RESUMO
Pulmonary sequestration is an uncommon congenital malformation of the lung that can be classified as intralobar or extralobar (ELS). Approximately 90% of ELS occur in the left hemithorax. Approximately 10% of ELS may present below the diaphragm. Both types of sequestrations are characterized by pulmonary tissue that does not communicate with the bronchial tree. The arterial blood supply to 80% ELS is through a direct branch of the thoracic or abdominal aorta, in 15% via another systemic artery and 5% from the pulmonary artery. The venous drainage of ELS is variable, predominantly into the systemic circulation (via the azygos vein, hemiazygos vein, or inferior vena cava). Approximately 25% drain completely or partially through the pulmonary veins. We report an extremely rare case of ELS with unusual venous drainage to the portal vein.
Assuntos
Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/cirurgia , Sequestro Broncopulmonar/diagnóstico , Sequestro Broncopulmonar/cirurgia , Veia Porta/anormalidades , Cirurgia Torácica Vídeoassistida , Sequestro Broncopulmonar/complicações , Humanos , Recém-Nascido , Masculino , Cuidados Pré-OperatóriosRESUMO
Intrauterine intussusception is an uncommon cause of intestinal atresia. We report a case of ileal atresia owing to antenatal intussusception revealed as an intraluminal polypoid lesion after surgical intervention.
Assuntos
Doenças Fetais/diagnóstico , Doenças Fetais/epidemiologia , Doenças do Íleo/etiologia , Íleo/anormalidades , Atresia Intestinal/etiologia , Intussuscepção/diagnóstico , Intussuscepção/epidemiologia , Feminino , Humanos , Doenças do Íleo/diagnóstico , Doenças do Íleo/embriologia , Recém-Nascido , Atresia Intestinal/diagnóstico , Atresia Intestinal/embriologia , Obstrução Intestinal/etiologia , Intussuscepção/embriologia , Masculino , Gravidez , Ultrassonografia Pré-NatalRESUMO
PURPOSE: The aim of the study is to increase clinical awareness of torsion of wandering spleen (WS) in childhood and the need of a rapid diagnosis. METHODS: Four cases operated for torsion of WS are retrospectively reviewed. Ages at presentation were, respectively, 30 months, 5 years, 4 years, and 3 years, without sex preference. All subjects led a history of abdominal pain and a mass on physical examination. RESULTS: Torsion of WS should be suspected in any child presenting with acute abdomen. Moreover, in case of acute abdomen and intermittent abdominal pain, we suggest studying spleen position with ultrasound. CONCLUSIONS: Ultrasonography with color Doppler is the best choice for diagnosis of torsion of WS. Computed tomography is a good complementary examination, but it needs to submit young patients to a general anesthesia and delays an emergency situation.
Assuntos
Dor Abdominal/diagnóstico , Esplenectomia/métodos , Baço Flutuante/diagnóstico , Dor Abdominal/etiologia , Dor Abdominal/cirurgia , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler em Cores , Baço Flutuante/complicações , Baço Flutuante/cirurgiaRESUMO
In infants with necrotizing enterocolitis (NEC), intestinal gangrene defines advanced disease. Since intestinal ischemia is considered a pathogenetic factor for intestinal gangrene, serum activity of mucosal and seromuscular enzymes may be elevated in these patients. Our aim was to evaluate if serum enzymes activity is increased in infants with NEC associated with intestinal gangrene. We performed a retrospective review of the case notes of infants operated on for NEC between 1998 and 2006. Patients with preoperative determination of serum enzymes were included in the study, and were divided into Group A and Group B based on the presence or absence of intestinal gangrene, respectively. Serum activities of alkaline phosphatase (ALP), glutamic oxaloacetic transaminase (GOT), creatine kinase (CK), and lactate dehydrogenase (LDH) were compared in the two Groups. Values are medians (interquartile range). Thirty-five infants were operated on for NEC in the study period. Eighteen patients fulfilled the inclusion criteria: 12 in Group A and six in Group B. Group A patients had significantly higher LDH activity [1131.0 (1092.0-1300.0) vs. 482.0 (440.0-624.5) IU/L; P < 0.005]. Our findings suggest that LDH activity may be increased in infants with NEC and intestinal gangrene. Its evaluation could be a further tool in the surgical decision making process in infants with NEC.