[Analysis of 34 cases of distal hypospadias treated by modified Koff's technique]. / Análisis de 34 casos de hipospadias distal intervenidos mediante la técnica de Koff modificada.

Koff's procedure in the treatment of distal hypospadias consist in a large mobilization of the distal urethra. The association to a transglandular funelization and minimal urethroplasty is useful for the treatment in the majority of patients with distal hypospadias. In the last two years 34 patients with distal types of hypospadias were operated with a Koff's modified procedure. The technique consists in a urethral advancement without glanduloplasty and distal cutaneous tubulization. The primitive meatal localization was subcoronal (n = 22), glandular (n = 6), and on the distal shaft (n = 6). In 10 cases urethral catheters was not necessary. A patient develops a proximal fistula successfully treated with 14 days catheterization. Cosmetic and functional results were good in all cases. Extensive urethral mobilization can be done in cases of distal hypospadias and is evidence of the preserved vascularity and viability of the mobilized urethra.

[Intrahepatic biloma. Conservative management with external drainage]. / Bilioma intrahepático. Tratamiento conservador mediante drenaje externo.

A seven year old boy, one week after surgical intervention for blunt liver trauma, presents an intrahepatic bilioma. Under ultrasonografic guidance, an external drainage is inserted. Contrast injection shows billiary fistula. Three weeks later, after a new contrast injection, billiary fistula resolution is proved, and dranaige tube is withdrawn. Ultrasonografic and CT Scan studies showed total resolution of intrahepatic collection. Intrahepatic billiary collections are a rare complication of the hepatic traumatism. Conservative management with external drainage, should be keept in mind like a first choice terapeutic option.