[Pediatric surgery 2.0]. / Cirugía pediátrica 2.0.

New tools from the web are a complete breakthrough in management of information. The aim of this paper is to present different resources in a friendly way, with apps and examples in the different phases of the knowledge management for the paediatric surgeon: search, filter, reception, classification, sharing, collaborative work and publication. We are assisting to a real revolution on how to manage knowledge and information. The main charateristics are: immediateness, social component, growing interaction, and easiness. Every physician has clinical questions and the Internet gives us more and more resources to make searchs easier. Along with them we need electronic resources to filter information of quality and to make easier transfer of knowledge to clinical practice. Cloud computing is on continuous development and makes possible sharing information with differents users and computers. The main feature of the apps from the Intenet is the social component, that makes possible interaction, sharing and collaborative work.

[Cystic adenomatoid malformation pulmonary: are we able to foresee its evolution?]. / Malformación adenomatoidea quística: somos capaces de prever su evolución?

The congenital pulmonary malformation are a rare entity in pediatric age. Between of them, the cystic adenomatoid malformation (MAQ) is the most ferquent entity, followed by pulmonary sequestration (SP) and the most rare broncogenic cyst. As a consequence of ultrasound and fetal magnetic resonance we are abble to diagnose earlier this patology. To know the clinical findings, the diagnosis, and the evolution, we have done a retrospective study of underwented MAQ at our hospital during the last 17 years, including such with late diagnosis as with prenatal diagnosis, and describing those presenting impredictable evolution or a different difficul diagnosis. We report four MAQ's cases. Three of them, about late diagnose: the first one evolutioned till malignant tumor, the second one with a supplementary lobe and third one with a wrong MAQ diagnose. The fourth one associated MAQ with a SP.

[Retrospective evaluation of carcinoid tumors of the appendix in children]. / Estudio retrospectivo del tumor carcinoide apendicular en niños.

Carcinoids of the appendix are rare in children. Usually diagnosed incidentally on histologic investigation following appendectomy for acute apendicitis. To investigate the significance of the diagnosis of appendiceal carcinoid tumors in children, we conducted a retrospective study in our institution. Between 1990 and 2007 a total of 1158 appendectomy were done. In four patients the diagnosis was appendiceal carcinoid. We studied treatment, follow-up and prognosis of this patients. Indicacion for appendectomy was acute pain in lower right quadrant. The median tumor diameter was lower than 1 cm and the appropriate treatment was appendectomy. The prognosis was excellent in all the patients.

Magnetic resonance imaging of the intrauterine fetal genitourinary tract: normal anatomy and pathology.

Although ultrasonography (US) remains the most widely used diagnostic imaging modality for routine evaluation of the fetus, magnetic resonance (MR) imaging has become an invaluable complement to US in all cases in which additional information is desirable. While the ability of US to detect fetal abnormalities is limited in cases such as maternal obesity, oligohydramnios, and in certain fetal positions, MR using fast and ultrafast pulse sequences enables high-quality fetal images to be acquired regardless of the mother's physical condition or fetal position. Fetal genitourinary disorders are the most common intrauterine abnormalities detected by US, accounting for approximately 30% of all antenatally detected anomalies. Although they usually occur in isolation, these defects can form part of more complex syndromes or chromosomopathies, and MR is indicated to rule out associated abnormalities. In some severe genitourinary disorders, there is a severe deficit of amniotic fluid; these cases are associated with other fetal anomalies such as pulmonary hypoplasia and very poor prognosis. In other cases, the amniotic fluid is not compromised, yet the further detection, localization, and characterization of prenatal disorders will have an impact on postnatal follow-up. This article reviews the role of fetal MR in urogenital tract disorders.

[Conservative surgery of ovarian torsion in pediatrics]. / Cirugía conservadora de la torsión de ovario en pediatría.

The authors describe the case of two girls diagnosed of ovarian torsion secondary to a cyst. They were operated on by conservative ovarian therapy regardless the time of evolution and ovary macroscopical aspect. These 2 patients were 9 and 13 years old, with abdominal colic pain of 48 and 36 hours of evolution. The diagnosis by doppler sonography was ovarian torsion, with a 4 cms cyst in the right ovary in the first case and a 5 cms cyst in the left ovary in the second patient. Both patients were operated on. After untwisting the ovary, we instille warm saline solution to this ovary and, after waiting for 10 minutes, we resect the ovarian cyst and it recuperates partial and heterogeneous its pink colour. We advise to the family about the possibility of surgical reintervention if the ovary is not viable. After 10 and 12 days of surgical intervention, the Doppler sonography has confirmed the existence of ovary flow and the symmetry of affected ovary in comparation to the opposite on. At the present, both patients are asymptomatic, with exhaustive ultrasound controls. Ovarian torsion is the most frequent complication of ovarian tumours of pediatrics (3-16%) and this is a real emergency in gynecology. Traditionally, it has been recommended the exeresis of ovarian torsion. Regardless the blue aspect of isquemic ovary affected by torsion and the time of evolution, in our experience when there is a minimal possibility of ovarian viability, it is possible to follow a conservative therapy because the macroscopical aspect of the ovary is not necessarily related with the following evolution of the case.

[Septic arthritis in children]. / La artritis séptica en el niño.

A review was made of 15 cases of septic arthritis in children. 13 of these cases corresponded to purulent arthritis, one to tuberculous arthritis and one to brucellar arthritis. All of them received diagnostic punction. Five joints received arthrotomy, by a washed-aspiration system. The antibiotic treatment was given approximately during for six weeks. We had two complications, die to a delayed diagnosis: one coxa valga and one capital femoral necrosis. It is important the insist on a early diagnosis and decompressive arthrotomy, specially in those cases in which the hip is the joint affected.

[Rib actynomycosis]. / Actinomicosis costal.

A unusual case of rib actynomycosis, observed several months after surgery for acute appendicitis in a 11 year boy is reported. Surgical excision of the affected segment of rib had to be implemented with lyncomycin in order to obtain the cure. Laboratory data are consistent with the above mentioned diagnosis.