Segmental absence of intestinal musculature in newborn: Case report.

INTRODUCTION AND IMPORTANCE: Segmental absence of the muscularis propria intestinalis (SAIM) is a rare pathology characterized by a partial or complete absence of the intestinal musculature. Diagnosis requires histological confirmation, and treatment includes urgent laparotomy, resection of affected areas, and end-to-end anastomosis or creation of stomas. The work has been reported in line with the SCARE guideline criteria. CASE REPORT: We present the case of a 31-week preterm newborn with prenatal diagnosis of polyhydramnios and non-immune fetal ascites. Radiological tests confirmed meconium peritonitis, and laparotomy was indicated. The patient had a torpid postoperative course requiring multiple surgeries due to intestinal occlusion and leakage of the anastomosis. Finally, he was discharged with good oral tolerance and bowel function. The anatomopathological examination reported the congenital absence of intestinal muscle with segmental and multifocal distribution. CLINICAL DISCUSSION: Most neonatal cases share similar clinical features, and if SAIM is suspected during surgery, the suspicious areas should be resected to prevent future complications. The prognosis depends on the extent of the lesion, possibility of resecting affected segments, and concomitant pathologies. CONCLUSION: In conclusion, this study aims to describe SAIM based on a clinical case and review of the literature. SAIM is a rare pathology that requires prompt diagnosis and treatment to prevent complications. Surgeons should consider resecting suspicious areas during surgery to prevent future complications.

Lead ingestion, medical emergency and action plan.

Ingestion of lead material represents a therapeutic challenge involving high toxicity, significant clinical impact, and controversy regarding management. We report the case of a 2-year-old girl, who accidentally ingested a fishing sinker. She remained asymptomatic and first level tests were performed (blood lead levels and x-ray to locate object). Because of sinker location in the jejunum, two rectal enemas and polyethylene glycol (PEG) were administered, serial blood lead level measurements were performed. Because of sinker persistence, a colonoscopy was undertaken. She did not require chelation treatment. However, she required follow-up to monitor long-term toxicity and sequels.

The effects of tobacco consumption on paternity rates of adults with a history of cryptorchidism.

OBJECTIVE: To determine the effect of tobacco consumption on paternity rates in men with a history of cryptorchidism. To compare the paternity rates between formerly unilateral, bilateral cryptorchid smokers, and nonsmokers. METHODS: A retrospective cohort study of 153 men who had undergone orchiopexy between 1961 and 1985 at the Miguel Servet University Hospital (116 unilateral and 37 bilateral) and a control group of 100 men were evaluated by review of medical records and a questionnaire. RESULTS: A total of 197 men filled the questionnaire (76.7%). There was no difference in paternity rates between smokers compared to nonsmokers (P = 0.21). In the unilateral cryptorchid men (ULC) group, there is no difference in paternity rates when compared with the controls (P = 0.079) or when comparing ULC smokers to ULC nonsmokers (P = 0.35). In the bilateral cryptorchid men (BLC) group, there is no difference in paternity rates when compared to controls (P = 0.075) or when comparing BLC smokers to BLC nonsmokers (P = 0.36). When comparing according to consumption, there is no difference between mild, moderate or heavy smoker cases and controls. CONCLUSION: There is no difference in paternity rates between men with a history of cryptorchidism that consume tobacco compared to nonsmokers or controls. More studies are needed to determine the impact of tobacco consumption in formerly cryptorchid men.