[Uroperitoneum in neonatal foals - a review of the literature]. / Uroperitoneum beim Fohlen ­ eine Literaturübersicht.

Uroperitoneum is a typical disease in newborn foals. An accumulation of urine develops in the abdominal cavity in consequence to a congenital or acquired leakage in the urinary tract. Colts are more frequently affected than fillies. The most common cause of uroperitoneum is a rupture of the dorsal urinary bladder wall. The urinary bladder is affected in 73.1 %, the urachus in 21.6 % and the ureter in 5.2 % of cases. Typical clinical signs occur 2-5 days postpartum, and encompass reduced general condition, abdominal distention, mild colic symptoms and unphysiologic micturition. Ultrasound examination in conjunction with abdominocentesis is considered as the gold standard of diagnostics. Typical laboratory findings are azotemia, metabolic acidosis as well as electrolyte imbalances, particularly hyperkalemia, hyponatriemia and hypochloridemia. Surgical treatment is the only reasonable therapy. Preoperative metabolic disorders and electrolyte abnormalities should be corrected prior to surgery. Especially hyperkalemia leads to a high potential for complications during general anesthesia. Following effective perioperative stabilization, the presence of a defect in the bladder wall or the urachus carries a good prognosis. In total, 63.6 % of the affected foals are healed. Most common complication is a recurrence of uroperitoneum caused by disruption of the suture line or an incomplete closure of the defect.

Peritoneal Encapsulation - A Rare Cause of Small Bowel Obstruction.

Peritoneal encapsulation (PE) is a rare anatomic anomaly which occurs due to an accessory peritoneal sac covering the small bowel which can cause chronic recurrent abdominal pain and even small bowel obstruction, most often in children or patients with no previous surgical history. The diagnosis is usually made during surgery, but recently it has been suggested that mindful examination of the abdominal CT may be helpful in considering PE beforehand. We present the case of a 21-year old patient who was admitted due to intense abdominal pain, asymmetrical abdominal distension, air fluid levels on the abdominal X-ray, but no specific findings on the abdominal CT. He underwent emergency surgery and PE was found and the peritoneal sac was excised. The postoperative course was uneventful. Histopathologic examination of the specimen confirmed the diagnosis. PE is often misdiagnosed as abdominal cocoon or sclerosing encapsulating peritonitis, but it is a pathology with a much lower rate of recurrence and postoperative complications, which can be treated successfully if the surgeon is aware of this pathology when making the differential diagnosis.

Encysted hydrocele of the canal of Nuck in an 11-month-old child with a past history of duodenal atresia and Arnold-Chiari malformation: A case report.

RATIONALE: Hydrocele of the canal of Nuck is a rare developmental disorder and represents of a homolog of hydrocele of spermatic cord in males. Hydrocele of the canal of Nuck is a very rare cause of inguinal swelling in female infants and children. It results from the failure of obliteration of the distal portion of evaginated parietal peritoneum within the inguinal canal, which forms a sac containing fluid. PATIENT CONCERNS: We describe a case of hydrocele of the canal of Nuck in an 11-month-old girl with a past medical history of duodenal atresia and Arnold-Chiari malformation. DIAGNOSIS: Physical examination and ultrasound revealed a soft, cystic, noncompressible, and non-fluctuant labial mass measuring approximately 5 cm. INTERVENTIONS: The patient underwent surgical exploration through a right skin crease incision. The cystic lesion was histologically confirmed to be a non-communicated hydrocele of canal of Nuck. OUTCOMES: The child is doing well at 1-year follow-up with no swelling or recurrence on the operated side. LESSONS: Hydrocele of the canal of Nuck is a rare developmental disorder but should be considered in a differential diagnosis in young girls with an inguino-labial swelling.

Abdominal Pain due to a Wandering Liver.

Wandering liver syndrome is an extremely rare congenital disorder. It is mainly diagnosed within the first years of life. Herein we report the case of a 40-year-old woman with hepatoptosis due to the absence of anatomical peritoneal attachments of the liver. Surgical treatment consisted in inserting the floppy right lobe of the liver in a subphrenic retroperitoneal pouch. This original technique provided excellent postoperative result.

