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1.
BMJ Case Rep ; 12(3)2019 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-30852494

RESUMO

Anterior rectal duplication cyst is rare entity with <50 reported cases to date. It has myriad presentations like bleeding per rectum, constipation, rectal prolapsed and intestinal obstruction due to extrinsic compression of rectum. However, the association of enlarged duplication cyst compressing the bladder neck or ureter, and leading to bladder outlet obstruction or hydroureteronephrosis is extremely rare with only a handful of reported cases. We report a rare case of large anterior rectal duplication cyst in a young girl leading to acute urinary retention with bladder outlet obstruction which was eventually managed by laparoscopic-assisted transabdominal surgical excision of the cyst. The authors believe that such an association has not been previously reported in this age group.


Assuntos
Malformações Anorretais/complicações , Cistos/patologia , Doenças Retais/patologia , Reto/anormalidades , Obstrução do Colo da Bexiga Urinária/patologia , Retenção Urinária/patologia , Criança , Cistos/congênito , Feminino , Humanos , Doenças Retais/congênito , Reto/patologia , Obstrução do Colo da Bexiga Urinária/congênito , Retenção Urinária/congênito
3.
BJU Int ; 94(1): 143-6, 2004 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15217450

RESUMO

OBJECTIVE: To investigate the distribution of c-kit-positive interstitial cells of Cajal (ICCs) in normal bladder and bladders from patients with megacystis-microcolon-intestinal peristalsis syndrome (MMIHS, a rare congenital and generally fatal cause of functional intestinal obstruction in the newborn), the most characteristic feature of which is abdominal distension caused by a distended unobstructed urinary bladder. PATIENTS AND METHODS: Full-thickness bladder specimens were obtained from four infants with MMIHS and four controls, and processed as paraffin-wax and frozen sections. Sections were assessed using single immunohistochemistry with monoclonal and polyclonal anti-c-kit antibodies. Anti-alpha-smooth muscle actin (SMA) antibody was used to investigate the contractile apparatus in smooth muscle cells of the urinary bladder. Specimens were examined using light and confocal scanning microscopy. RESULTS: There were many c-kit positive ICCs in the normal urinary bladder, appearing as small, long, bipolar cells with only two long and several short processes. In contrast, ICCs were absent in the MMIHS bladder. alpha-SMA immunoreactivity was lower in MMIHS urinary bladder than in control sections. CONCLUSION: This study shows for the first time the presence of c-kit-positive ICCs in the normal human urinary bladder. The lack of ICCs in the MMIHS bladder may contribute to the voiding dysfunction in this disease.


Assuntos
Colo/anormalidades , Doenças do Colo/patologia , Obstrução Intestinal/patologia , Peristaltismo , Proteínas Proto-Oncogênicas c-kit/metabolismo , Bexiga Urinária/anormalidades , Colo/metabolismo , Doenças do Colo/congênito , Células do Tecido Conjuntivo/metabolismo , Dilatação Patológica/congênito , Dilatação Patológica/metabolismo , Humanos , Imuno-Histoquímica , Lactente , Obstrução Intestinal/congênito , Mastócitos/metabolismo , Músculo Liso/metabolismo , Síndrome , Bexiga Urinária/metabolismo , Retenção Urinária/congênito , Retenção Urinária/patologia
4.
J Urol ; 170(4 Pt 2): 1514-5; discussion 1516-7, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14501648

RESUMO

PURPOSE: Alpha blocker therapy has been successfully used to decrease residual urine in children with complex neuropathic and nonneuropathic voiding dysfunction. We evaluated the safety and efficacy of using selective alpha blocker therapy for children with uncomplicated voiding dysfunction and underlying poor bladder emptying. MATERIALS AND METHODS: A total of 55 patients with a mean age of 7.9 years presented with symptoms of urinary incontinence, urgency and urinary tract infection. All patients had increased post-void residual (PVR) on bladder ultrasound, with a mean residual volume of 65 ml (22% of age expected capacity). All patients were treated with doxazosin, a selective alpha-1 adrenergic antagonist, at dosages of 0.5 mg to 2.0 mg daily. Of the patients 38 were treated at presentation with a regimen of anticholinergics, timed voiding and antibiotic prophylaxis before initiating alpha blocker therapy. Patients were reevaluated with post-void ultrasound of the bladder 6 weeks after initiating alpha blocker therapy. RESULTS: After starting doxazosin average PVR decreased to 8 ml (p <0.0001), representing an 88% reduction in residual urine (or reduction to only 2.7% of age expected bladder capacity). Medication was discontinued in 2 patients due to minor side effects. CONCLUSIONS: Selective alpha blocker therapy appears to be effective for improving bladder emptying in children with an overactive bladder, wetting, recurrent infection and increased PVR urine. This therapy may be used as either a replacement or in addition to biofeedback in patients with urinary retention. Further investigation, including a prospective randomized trial of alpha blocker therapy in children with urinary tract dysfunction, is warranted based on the findings of our study.


