Continence in patients who undergo posterior rectal flap anorectoplasty.

PURPOSE: The authors report the postoperative follow-up results of patients who underwent posterior rectal flap anorectoplasty (PRFA), with emphasis in fecal continence. Variables considered on each patient were sex, presence of fistula, location of the fistula, severity of the defect during the correction, sacral condition, dysraphism, and age at surgery. METHODS: Continence was rated using the Peña method and defecogram. The authors studied 20 patients (17 boys and three girls). RESULTS: Postoperatively, normal continence was found in 18 patients. Of the two remaining (boys), one had grade II spotting (sacrum agenesia and uretrobulbar fistula) and the other had grade II staining; this patient had the most severe malformation requiring an abdominoperineal approach. All of the defecograms showed complete emptying of the rectum. No recurrent fistulas occurred. CONCLUSIONS: The posterior rectal flap anorectoplasty is a new technique that takes into consideration all known factors that contribute to continence. This initial report confirms that this technique results in excellent continence for patients with imperforate anus.

[Anorectoplasty with a distal tubular flap via a posterior sagittal approach]. / Anorrectoplastía con colgajo tubular distal por abordaje sagital posterior.

Were combined posterior sagittal approach and a posterior flap of the rectal wall. This allowed to perform the pull through operation in two patients with anorectal malformation who had a prior colostomy which just one intervention. With this combination we spare surgical procedures.

[Pancreatic pseudocyst. Description of a case in an infant]. / Pseudoquiste pancreático. Descripción de un caso en un lactante.

A case of pancreatic pseudocyst (PP) in a 22 month old girl is described. The lesion was huge and posed diagnostic difficulties which led to an inadequate procedure. The anatomic lesion consisted of a lymphocytic pancreatitis associated with two previous episodes of "erratic migration" of Ascaris lumbricoides. Physiopathology and clinical picture is discussed and emphasis is made on the need of suspicion of pancreas as the site of origin of disease in spite of short age.