Cas 2015.3. Lactant de 9 mesos amb lesió perianal / No disponible

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Apple peel deformity of the small bowel without atresia in a congenital mesenteric defect.

Congenital mesenteric defects are rare causes of bowel obstruction. Even rarer are mesenteric defects with an apple peel type of deformity, probably described definitively only once previously. We present a case of a 3 year old boy who presented with a septic-like picture of severe metabolic acidosis and lethargy from a bowel obstruction with bowel ischemia. At laparotomy he was found to have bowel infarction due to herniation through a congenital mesenteric defect with an apple peel type of deformity of the bowel without bowel atresia.

Congenital and acquired mesocolic hernias presenting with small bowel obstruction in childhood and adolescence.

OBJECTIVE: The objective was to present a case series of pediatric patients presenting with small bowel obstruction secondary to both congenital and acquired internal mesocolic hernias, and the use of imaging technology in the management of this condition. METHODS: A retrospective review of patients treated at the Yale-New Haven Children's Hospital for small bowel obstruction from 1998 to 2008 (n = 6) who presented with acute small bowel obstruction secondary to internal mesocolic hernias was performed. RESULTS: We present 6 patients with small bowel obstruction caused by congenital (n = 4) and acquired (n = 2) mesocolic hernias after previous surgery. The median age at presentation was 13 years. Small bowel obstruction with a mesocolic hernia was identified by preoperative abdominal computerized tomography in 3 patients (50%) and at operation in the others. The mean length of stay was 6 days, with no recurrent episodes in the follow-up period. CONCLUSION: Small bowel obstruction secondary to mesocolic hernias, although rare, may be considered in the differential diagnosis of patients with history of malrotation or abdominal wall defects owing to their association with congenital mesenteric anomalies. This condition requires special attention from the clinician because of its catastrophic consequences. Imaging studies are an important asset because of the difficulty in making an accurate clinical diagnosis and the rarity of internal hernias.

Positive contrast peritoneography in the diagnosis of a pleuroperitoneal diaphragmatic hernia in a cat.

A young adult entire male domestic shorthair cat was presented with a known history of a road traffic accident. Survey radiographs suggested a congenital diaphragmatic hernia unrelated to the recent trauma. Positive contrast peritoneography was undertaken and findings were consistent with a pleuroperitoneal diaphragmatic hernia (or true hernia). This was repaired surgically and was thought to be an incidental finding. This case report demonstrates the use of positive contrast peritoneography as a simple and effective tool in the diagnosis of pleuroperitoneal diaphragmatic hernias.

Examination of FGFRL1 as a candidate gene for diaphragmatic defects at chromosome 4p16.3 shows that Fgfrl1 null mice have reduced expression of Tpm3, sarcomere genes and Lrtm1 in the diaphragm.

Fgfrl1 (also known as Fgfr5; OMIM 605830) homozygous null mice have thin, amuscular diaphragms and die at birth because of diaphragm hypoplasia. FGFRL1 is located at 4p16.3, and this chromosome region can be deleted in patients with congenital diaphragmatic hernia (CDH). We examined FGFRL1 as a candidate gene for the diaphragmatic defects associated with 4p16.3 deletions and re-sequenced this gene in 54 patients with CDH. We confirmed six known coding single nucleotide polymorphisms (SNPs): c.209G > A (p.Pro20Pro), c.977G > A (p.Pro276Pro), c.1040T > C (p.Asp297Asp), c.1234C > A (p.Pro362Gln), c.1420G > T (p.Arg424Leu), and c.1540C > T (p.Pro464Leu), but we did not identify any gene mutations. We genotyped additional CDH patients for four of these six SNPs, including the three non-synonymous SNPs, to make a total of 200 chromosomes, and found that the allele frequency for the four SNPs, did not differ significantly between patients and normal controls (p > or = 0.05). We then used Affymetrix Genechip Mouse Gene 1.0 ST arrays and found eight genes with significantly reduced expression levels in the diaphragms of Fgfrl1 homozygous null mice when compared with wildtype mice-Tpm3, Fgfrl1 (p = 0.004), Myl2, Lrtm1, Myh4, Myl3, Myh7 and Hephl1. Lrtm1 is closely related to Slit3, a protein associated with herniation of the central tendon of the diaphragm in mice. The Slit proteins are known to regulate axon branching and cell migration, and inhibition of Slit3 reduces cell motility and decreases the expression of Rac and Cdc42, two genes that are essential for myoblast fusion. Further studies to determine if Lrtm1 has a similar function to Slit3 and if reduced Fgfrl1 expression can cause diaphragm hypoplasia through a mechanism involving decreased myoblast motility and/or myoblast fusion, seem indicated.

