RESUMEN
The spleen is the organ most frequently affected in abdominal trauma. Conservative treatment of traumatic spleen injuries is already generally accepted, avoiding surgery whenever possible. We present a wide serie (54 cases) of traumatic spleen injuries along a period of ten years (1990-2000) during which 83% of these were solved with conservative therapy we analyse our treatment procedure and post-treatment follow-up of these patients.
Asunto(s)
Traumatismos Abdominales/terapia , Bazo/lesiones , Traumatismos Abdominales/diagnóstico por imagen , Adolescente , Niño , Preescolar , Tratamiento de Urgencia/métodos , Femenino , Humanos , Masculino , Bazo/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Heridas no Penetrantes/diagnóstico por imagen , Heridas no Penetrantes/terapiaRESUMEN
El bazo es el órgano que con más frecuencia se afecta en los traumatismos abdominales. En la edad pediátrica el tratamiento conservador de las lesiones esplénicas traumáticas está ya generalmente aceptado, evitando la cirugía siempre que sea posible. Presentamos una amplia serie (54 casos) de lesiones esplénicas traumáticas, en un período de 10 años (1990-2000), en la que el 83% delas mismas se resolvieron con tratamiento conservador. Analizamos nuestra pauta de tratamiento y seguimiento en estos enfermos (AU)
Asunto(s)
Humanos , Bazo/lesiones , Traumatismos Abdominales/terapia , Accidentes de Tránsito/estadística & datos numéricos , EsplenectomíaRESUMEN
OBJECTIVE: We comment and update the surgical treatment for pulmonary metastases (PM) within a multidisciplinary approach for paediatric cancer. MATERIAL AND METHODS: We analyse patients with PM who have been operated between 1976-1996. Scientific literature published in the last 25 years (Cancerlit and Medline) was reviewed. RESULTS: PM from 13 patients were removed. Seven were males and 6 females with a mean age 5 4/12 years (range: 11 months- 12 3/12 years). Diagnoses were Wilms' tumour (7), osteosarcoma (3), Ewing sarcoma (1), rabdomiosarcoma (1), Yolk sac tumour (1). PM were unilateral in 7 cases and bilateral in six cases. PM appeared synchronically in four patients and metacronically in nine cases (3 of these after chemotherapy). All patients received chemotherapy and four of them local radiotherapy. Surgery consisted on radical segmentectomy and only one patient needed lobectomy due to a local relapse. Nowadays five patients (38%) are in complete remission with a mean follow-up from surgery of 11 11/12 years (range: 6 3/12-20 years). CONCLUSIONS: Metastasectomy is an important surgical technique in global treatment of children with PM and for a selected group of patients it can offer the only opportunity for curation.
Asunto(s)
Neoplasias Óseas/patología , Neoplasias Óseas/cirugía , Neoplasias Pulmonares/secundario , Neoplasias Pulmonares/cirugía , Osteosarcoma/secundario , Sarcoma de Ewing/secundario , Tumor de Wilms/patología , Tumor de Wilms/cirugía , Neoplasias Óseas/radioterapia , Niño , Preescolar , Terapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/radioterapia , Masculino , Estadificación de Neoplasias , Osteosarcoma/radioterapia , Sarcoma de Ewing/radioterapia , Tumor de Wilms/radioterapiaRESUMEN
Pancreatitis in children is uncommon, but can be associated with severe morbidity rates. Eleven patients (14 months to 9.5 years of age) with acute pancreatitis and one patient with chronic idiopathic pancreatitis beginning the second year of life, were treated over a 11-year period. Half of them had history of blunt abdominal trauma. The most frequent clinical presentations included abdominal pain and vomiting. Diagnosis of pancreatic injury was suggested by hypera-amylasemia, being the computerized tomography scan the most useful radiologic investigation. Medical treatment consisted of intravenous fluids, nasogastric suction and total parenteral nutrition. One third of the patients developed pancreatic pseudocysts (4); spontaneous resolution after observation and conservative therapy occurred in two and the others were treated by surgery. Ranson and Imrie scores can help predicting the severity of this disease in children; three of four pancreatic pseudocysts were judged to have severe pancreatitis by this criteria.
Asunto(s)
Seudoquiste Pancreático/diagnóstico por imagen , Pancreatitis/sangre , Pancreatitis/orina , Amilasas/sangre , Amilasas/orina , Niño , Preescolar , Humanos , Lactante , Páncreas/lesiones , Estudios Retrospectivos , UltrasonografíaAsunto(s)
Neoplasias de las Glándulas Suprarrenales/diagnóstico , Feocromocitoma/diagnóstico , Adolescente , Neoplasias de las Glándulas Suprarrenales/cirugía , Glándulas Suprarrenales/diagnóstico por imagen , Adrenalectomía , Niño , Femenino , Humanos , Masculino , Feocromocitoma/cirugía , Radiografía , Cintigrafía , UltrasonografíaAsunto(s)
Coristoma/diagnóstico por imagen , Bazo/diagnóstico por imagen , Niño , Coristoma/cirugía , Femenino , Humanos , Bazo/cirugía , Esplenectomía , UltrasonografíaRESUMEN
In the pediatric surgical Department of the "Le Fe" Hospital, from January 1971 to December 1982 2,350 laparotomies were performed in neonates, infants and children. In 67 patients abdominal surgery was complicated by bowel obstruction for which a second laparotomy had to be performed. In 86.56%, of patients with obstruction (58 cases) this became obvious during the first three months after the previous operation. In 54 out of the 67 patients reviewed (80.59%), adhesions were the cause for obstruction and only twelve was this caused by an abscess.