[Congenital cystic adenomatoid malformation of the lung. A report of 12 cases]. / Malformación adenomatoidea quística pulmonar congénita. Presentación de 12 casos.

The congenital cystic adenomatoid malformation of the lung is uncommon. In the Hospital Infantil de México Federico Gómez, 12 cases have been seen over a period of 31 years, which points out how rare this malformation is. There was a male predominance, and 75% of the patients had symptoms by 8 months of age. The main complaints were progressive respiratory failure in the newborn period and recurrent lung infection in older children. Treatment was surgical in all cases. There was only one fatality due to cardiac failure.

[Diaphragmatic eventration. Our experience with 50 cases]. / Eventración diafragmática. Experiencia de 50 casos.

Diaphragmatic eventration is the abnormal elevation of the diaphragm as a result of paralysis, aplasia or atrophia of the muscular fibers. This is a diagnostic problem specially in the newborn. The objective of this report is present the clinical course and surgical management of 50 cases attended in the Hospital Infantil de México Federico Gómez. Of them, 56% were males; eight were newborns; five with previous surgery. The clinical course was variable; the landmark was the chest X-ray findings. There were operated 36 cases. The right diaphragm was the most frequent affected; the surgical management was with thoracotomy in the great majority of them. In 30 cases had good evolution two years after surgery.

[Congenital lobar emphysema]. / Enfisema lobar congénito.

This article includes the way cases of congenital lobe emphysema were treated at the Hospital Infantil de México "Federico Gómez" during 1971 to 1989. A total of 17 cases were gathered, 13 were males and 4 were females; admittance age varied from 13 days to 3 years. The children's main symptoms were respiratory failure and cyanosis. The diagnosis was enhanced by a chest X-ray where lobe hyperclarity was detected, as well as a deviation of the mediastinum and a collapsed lung. A lobectomy was performed in all cases. The upper left lobe was seen to be the most affected. Two of the children died. It is important to recognize this disease early on and conduct prompt surgical treatment.

[Congenital esophageal diverticulum]. / Divertículo esofágico congénito.

The congenital or acquired variety of esophageal diverticulum is a rare childhood disease. Reported is a case-study which deals with a five year old patient who arrived at our hospital complaining of a constricture at the cricopharyngeal level. A month later he returned to the hospital with dysphasia and regurgitation; the X-rays and endoscopic diagnosis showed stenosis of the esophagus and the presence of an esophageal diverticulum. Esophageal dilatations were carried out until an acceptable esophageal diameter was reached. Later on, the surgical removal of the diverticulum was performed without any complications. The histopathological study showed the congenital nature of the diverticulum. The patient's recovery went well and is currently considered as cured.

[Post traumatic diaphragmatic hernia with situs inversus in a student 11 years old]. / Hernia diafragmática postraumática con situs inversus en un escolar de 11 años de edad.

A case is reported of generalized acute abdominal pain in a school boy 11 years old with history of abdominal trauma produced by the introduction of a steel rod into the right hypochondrium. Laparatomy and prophylactic appendectomy were practiced and the diagnosis of situs inversus was made in his homestead. Six months later, the patient complained of intermittent abdominal pain, vomiting and absence of stools. With this picture, he was reoperated at this hospital where a right perforation of the diaphragm was found, through which the stomach, the epiploon and part of the ascending colon protruded into the chest. Said viscera were returned to the abdominal cavity and the diaphragmatic defect was sutured. The evolution was uneventful and the patient was discharged 10 days after surgery.

[Tumor of the thymus in a five month old infant]. / Tumor del timo en un niño de 5 meses de edad.

A case of respiratory insufficiency in a five-month-old infant is reported. The distress was caused by a tumor of the anterior mediastinum. At the operation, it was found that the tumor originated in the right lobe of the thymus. The mass was totally resected and the pathologic study reported thymic tumorous mass compatible with thyoma. The patient followed an uneventful course.

[Congenital pulmonary cysts]. / Quistes pulmonares congénitos.

The clinical and surgical experience on congenital pulmonary cysts at the Hospital Infantil of México was reviewed. No preponderance in sex or family inheritance was found. The clinical diagnosis was made in over one half of the patients and was confirmed in the 18 patients who were operated. Treatment should be surgical with resection of the affected pulmonary lobe. In some cases it was possible to excise only the pumonary cyst, without total removal of the lobe. Mortality resulted in three of the surgical patients. The most frequent pulmonary cysts in this series were the bronchogenic and patients with parasitic cysts, lobe emphysema and pulmonary sequestrum were excluded.

[Perforation of the esophagus. Diagnosis and treatment. Analysis of 20 cases]. / Perforación de esófago. Diagnóstico y tratamiento. Análisis de 20 casos

The experience on perforation of the esophagus at the Hospital Infantil de México is reviewed. Between 1961 and 1975, 20 cases were attended. The most frequent perforation is the iatrogenic subsequent to dilatations or to esophagoscopy. Esophageal perforation is the most serious of the digestive tube perforations and must be considered as a real medicosurgical emergency. The clinical picture is analyzed and the necessity to take chest x-rays and esophagogram as urgent measures is emphasized at the slightest clinical doubt. The different treatment methods are mentioned and it is stressed that the best results are obtained with an urgent thoracotomy, closure of the perforation, full canalization and antibiotic therapy at high doses. According to the literature referred and to the results obtained from the present study, mortality is higher in cases where treatment is delayed. The clinical and radiological pictures are described together with the therapeutic behavior in spontaneous perforation in the newborn. The theories to explain this etiology are set forth. At present, mortality is still high; therefore, in order to bring down this high percentage, it is concluded that an early diagnosis together with an agressive surgical treatment are necessary.

[Thoracic complications of liver abcess in children]. / Complicaciones torácicas del absceso hepático en el niño

The study included 58 cases of liver abscess draining into the thorax, seen at the Hospital Infantil de Mexico from January, 1963 to December, 1973. These 58 complicated cases represent 16.2% from a total of 358 patients with liver abscess seen through the same period of time. The clinical picture, period of evolution, methods of diagnosis, treatment and results are analyzed finding that out of 50 cases draining into pleura or lungs, 44 were admitted with this complication already present, the same as 5 out of the 8 cases to pericardium. From the 58 cases, 24 died and 34 recovered. An early diagnosis of uncomplicated amebic liver abscess and adequate treatment constitute the basis to prevent the high morbilethality subsequent to complications.