients.

[Labia minora hypertrophy in the puberty]. / Hipertrofia de labios menores en la pubertad.

The labia minora hypertrophy is a very low frequent entity, being probably at any age, but with more incidence in puberty. In some cases, the labia hypertrhophy is so big to provoke urinary and sexual-relationship problems, with theirs behaviour consequences. We present two cases in which an labioplasty was done, without any complications. Also from the aesthetic point of view the long term results have been excellent for our patients.

Catéter intrarrenal. Complicación post-pieloplastia / Intrakydney-catheter. post pielo-plasty complication

Las complicaciones urológicas yatrogénicas son excepcionales, siendo una de las más frecuentes el olvido de material dentro del campo quirúrgico, principalmente las gasas y compresas, que son el material más frecuente, el cual puede ser asintomático u originar diferentes complicaciones. Presentamos a un varón operado de una hidronefrosis izda, al que se le colocó una sonda de nefrostomía y un catéter transanastomótico retirado al 5º día. En la urografia descendente inmediata a la intervención y enla ecografía realizada al mes, no se observa ningún cuerpo extraño, pero en la urografía realizada al 6º mes de la intervención se comprueba un fragmento de catéter dentro de la pelvis renal que precisó nueva lumbotomía. Se realiza una revisión bibliográfica de las complicaciones urológicas y atrogénicas y se llama la atención sobre las pocas publicaciones existentes de yatrogenia urológica pediátrica, al contrario que los urólogos de adultos, que sí las publican. Esta falta de publicaciones repercute negativamente en la formación de los cirujanos pediátricos, especialmente, de los residentes (AU)

One of the more severe urology complications are the forgetfulness of surgical instruments or materials (compress, gauzes…), with different types of complications. We present a male, operated of left hydronephosis. The post surgical catheter was retired five days after the anterograde urography, being all normal. But, in the new urography, practised six month after, a little fragment of catheter was discover, being necessary to do a new lumbotomy and extraction. After revised the paediatric-urology bibliography, we note the very few articles about surgical complications, which is not the case of the adult’s urologist. And this is very negative to the resident training, and also to our patients (AU)

Hipertrofia de labios menores en la pubertad / Labia minora hypertrophy in the puberty

La hipertrofia de los labios menores es una patología muy poco frecuente, que puede aparecer a cualquier edad, aunque se ha observado con mayor incidencia durante la pubertad .En algunos casos, la hipertrofia es tan grande que, no solamente va a originar trastornos locales, sino que puede dificultar las relaciones sexuales, desencadenando problemas serios de comportamiento. Presentamos 2 casos a los que se les realizó una labioplastia, no teniendo ninguna complicación inmediata; desde el punto de vista esté-tico, a largo plazo, ha sido excelente el grado de satisfacción de nuestras pacientes y de los cirujanos (AU)

The labia minora hypertrophy is a very low frequent entity, being probably at any age, but with more incidence in puberty. In some cases, the labia hypertrhophy is so big to provoke urinary and sexual-relationship problems, with theirs behaviour consequences. We present two cases in which an labioplasty was done, without any complications. Also from the aesthetic point of view the long term results have been excellent for our patients (AU)

[Prophylactic thyroidectomy in children at risk for medullary thyroid carcinoma]. / Tiroidectomía profiláctica en pacientes pediátricos con riesgo de carcinoma medular tiroideo.

The medullary thyroid carcinoma (MTC) is a rare neoplasia occurring during childhood. At present time the molecular examination of the proto-oncogen RET, related to syndromes of multiple endocrine neoplasia (MEN II) and familial medullary thyroid carcinoma (FMTC) to allows identify patients with risk of suffering of medullary thyroid carcinoma in early ages, before the disease becomes clinically pronunced. Children with familial antecedents of MEN II or FMTC were biochemically (pentagastrin-stimulated) and genetically studied with the purpose of determining the risk of developing a MTC and in order to assess the possibilities of making a prophylactic thyroidectomy.

[Spigelian hernia: two cases associated to cryptorchidism]. / Hernia de Spiegel: a propósito de 2 casos asociados a criptorquidia.

Spigelian hernia (SH) is rare in children, it occurs primarily en adults the mean age of presentacion is 50 years. We present two patients with hernia associated to cryptorchidism one of them bilateral.

Tiroidectomía profiláctica en pacientes pediátricos con riesgo de carcinoma medular tiroideo / Prophylactic thyroidectomy in children at risk for medullary thyroid carcinoma

El carcinoma medular de tiroides (CMT) es una rara neoplasiaen la infancia. En la actualidad el estudio molecular del proto-oncogén RET, relacionado con los síndromes de neoplasia endocrina múltiple (MEN II) y carcinoma medular familiar de tiroides (CMFT)permiten identificar pacientes con riesgo de padecer carcinoma medularde tiroides en edades precoces, antes de que se manifieste la enfermedad clínicamente. Niños con antecedentes familiares de MEN II o CMFT fueron estudiados bioquímica (test de pentagastrina) y genéticamente con el fin dedeterminar el riesgo de padecer CMT y evaluar la posibilidad de realizar tiroidectomía profiláctica (AU)

The medullary thyroid carcinoma (MTC) is a rare neoplasiaoccurring during childhood. At present time the molecular examinationof the proto-oncogen RET, related to syndromes of multipleendocrine neoplasia (MEN II) and familial medullary thyroid carcinoma(FMTC) to allows identify patients with risk of suffering of medullarythyroid carcinoma in early ages, before the disease becomes clinicallypronunced. Children with familial antecedents of MEN II orFMTC were biochemically (pentagastrin-stimulated) and geneticallystudied with the purpose of determining the risk of developing a MTCand in order to assess the possibilities of making a prophylactic thyroidectomyThe medullary thyroid carcinoma (MTC) is a rare neoplasia occurring during childhood. At present time the molecular examinationof the proto-oncogen RET, related to syndromes of multiple endocrine neoplasia (MEN II) and familial medullary thyroid carcinoma(FMTC) to allows identify patients with risk of suffering of medullary thyroid carcinoma in early ages, before the disease becomes clinically pronunced. Children with familial antecedents of MEN II orFMTC were biochemically (pentagastrin-stimulated) and genetically studied with the purpose of determining the risk of developing a MTCand in order to assess the possibilities of making a prophylactic thyroidectomy (AU)

Hernia de Spiegel: A propósito de 2 casos asociados a criptorquidia / Spigelian: two cases associated to cryptorchidism

La hernia de Spiegel es una hernia rara en la población infantil, más común en la población adulta con predominio en la 5ª década de la vida. Presentamos dos pacientes con hernia asociada a criptorquidia, una de ellas bilateral (AU)

Spigelian hernia (SH) is rare in children, it occurs primarily en adults the mean age of presentacion is 50 years. We present two patients with hernia associated to cryptorchidism one of them bilateral (AU)