RESUMEN
INTRODUCCIÓN: El piometra es una afección infrecuente, pero grave, que en general se diagnostica en mujeres posmenopáusicas. En adolescentes es sumamente raro, y si se acompaña de amenorrea primaria hay que tener en mente las anomalías congénitas. CASO CLÍNICO: Adolescente de 13 años, sin antecedentes personales de interés salvo amenorrea primaria, que acude con abdomen agudo y es intervenida por una peritonitis difusa causada por un piometra secundario a disgenesia (estenosis) cervical congénita. Se realizó dilatación cervical y se dejó una sonda vesical intrauterina para prevenir la reestenosis. CONCLUSIONES: Un diagnóstico precoz y un tratamiento conservador con dilatación cervical y colocación temporal de un catéter urinario son esenciales para un manejo seguro y efectivo de la estenosis cervical en adolescentes.
INTRODUCTION: Pyometra is an uncommon but serious condition that is generally diagnosed in postmenopausal women. In adolescents it is extremely rare; if accompanied by primary amenorrhea, consider congenital abnormalities. CASE REPORT: A 13-year-old adolescent, with no relevant personal history except primary amenorrhea, who presented with an acute abdomen and was operated on for diffuse peritonitis caused by pyometra secondary to congenital cervical dysgenesis (stenosis). Cervical dilation was performed and a urinary catheter was temporarily placed inside the uterus to prevent restenosis. CONLUSIONS: An early diagnosis and conservative treatment with cervical dilation and temporary placement of a urinary catheter are essential for the safe and effective management of cervical stenosis in adolescents.
Asunto(s)
Humanos , Femenino , Adolescente , Enfermedades del Cuello del Útero/etiología , Constricción Patológica/etiología , Piómetra/complicaciones , Cateterismo Urinario , Stents , Enfermedades del Cuello del Útero/congénito , Enfermedades del Cuello del Útero/terapia , Constricción Patológica/congénito , Constricción Patológica/terapia , DilataciónRESUMEN
Posterior urethral valve pathologies are the most frequent childhood obstructive uropathy reported, and we infer their presence on diagnosing foetal ascites and oligohydramnios. Early action is vital to determine the long-term development and the degree of impairment of renal function. We report a newborn male 34 weeks of gestation with a prenatal diagnosis of foetal ascites, fluid on the loose in renal fossa and oligohydramnios. Subsequent studies have shown the presence of posterior urethral valves with associated significant vesicoureteral reflux. There was no secondary renal damage. Intrauterine decompression of the urinary tract seems to have exerted a protective role against kidney damage. This finding supports the role of foetal decompression surgery in early and severely obstructive forms to improve the prognosis of renal function in the long term.
Asunto(s)
Ascitis/congénito , Ascitis/diagnóstico , Riñón/fisiología , Oligohidramnios/diagnóstico , Oligohidramnios/etiología , Adulto , Ascitis/complicaciones , Ascitis/terapia , Femenino , Humanos , Recién Nacido , Enfermedades del Prematuro/diagnóstico , Enfermedades del Prematuro/etiología , Enfermedades del Prematuro/terapia , Masculino , Oligohidramnios/patología , Oligohidramnios/terapia , Embarazo , ResucitaciónRESUMEN
Most of inguinal masses in children correspond to inguinal indirect hernias, but other pathologic entities may be found. Dermoid cysts of the spermatic cord are very rare, with only 9 clear cases reported in the literature to date, all of them in adults. We present a case of dermoid cyst of the spermatic cord in a 2-year-old boy, the youngest patient reported so far. Dermoid cysts of the spermatic cord should be considered as part of the differential diagnosis of inguinal masses in children, especially in cases of long-standing, nontender, and irreducible inguinal mass.