RESUMO
BACKGROUND AND OBJECTIVES: Hypertrophic pyloric stenosis (HPS) is a common cause of gastric outlet obstruction (GOO) in infants. Prolonged GOO is believed to result in acid and electrolyte disturbances, gastric atony, and delayed postoperative recovery. We studied the impact of prolonged vomiting as an indicator of GOO symptoms on the post-operative outcomes in HPS. DESIGN AND SETTING: A retrospective chart review of all patients who underwent pyloromyotomy at a tertiary care center between February 1997 and February 2009. PATIENTS AND METHODS: The duration of pre-operative vomiting was correlated with presenting electrolytes and acid-base balances, postoperative time to full feed, postoperative morbidity and duration of hospitalization. RESULTS: Forty-seven patients were identified. At presentation, the median (range) for duration of symptoms was 14 (3-60) days, and surgeries were performed at 2 (0-6) days after admission. Apart from one case of postoperative wound infection, all patients had an unremarkable recovery. The unusually prolonged duration of vomiting in our cohort did not correlate with the mean (SD) preoperative chloride level of 93.9 (8.8) mEq/L, mean (SD) pH level of 7.5 (0.9), mean postoperative time to full feeding of 31 (15.1) hours, or mean duration of hospitalization of 5.1 (2.2) days. CONCLUSION: Duration of vomiting in HPS at presentation does not seem to have a significant impact on the postoperative outcomes.
Assuntos
Desequilíbrio Ácido-Base , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Obstrução da Saída Gástrica , Complicações Pós-Operatórias/sangue , Estenose Pilórica Hipertrófica , Vômito , Desequilíbrio Ácido-Base/sangue , Desequilíbrio Ácido-Base/etiologia , Cloretos/sangue , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Feminino , Obstrução da Saída Gástrica/etiologia , Obstrução da Saída Gástrica/fisiopatologia , Obstrução da Saída Gástrica/cirurgia , Humanos , Lactente , Tempo de Internação , Masculino , Prognóstico , Estenose Pilórica Hipertrófica/complicações , Estenose Pilórica Hipertrófica/fisiopatologia , Estenose Pilórica Hipertrófica/cirurgia , Recuperação de Função Fisiológica , Estatística como Assunto , Fatores de Tempo , Resultado do Tratamento , Vômito/sangue , Vômito/etiologia , Vômito/fisiopatologiaRESUMO
Breast tumors are very rare in infants. We describe a 4-month-old female infant who presented with a firm and painless right breast mass. It was first noticed at the age of 1 month and then gradually increased in size. Further physical examination and imaging studies revealed other subcutaneous masses and lytic bone lesions. True-cut biopsy from the breast lesion was consistent with infantile myofibromatosis. Infantile myofibromatosis is a group of uncommon mesenchymal tumors that tend to occur in infancy and regress spontaneously, as demonstrated in our case. Surgical excision of such lesion might have led to permanent loss of breast tissue. The report discusses the clinical, radiological, and pathologic features, in addition to the previously described treatment options for this condition.