[Ureter triplex with non-functioning upper pole due to ectopic ureterocele and refluxive third ureter bud : case report and review of the literature]. / Ureter triplex mit afunktionellem Oberpol bei ektoper Ureterozele und refluxiver dritter Ureterknospe : Fallbericht und Literaturübersicht.

We present the case of an 8-month-old boy with ureter triplication on the left side with non-functional upper pole due to ectopic ureterocele and a refluxive third ureter bud. We performed an upper pole heminephroureterectomy with resection of the ureterocele and of the refluxive third ureter bud and reimplantation of the lower pole ureter using the psoas hitch technique.

Hydrometrocolpos: the Fjord sign.

We want to stress a diagnostic sign in the diagnosis of pelvic cysts in newborns. In these cases the detection of an attached uterus is proof of a hydrocolpos or in cases with a dilated uterine cavity of a hydrometrocolpos.

Right esophageal lung in a preterm child with VACTERL association and Mayer-Rokitansky-Kuster-Hauser syndrome.

We report on a preterm girl (birth weight 1,200 g) with a right esophageal lung in esophageal atresia type VIag (according to the extended classification of Kluth). Additionally, the child suffered from an atrioseptal defect, a dextrocardia with a left descending aorta, a duodenal atresia, a high type of anal atresia (VACTERL association), agenesis of the left kidney, and agenesis of the vagina, uterus, and ovarian tubes (Mayer-Rokitansky-Kuster-Hauser syndrome or incomplete MURCS association). The child was treated with an emergency gastrostomy because of increasing abdominal dilatation. Thereafter, the parents refused further surgical treatment, and the child was maintained on basic therapy. After an uneventful period of 4 weeks, the child died of an acute massive aspiration. This case shows that sufficient spontaneous ventilation is possible in esophageal lung as long as a gastrostomy is kept on suction to prevent overinflation of the affected lung and the stomach. Ethical aspects have to be considered when treatment is planned in cases of prematurity and associated malformations when a chance of good survival is rather limited. The stepwise approach as proposed in the present case appears to be the only possible therapeutic regimen that can be offered in this complicated condition.

[Diagnosis of elevated intracranial pressure in children with shunt under special consideration of transglobe sonography of the optic nerve]. / Diagnostik eines erhöhten Hirndrucks bei shuntversorgten Kindern unter besonderer Berücksichtigung der transbulbären Sonographie des Nervus opticus.

OBJECTIVE: Transglobe B-mode sonography of the optic nerve and its sheets is evaluated in respect to its value in detecting increased intracranial pressure. METHODS AND PATIENTS: For a standardized procedure we used linear probes (7-13 MHz). We measured the total diameter of the optic nerve and evaluated the optic nerve papilla. 60 controls and 102 patients with internal hydrocephalus were studied; of these 50 had no signs and 52 showed signs of elevated intracranial pressure. RESULTS: The total diameter of the nerve with its sheets in the control group varied between 1.8 and 4.1 mm (mean 3.1mm). In 50 patients without signs of elevated intracranial pressure it measured between 2.6 and 4.1 mm (mean 3.5 mm), and in 52 patients with signs of elevated intracranial pressure between 3.9 and 6.9 mm (mean 5.4 mm). The diameter of the optic nerve in patients with elevated intracranial pressure was significantly wider compared to normal data (Wilcoxon's test p < 0.01). 24 patients with a history of elevated intracranial pressure of more than 48 hours' duration showed a papilloedema as an additional finding. The upper limit of the normal diameter of the optic nerve with its sheets is 4.1 mm. CONCLUSION: A standardized transglobe sonogram of the optic nerve in combination with transcranial and abdominal sonography is a reliable method for the detection of elevated intracranial pressure.

[Intestinal emergencies in newborn infants]. / Intestinale Notfälle bei Neugeborenen.

Imaging plays a major role in most neonatal gastrointestinal emergencies. The role may vary from helping to establish a diagnosis, to the evaluation of associated abnormalities, to surgical planning, or to therapy for some conditions like meconium ileus or meconium plug syndrome. Plain radiographs and ultrasound serve a primary imaging modalities with bowel contrast examinations, CT scan, and MR imaging playing roles in more complex cases.