[Intestinal obstruction caused by milk curds in newborns]. / Obstrucción intestinal por tapón de leche en neonatos.

Intestinal obstruction due to milk curds syndrome may present with a clinical picture and radiological findings which suggest the correct diagnosis. This type of intestinal obstruction usually affects neonates, previously healthy, with concentrated formula feeding. Surgical treatment may be avoided in some cases by the administration of Gastrografin enemas. Two patients with milk curd obstruction treatment in our Hospital, are presented.

Polyorchidism: an exceptional case of three homolateral testes.

Polyorchidism is an uncommon congenital anomaly defined as the presence of more than two histologically proved testes. The present case of polyorchidism was discovered casually in an 11-year-old boy while performing an orchiopexy. Three testes were found on the left side; we have been unable to find this exceptional anomaly previously published in the medical literature.

[New aspects of gallbladder pathology in children]. / Nuevos aspectos de la patologia de la vesicula biliar en niños.

We have reviewed in a retrospective study 38 children treated in our Hospital, during the last seven years, because of non congenital gall-bladder disease. The diagnosis established were cholelithiasis 58 for 100, hydrops 26 for 100, acalculous cholecystitis 13 for 100 and hemobilia in one child. Cholelithiasis was more frequent in females at a rate of 2/1. Just the opposite incidence was found for acalculous gall-bladder pathology. Mean age at time of first hospitalization was 7.6 years for the cholelithiasis group and 6.6 years for the rest. Symptoms in order of frequency were abdominal pain, vomiting and fever. Abdominal sonography has been basic in establishing to correct diagnosis in practically all cases. Our most interesting finding has been the clinical manifestations of patients with "Hydrops", consisting of abdominal pain which disappears spontaneously after 24 to 48 hours. The diagnosis has been established only after performing abdominal sonographic studies in children with abdominal pain of unclear etiology.

[Pyeloureteral stenosis secondary to Schoenlein-Henoch purpura]. / Estenosis pieloureteral secundaria a púrpura de Schönlein-Henoch.

We present an 8-year-old male suffering from Schönlein-Henoch purpura with multisystemic clinical manifestations, which developed as a complication a pyeloureteral stenosis secondary to vasculitis. He was operated on and a ureteropyeloanastomosis was carried out according to the Anderson-Hynes technique with good results. We discuss the etiology, diagnostic methods and therapeutic possibilities. It is the eighth case in the literature requiring surgical correction as a result of this exceptional complication.

[Tendon and/or nerve lesions of the hand in childhood]. / Lesiones tendinosas y/o nerviosas de la mano en la infancia.

We have reviewed 50 consecutive children treated during the last five years of injuries of nerves and tendons of the hand, wrist and forearm. Seventy six per cent of these injuries affected the hand and/or fingers. The rest were located in the wrist or forearm.

Hepatic artery aneurysm in a child.

The present report refers to a child hospitalized because of nonspecific symptomatology, who was found to have aneurysms of both hepatic arteries. A year after simple proximal ligature of both hepatic arteries, the child remains symptom-free and developing normally. Proximal ligation appears to be a simple and effective technique for treating hepatic artery aneurysm in children in preference to direct approach of the vascular pathology.

Bilateral multifocal Wilms' tumor.

A three-year-old boy who presented with symptoms of peritonitis was found to have four Wilms' tumors affecting both kidneys. Individual enucleation of three tumors in the right kidney plus left lower nephrectomy were performed. Chemotherapy was administered for one year. The diagnosis of Wilms' tumor was confirmed on each specimen by the histologic studies. The child remains asymptomatic and developing normally six years after the initial surgical treatment. Bilateral partial nephrectomies is the most conservative of the surgical treatments available for bilateral Wilms' tumor.

[Complete sternal fissure. Use of autogenic grafts in modified surgery]. / Fissure sternale complète. Utilisation de greffons autogènes en chirurgie différée.

A patient with complete sternal cleft, was referred to us over the neonatal period. For this reason, she was treated with a modified technic consisting of breaching the sternal defect with free rib grafts covered by prosthetic material made of silastic and teflon. Late results were excellent.