Giant congenital mesenteric hernia in the adult.

INTRODUCTION: Internal hernia is a visceral protrusion through a defect or aperture, either mesenteric or peritoneal and is an uncommon cause of intestinal obstruction. Within this group, the congenital mesenteric (transmesenteric) hernia is extremely rare, being more common in the pediatric population. OBJECTIVE: To present the case of a 38-year-old woman with intestinal obstruction and acute abdomen who underwent surgery. A giant mesenteric (transmesenteric) hernia was found. The hernia was reduced and the defect closed. Discharge was made without complications. CONCLUSIONS: Congenital mesenteric hernias are an infrequent pathology that may cause intestinal obstruction, predominantly in the pediatric population. Occurrence in adults is extremely rare.

Treves' field pouch hernia: our experience and literature review.

Treves' field pouch hernia (TFPH) is an unusual type of congenital internal hernia. Although eight cases of TFPH have been reported in the English literature, they were seldom diagnosed preoperatively with high mortality rates. We describe a 12-year-old girl with TFPH diagnosed as an internal hernia on computed tomography and confirmed laparoscopically, and review the literature.

Imaging diagnosis--positive contrast peritoneographic features of true diaphragmatic hernia.

A true diaphragmatic hernia is a congenital diaphragmatic malformation that can appear identical to a peritoneopericardial diaphragmatic hernia (PPDH). True diaphragmatic hernias are rare in dogs. Herein we describe the use of positive contrast peritoneography for diagnosis of a true diaphragmatic hernia in two dogs.

[Congenital transmesenteric hernia]. / Hernia transmesentérica congénita.

INTRODUCTION: Acute intestinal obstruction due to congenital defects in the mesentery of the small bowel are quite uncommon. The most frequent location of the defect is the mesentery of the terminal ileum. MATERIAL AND METHODS: Five cases of small bowel obstruction caused by congenital transmesenteric hernia was reviewed. RESULTS: Four were male and all patients had an intestinal obstructive disease, small bowel gangrene and peritonitis. Two patients died. DISCUSSION AND CONCLUSIONS: Diagnosis is difficult and most cases recorded until today are incidental findings on laparotomy and surgical treatment is mandatory.

Small bowel obstruction caused by congenital mesocolic hernia: case report.

Transmesocolic hernias are extremely rare. Their exact incidence is still unknown. A strangulated hernia through a mesocolic opening is a rare operative finding. Preoperative diagnosis still is difficult in spite of imaging techniques currently available. This is the case of a 4-month-old boy with transmesocolic internal hernia and coincident intestinal malrotation and volvulus of small bowel.

Laparoscopic surgery in infants with intra-abdominal cysts: two case reports.

OBJECTIVES: We report two cases of infants found to have congenital omental cystic lesion with torsion and ovarian cyst treated by laparoscopy-assisted surgery (LAS). METHODS: A laparoscope was inserted by an open method. The intra-abdominal pressure was maintained at 8 mm Hg. We diagnosed the cystic lesions with torsion. At aspirator was used to aspirate the cystic content and remove the cyst. RESULTS: No intra- or postoperative complications were encountered. Oral intake was commenced on postoperative day 2 in both patients. The cosmetic results following LAS were excellent. CONCLUSIONS: We conclude that LAS is suitable for the management of omental cystic lesions with torsion and ovarian cyst in nursing infants. An aspirator is useful in preventing spillage of cystic contents in patients with intra-abdominal cystic lesion.