RESUMO
Symptoms of gastroesophageal reflux disease (GERD) in children with developmental disorders could be often confusing. Especially when considering accidental foreign body ingestion, with no acute signs or symptoms of choking. We hereby present a case of an 11-year-old male with a well-hidden esophageal foreign body who was already treated for GERD and finally diagnosed with a hidden foreign esophageal object, ingested 12 months ago. Ingestion of objects of any kind, especially in certain groups of children, must always raise high suspicion for the clinical pediatric specialties, regardless of the presence or absence of classic symptoms.
Assuntos
Obstrução das Vias Respiratórias , Corpos Estranhos , Refluxo Gastroesofágico , Obstrução das Vias Respiratórias/complicações , Criança , Corpos Estranhos/complicações , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/etiologia , Humanos , MasculinoRESUMO
Scrotal injuries are not very common in children and are mostly due to blunt trauma from direct injury, sports injuries or motor vehicle accidents. Traumatic testicular torsion in children has been also infrequently reported in the literature. To ensure testicular salvage, an urgent and specialised diagnosis and management are necessary. We present a case of a partial epididymal rupture and spermatic cord haematoma with an associated secondary testicular torsion due to blunt scrotal injury, in a 12-year-old boy.
Assuntos
Torção do Cordão Espermático , Cordão Espermático , Ferimentos não Penetrantes , Criança , Hematoma/diagnóstico , Hematoma/diagnóstico por imagem , Humanos , Masculino , Ruptura/complicações , Cordão Espermático/cirurgia , Torção do Cordão Espermático/complicações , Torção do Cordão Espermático/diagnóstico , Ultrassonografia , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/cirurgiaAssuntos
Dor Abdominal/diagnóstico , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Ruptura Aórtica/diagnóstico por imagem , Dor Abdominal/etiologia , Aneurisma da Aorta Abdominal/patologia , Ruptura Aórtica/epidemiologia , Ruptura Aórtica/mortalidade , Serviço Hospitalar de Emergência , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia/métodosRESUMO
Lymphangioma is a rare benign neoplasm affecting mainly children. In this report we present a complicated case of polycystic omental lymphangioma in a 3 year old female presenting with acute abdomen. The patient underwent a laparoscopic-assisted excision of the lesion and had an excellent postoperative course. We discuss the effectiveness and advantages of this laparoscopic surgical approach in children and elaborate on the current literature.
Assuntos
Abdome Agudo/etiologia , Linfangioma Cístico/cirurgia , Omento/cirurgia , Neoplasias Peritoneais/cirurgia , Pré-Escolar , Feminino , Humanos , Laparoscopia , Linfangioma Cístico/diagnóstico , Omento/patologia , Neoplasias Peritoneais/diagnósticoRESUMO
Automatic amputation of the ovary represents a rather uncommon condition. Especially asymptomatic autoamputation is an even more unusual laparoscopic finding. We hereby present a case of a 2-days´-old infant with a prenatal ultrasound (US) diagnosis of a cystic mass, laparoscopically proved as an amputated right adnexa. The female infant was asymptomatic and had normal laboratory exams, including hormone levels, according to her age. The infant was managed surgically, as the size of the cystic lesion, both prenatally and postnatally was indicative of surgical intervention. Careful monitoring is critical for the management of cystic lesions diagnosed prenatally. Although rare, the suspicion of an auto-amputated ovary has to be risen during diagnostic approach of infants with adnexal cysts, especially when these lesions are supposed to "wander" during imaging examinations, and also taking into account the size of the lesion in order for a final approach and management to be established.
Assuntos
Tubas Uterinas/patologia , Cistos Ovarianos/diagnóstico , Anormalidade Torcional/diagnóstico , Doenças dos Anexos/diagnóstico , Doenças dos Anexos/patologia , Tubas Uterinas/cirurgia , Feminino , Humanos , Recém-Nascido , Laparoscopia , Cistos Ovarianos/patologia , Cistos Ovarianos/cirurgia , Gravidez , Anormalidade Torcional/patologia , Anormalidade Torcional/cirurgia , Ultrassonografia Pré-NatalRESUMO
Crush syndrome, also known as traumatic rhabdomyolysis, is the result of the disruption of skeletal muscle fibers with the release of intracellular contents into the bloodstream. Although trauma is the main trigger for rhabdomyolysis in adults, in the pediatric population viral infections and inherited disorders seem to be the most frequent causes. Only a few reports in the literature mention rhabdomyolysis secondary to non-accidental pediatric trauma. We herein report an unusual case of traumatic rhabdomyolysis, following significant physical abuse in an infant. Rhabdomyolysis should be suspected in children presenting with a history of excessive blunt trauma, because a prompt diagnosis and treatment prevent from the potential life-threatening consequences.
