RESUMEN
A case of acquired neurogenic megacolon in a child is reported. The condition resulted after a Soave endorectal pull-through procedure for Hirschsprung's disease and was secondary to hypoganglionosis which developed in the pulled-through segment. The clinical, radiological, and pathologic features as well as the successful surgical management of this case are described.
Asunto(s)
Enfermedad de Hirschsprung/cirugía , Complicaciones Posoperatorias/cirugía , Recto/cirugía , Preescolar , Colectomía , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Masculino , RecurrenciaRESUMEN
Over a 10-year-period extending from January 1976 to September 1986, 800 peripheral vascular injuries were surgically treated at the American University of Beirut Medical Centre. Of these, 150 were operated on because of injury to the femoral vessels. Bullets were the commonest wounding agents (60% of cases). Thirty-seven patients had a femoral artery injury, 27 a femoral vein injury and 86 combined femoral artery and vein damage. Twenty-three per cent of the patients had an associated fracture of the femur. Patients with fractures had an 11% amputation rate compared with 1% for those without fractures. Our data reveals the importance of venous reconstruction in the presence of an arterial injury instead of its ligation (P less than 0.05), particularly when there is an associated fracture of the femur. Thirty-seven per cent of patients were in shock on admission (systolic BP 90 mmHg). The amputation rate in these patients was 6.8% in contrast to 1% in the haemodynamically stable group (P less than 0.05). The overall amputation rate was 3.3%. Complications occurred in 36.6% of patients and the mortality was 4.0%.