Assuntos
Antagonistas Adrenérgicos alfa/uso terapêutico , Doxazossina/uso terapêutico , Bexiga Urinaria Neurogênica/tratamento farmacológico , Incontinência Urinária/tratamento farmacológico , Retenção Urinária/tratamento farmacológico , Urodinâmica/efeitos dos fármacos , Adolescente , Antagonistas Adrenérgicos alfa/efeitos adversos , Antibioticoprofilaxia , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Doxazossina/efeitos adversos , Esquema de Medicação , Quimioterapia Combinada , Feminino , Humanos , Masculino , Resultado do Tratamento , Bexiga Urinaria Neurogênica/congênito , Incontinência Urinária/congênito , Retenção Urinária/congênito
5.
Pediatr Surg Int ; 17(2-3): 221-3, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11315295

RESUMO

A case of cystic rectal duplication (RD) is presented. A 7-day-old female was admitted with acute urinary retention, voiding difficulty, and abdominal distention since she was 4 days of age. Ultrasound and abdominal computed tomography (CT) demonstrated a huge, cystic mass in the pelvis and abdomen that resulted in acute urinary retention and bilateral hydronephrosis. CT-guided drainage of the lesion followed by transabdominal surgical excision resulted in a cure. Pathologic examination demonstrated a RD lined by respiratory epithelium.


Assuntos
Cistos/congênito , Hidronefrose/congênito , Reto/anormalidades , Obstrução do Colo da Bexiga Urinária/congênito , Cistos/patologia , Cistos/cirurgia , Feminino , Humanos , Hidronefrose/patologia , Hidronefrose/cirurgia , Recém-Nascido , Reto/patologia , Reto/cirurgia , Tomografia Computadorizada por Raios X , Ultrassonografia , Obstrução do Colo da Bexiga Urinária/patologia , Obstrução do Colo da Bexiga Urinária/cirurgia , Retenção Urinária/congênito , Retenção Urinária/patologia , Retenção Urinária/cirurgia
6.
Clin Pediatr (Phila) ; 34(5): 241-7, 1995 May.
Artigo em Inglês | MEDLINE | ID: mdl-7628166

RESUMO

Between January 1985 and January 1990, six cases of neonatal-onset chronic intestinal pseudo-obstruction syndrome (CIPS) were identified. Failure to gain weight in six cases, abdominal distention in five, and vomiting in five were the most common presenting symptoms. The contrast studies of the gastrointestinal tract demonstrated delayed transit time in 6/6, jejunal or ileal dilatation in 1/6, megaduodenum in 1/6, dilatation of the colon with barium retention in 4/6, and microcolon in 1/6. Urinary tract involvement was noted in three patients. Laparotomy, performed in three patients, revealed no mechanical obstruction. Except for hypoganglionosis in Patient 4, no recognizable neuropathy or myopathy was noted histopathologically. Four patients expired within 2 months after discharge. We conclude that CIPS with neonatal onset should be suspected when infants have urinary retention and abdominal distention or constipation beginning at birth or soon after. The prognosis of CIPS presenting in the newborn period appears worse than that presenting in childhood or adulthood.


Assuntos
Pseudo-Obstrução Intestinal/diagnóstico , Abdome , Doença Crônica , Doenças do Colo/congênito , Doenças do Colo/diagnóstico , Constipação Intestinal/congênito , Constipação Intestinal/diagnóstico , Dilatação Patológica/congênito , Dilatação Patológica/diagnóstico , Duodenopatias/congênito , Duodenopatias/diagnóstico , Insuficiência de Crescimento , Feminino , Trânsito Gastrointestinal , Humanos , Doenças do Íleo/congênito , Doenças do Íleo/diagnóstico , Lactente , Recém-Nascido , Pseudo-Obstrução Intestinal/congênito , Pseudo-Obstrução Intestinal/patologia , Doenças do Jejuno/congênito , Doenças do Jejuno/diagnóstico , Masculino , Estudos Retrospectivos , Síndrome , Retenção Urinária/congênito , Retenção Urinária/diagnóstico , Vômito/diagnóstico
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