[A technic to avoid postoperative intestinal hypodynamia]. / Técnica para evitar la hipodinamia intestinal postoperatoria.

The hypodynamic postoperative ileus in children, has as main cause the circle gastric distension-reflex intestinal ileus, produced by the swallowed air. The gastric emptying system-through a Levin tube from the stomach is not usually sufficient to get off all the swallowed air. Nevertheless, a continuous suction from the lower third of oesophagus, through a double lumen sump tube is twelve times more effective in the getting off de air before it comes into the stomach, without need of a nasogastric tube.

Ureteral triplication and duplicated opposite kidney with refluxing ureterocele.

A case is reported of ureteral triplication with ectopia of two of the ureters and contralateral duplication with a ureterocele. This patient is the youngest that we have found reported with this type of anomaly and the only one presenting with abdominal distention and an intact but refluxing ureterocele.

Experimental antireflux intestinal valve.

A reflux-preventing valve was obtained by invaginating a 3.5 to 4.5 cm segment of small bowel into the distal lumen, after removing the seromuscular layers at both ends of the segment of bowel. Antiperistaltic pressure resistance, measured at regular intervals during 6 months, showed valves with competence equal or superior to the ileocecal valve. The blood supply to the intussuscepted segment must be carefully preserved.

[Regional adenitis following BCG vaccination (author's transl)]. / Adenitis regionales tras vacunación con B.C.G.

During a period of time close to four years, 239 children with regional lymphadenopathy following BCG vaccination have been treated. Early neonatal vaccination, individual sensitivity and possible mistakes in the dose of vaccine administered may all influence the development of pathological regional lymphadenopathy. In advanced cases, surgery is proposed as the most effective treatment for a rapid recovery. No cases of recurrence or fistulization appeared in our series.

Hemithyroid agenesis associated with a cervical thymic cyst.

A case is presented of a 7-yr-old boy with left hemithyroid agenesis associated with cervical thymic cyst. No left parathyroid glands were found. The diagnosis was established after surgical excision and histologic examination. Clinical and embryological implications of this condition are briefly discussed. No similar case has been found in the literature.

[Venous aneurysms of the neck in childhood (author's transl)]. / Aneurismas fusiformes venosos cervicales en la infancia.

Three children with four fusiform venous aneurysms in the neck are described. A correct referral clinical diagnosis had not been established in any of these children. The diagnosis should be made generally on the basis of the physical examination, including the test of the "digital pressure", which is particularly useful to rule out a laringocele. Three of the aneurysms have been treated by surgical removal. Histological examination showed microscopic changes which were related to the time elapsed since the mass was first noticed. Areas of thinning out and sclerosis of the venous wall were evident in one case. The patient with the remaining aneurysm is being followed closely.

A modified method for the repair of esophageal atresia with tracheoesophageal fistula.

Forty patients with esophageal atresia with tracheoesophageal fistula were operated upon during a period of 2 years, 39 of them with the end-to-side anastomosis technique. According to Waterston's classification, the survival rate was 91 percent for Group A (11 patients), 60 percent for Group B (15 patients), and 14 percent for Group C (14 patients). A prospective study carried out with the first 30 patients showed that the partial removal of the mucosa of the lower esophagus, just distal to its junction with the trachea, reduced significantly the incidence of recanalization of the tracheoesophageal fistula.

[Intestinal recirculation in the management of experimental short bowel syndrome (author's transl)]. / Recirculación intestinal como tratamiento del síndrome de intestino corto experimental

A short bowel syndrome was produced in 33 mongrel puppies less than one month of age, by resecting 80% of the small bowel. An end-to-end anastomosis was performed in 14 dogs (Group A). Sixteen dogs were reanastomosed by performing an isoperistaltic circular intestinal loop, modified from Tanner and Mackby (Group B). Three dogs had a circular loop performed using Mackby method, but this technique was abandoned because of intraluminal stasis. Long term survival on 18 dogs was 12,5% for Group A and 57% for Group B. Weight gain on the survivors was over 25% higher in Group B. Intestinal transit time was abnormally short only in Group A. The loop procedure seems worthy of further clinical trial.