Assuntos
Maus-Tratos Infantis/diagnóstico , Síndrome de Esmagamento/diagnóstico , Síndrome de Esmagamento/etiologia , Humanos , Lactente , Masculino , Índices de Gravidade do TraumaRESUMO
Sigmoid volvulus in children is a potentially disastrous situation, still remaining rare in terms of occurrence. We hereby present a case report of a 10-year-old male, having admitted in our department complaining about abdominal pain, who finally proved to suffer from sigmoid volvulus.
RESUMO
An umbilical hernia, although considered a benign condition of childhood, may rarely manifest with serious complications such as incarceration and viscous organ strangulation. One such case is presented in this report in an attempt to enrich the current literature, due to the relative lack of data in regard to complicated umbilical hernias in children and definite guidelines regarding the monitoring and management of uncomplicated cases. In addition, we discuss some of the latest advancements concerning the matter at issue.
RESUMO
Obstructive ureterohydronephrosis in childhood population is a matter of debate between paediatric surgeons and paediatricians, as far as the therapeutic protocol that should be applied. Close observation, chemoprophylaxis, endoscopic and surgical approaches are the universally used techniques that provide quality of life in the paediatric patients. Undoubtedly, "the less is more" even when we have to encounter obstructive ureterohydronephrosis in children. Herein, we present a short case series where the endoscopic management of obstructive uropathies proved to be therapeutic without any need of surgical intervention.
Assuntos
Endoscopia , Hidronefrose/terapia , Obstrução Ureteral/terapia , Feminino , Humanos , Hidronefrose/diagnóstico , Hidronefrose/patologia , Lactente , Masculino , Qualidade de Vida , Resultado do Tratamento , Obstrução Ureteral/diagnóstico , Obstrução Ureteral/patologiaRESUMO
Leydig cell tumor (LCT) is an infrequent stromal neoplasm of the testis with an incidence of less than 3% of all gonadal tumors in the general male population. Only 25% is found in prepubertal children, where Leydig cell tumors are always reported benign. The hospital records of two prepubertal male children, who underwent organ sparing surgery for testicular LCT the last five years, were retrospectively reviewed. In both of them, the lesion was incidentally found during a scrotal ultrasonography for testicular pain. The diagnosis of a benign LCT was based on the pre-operative physical examination and imaging (Ultrasound-US, Magnetic Resonance Imaging-MRI) as well as the negative tumor markers. A testicle-sparing procedure was decided and the pathologic examination of the surgical specimen confirmed the diagnosis. No tumor recurrence was noted on follow-up. Testis-sparing surgery provides the possibility of complete excision of such lesions and should be considered as the treatment of choice.
RESUMO
Traumatic perineal injury in children is a rather underestimated condition, in terms of occurrence. The rapid stretching of the soft perineal environment, combined with the surrounding osseous tissue of the pelvis, can cause severe injuries. The key to successful management of these injuries includes timely resuscitation, thorough physical examination and quick and safe repair of damages.
RESUMO
Abdominal hemangiolymphangioma (HLA) in neonates is a rare condition that demands surgical intervention after a complete preoperative diagnostic approach. The differential diagnosis and the establishment of a therapeutic algorithm is a challenge, both for the neonatologists and the pediatric surgeons, because there is no consensus in the management of HLAs in infancy according to the literature. We report a rare case of abdominal HLA in a female newborn that was admitted to our pediatric surgery department with a prenatal diagnosis of an abdominal cystic tumor. After a thorough preoperative diagnostic approach, the neonate underwent an explorative laparotomy and lesion excision with simultaneous splenectomy due to the operative findings. The neonate had an uncomplicated postoperative period and is free of recurrence a year after. Only the pathology examination can reveal the HLA diagnosis. When a total surgical excision is evitable, a close follow-up follows an uncomplicated postoperative hospitalization.
RESUMO
Gestation is a period of significant physiological changes that can severely affect the function of many systems, including the cardiovascular. The deviation from the standard that occurs during pregnancy may cause the deterioration of pre-existent cardiovascular diseases or the appearance of new ones. In this review we will present the most common congenital and acquired cardiovascular diseases, their clinical expression and therapeutic procedures according to the latest international guidelines.