RESUMO
INTRODUCTION: Umbilical reconstruction in pediatric patients who have developed a large proboscoid redundancy can be challenging after standard umbilical repair. We present a simple and unique surgical technique that results in a cosmetically appealing reconstruction. OPERATIVE TECHNIQUE: The operation is initiated with circumferential redundant skin excision and isolation of the hernia sac. Primary fascial repair is performed. Reconstruction utilizes the cut dermal/epidermal edge by approximating it to the exposed fascia just below the skin edge outside of the fascial repair in a purse string fashion for the creation of a neoumbilicus. CONCLUSION: This simple technique is unique from any currently published methods and results in a cosmetically pleasing reconstruction without evidence of any incision. LEVEL OF EVIDENCE: Level V: Expert Opinion.
Assuntos
Hérnia Umbilical/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Umbigo/cirurgia , Fáscia , Humanos , Ferida Cirúrgica , Umbigo/anormalidadesRESUMO
Congenital esophageal stenosis (CES) is associated with oesophageal atresia and tracheoesophageal fistula (EA-TEF). Tracheobronchial (cartilaginous) rests are typically found within the area of stenosis. The authors present a case report of EA-TEF associated with CES and present a modification of a novel technique to facilitate the management of CES. The impact of gastro-oesophageal reflux disease is discussed in this unique entity. Finally, the literature is reviewed for this unique entity.
Assuntos
Estenose Esofágica/congênito , Fístula Traqueoesofágica/complicações , Atresia Esofágica , Estenose Esofágica/complicações , Estenose Esofágica/cirurgia , Humanos , Recém-Nascido , Fístula Traqueoesofágica/cirurgiaRESUMO
Esophageal atresia with tracheoesophageal fistula (EA-TEF) associated with a right aortic arch poses a dilemma to the pediatric surgeon, often necessitating an operative approach via a left thoracotomy. A right aortic arch may be associated with a vascular ring, and EA-TEF, too, has been reported in association with a vascular ring. Rarely, esophageal atresia is associated with a second esophageal anomaly, such as a so-called "esophageal lung." To our knowledge, there is no report of all three in one patient. We report the first case of a patient with associated EA-TEF, vascular ring (diverticulum of Kommerell), and esophageal lung. The literature is reviewed for these rare entities.