Colangiografía oral y la atresia duodenal / Oral cholangiography and duodenal atresia

Se presenta el caso de un recién nacido masculino con síndrome de Down, que presentó al nacimiento vómito biliar y al examen físico ictericia y hepatomegalia leve. Los estudios radiológicos simple de abdomen y la serie gastrointestinal mostraron al duodeno dilatado y cambios inflamatorios de la mucosa. Esta imagen es conocida como la imagen en “doble burbuja” y es común en la obstrucción duodenal congénita. Simultáneamente fueron visualizados la vesícula biliar y el colédoco, siendo este hallazgo poco usual. Se le efectuó corrección del defecto mediante el procedimiento de Kimura.

A newborn male patient with trisomy-21 presented with bilious hemesis. The patient was icteric with slight hepatomegaly. Simple abdominal X-ray and upper gastrointestinal series with barium showed a dilated duodenal loop and inflammatory changes involving the duodenal mucosa. This image known as [quot ]double bubble[quot ] is characteristic of congenital duodenal obstruction. Simultaneously the gallbladder and choledochus were visualized. The former X-ray finding is very unusual. An uneventful Kimura procedure was performed.

[A pancreatobiliary malformation causing spontaneous perforation of the extrahepatic bile duct]. / Malformación del sistema pancreático-biliar como causa de perforación espontánea de la vía biliar extrahepática.

Biliaryascitis usually results from a spontaneous or traumatic perforation of the common bile duct, usually at the junction with the cystic duct. Distal duct obstruction, pancreatic fluid reflux up the common bile duct, congenital weakness or a localized mural malformation of the wall of the common duct have been proposed as possible causes. We present an 11-months-old infant girl who developed a biliary ascitis as a consequence of biliary rupture. Perforation was due to malformation of the pancreatico-biliary junction. An uneventful external derivation by tube was performed.

Malformación del sistema pancreático-biliar como causa de perforación espontánea de la vía biliar extrahepática / A pancreatobiliary malformation causing spontaneous perforation of the extrahepatic bile duct

La ascitis biliar usualmente resulta de la perforación espontánea o traumática del conducto biliar principal, usualmente en la unión con el conducto cístico. La obstrucción ductal distal, el reflujo hacia la vía biliar común, la debilidad o una muy localizada malformación mural de la pared del conducto común han sido propuestas como causas probables. Presentamos el caso de una niña de 11 meses de edad quien sufrió ascitis biliar como consecuencia de la ruptura del colédoco. La perforación probablemente se debió a una malformación de la unión pancreático-biliar. Se le derivó la bilis hacia el exterior mediante una sonda.

Biliaryascitis usually results from a spontaneous or traumatic perforation of the common bile duct, usually at the junction with the cystic duct. Distal duct obstruction, pancreatic fluid reflux up the common bile duct, congenital weakness or a localized mural malformation of the wall of the common duct have been proposed as possible causes. We present an 11-months-old infant girl who developed a biliary ascitis as a consequence of biliary rupture. Perforation was due to malformation of the pancreatico-biliary junction. An uneventful external derivation by tube was performed.

[Pulmonary contusion and hemothorax due to explosion]. / Contusión pulmonar y hemotórax por explosión.

Folklore and "uses and customs" in countries such as Mexico, under certain circumstances, have direct influences on risks for traumatic injuries. Such is the case of gunpowder explosive objects used during celebration holidays. We present a 14-year-old male who suffered a pulmonary contusion as a consequence of an explosion of "huevo de codorniz." A pleurostomy tube was required to resolve symptomatic hemothorax. The patient was discharged 5 days after admission.

[Hirschsprung in children over 6 years of age]. / Hirschsprung en niños mayores de seis años.

INTRODUCTION: Hirschsprung's disease or colonic agangliosis is a rare condition in schoolchildren and adolescents. It is common in infants and chronic constipation is the usual symptom. MATERIALS, METHODS, AND RESULTS: In a period of 5 years, 11-years-old patients were diagnosed and treated for Hirschsprung's disease. We studied six male patients; mean age was 8.6 years. All patients had classic disease and nine, severe chronic constipation, and two were admitted with encopresis. One had 10 kg of feces in 40 cm of colon. Diagnosis was established with barium enema and tissue biopsy. All patients had colostomy. In eight patients, Duhamel procedure was performed with good results. CONCLUSIONS: This disease is a rare condition in older patients and Duhamel procedure is a good surgical option.