Ano-rectal malformation and recurring orchioepididymitis in infants.

The case of a newborn boy is reported, incorrectly diagnosed as anal agenesis without urethrae fistula and treated by anoplasty. The patient later suffered several episodes of urinary infection and left epididymo-orchitis-orchioepididymitis, reflux of contrast being shown at micturating cystourethrography into the right vas deferens, the seminal vesicle, epididymis and left testicle. Rectal endoscopy revealed a rectourethral fistula, confirmed by fistulography. The patient improved after surgical removal of the fistula.

[Urinary de-diversion after diversion with chronic bladder contamination. An experimental study in male rats]. / Desderivación urinaria tras derivación con contaminación crónica vesical. Estudio experimental en ratas macho.

We have carried out an experimental model of urinary diversion and dis-diversion on male Wistar rats in order to study the complications that are produced after diversion, as well as to see whether the alterations continue unchanged, or increase, or diminish after dis-diversion. The following experimental design was used: a control group made up of 48 animals an a problem group of 200 animals all submitted to vesicosigmoidostomy of which 100 were designed to be subsequently dis-diverted. The sacrificed animals (n = 112) were studied for somatic, biochemical and histological parameters. Statistical comparison of the problem group with the controls showed significant differences for the somatic and biochemical parameters, especially in the form of weight-size retardation, increase of urea, creatinine, calcium, phosphorus, uric acid, cholesterol, transaminase, alkaline phosphatase, sodium and chlorine and decrease in albumin and total proteins. After dis-diversion there is an improvement of some of these parameters without reaching total normalization. This leads us to think that either the lesions are irreversible, or more time after dis-diversion is needed for there to be reversibility. We also describe the histological lesions found at the level of the vesicointestinal anastomosis, and the mortality of our series which is higher than that presented by females, a fact inducing us to think that factors exist in the male which increase the mortality.

[Consequences of the communication between lower urodigestive organs on gonads and gonad ducts]. / Consecuencias de la comunicación urodigestiva baja sobre gónadas y gonaductos.

Though there are not many cases described in the literature and very few for children, the existence of lower urodigestive communications may give rise to inflammatory processes in gonads and gonaducts in the male. We have carried out an experimental study of this aspect on 248 male Wistar rats according to the following design: A 48 animal control group (C) is divided into four equal subgroups sacrificed at the ages of one, two, three and four months. The problem group (P) of 200 animals are all submitted to vesicosigmoidostomy and then 100 are sacrificed after one and two months, and the other 100 are dis-diverted one and two months after the original diversion and sacrificed one month later. No histological alterations were observed in gonads and gonaducts for the sacrificed control animals (n = 48). The animals sacrificed after diversion (44 per 100) showed the following histological alterations: five cases of testicular tube necrosis, two cases of deferent conduit inflammation, one case of deferent conduit necrosis, 12 cases of epididymis inflammation and 13 cases of epididymis necrosis. The animals that also underwent dis-diversion and that were later sacrificed (20 per 100) showed: five cases of testicular tube necrosis, one case of testicular inflammation, two cases of deferent conduit inflammation, four cases of epididymis inflammation and seven cases of epididymis necrosis. Statistical analysis showed that the differences between the two P groups were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

[Multivesicular hepatic hydatidosis in childhood. Its relation with specific pharmacologic treatment]. / Hidatidosis hepática multivesicular en la infancia. Su relación con el tratamiento farmacológico específico.

Four cases of multivesicular hepatic hydatidosis are reported. Two of them were affected by exogenous growth. All patients had undergone a long-term treatment with mebendazole at the usual doses. We are contrasting our experience in the use of such drug and the previous reports by other authors. In our opinion, as mebendazole acts on the cyst in a double way (both inhibiting glucose uptake by the larva and modifying the structure of the cyst membranes) ir induces the cyst multivesiculation which is a sign of suffering or resistance of the parasite. Despite the fact that previous reports, and also one of the cases reported by us, point to a favourable evolution of the hepatic hydatidosis after treatment with Mebendazole, the possibility that the multivesicular cyst-with a more spreading growth and a surgical treatment which is occasionally more difficult, may be induced by that drug would perhaps discourage its use.

[Caliceal diverticulum and simple renal cyst. Developmental aspects of the same entity?]. / Divertículo calicial y quiste renal simple. Aspectos evolutivos de una misma entidad?

We report a case of calyceal diverticulum which evolved into what appeared anatomically and radiologically as a simple renal cyst. Similarities and differences between both entities are discussed based on a review of the literature. Our case report suggests that both conditions are related and that they can even be considered as evolutive forms of the same disease.

[Testicular teratoma in infancy]. / Teratoma testicular en la infancia.

The authors describe a case of testicle-based teratoma, in a 20-month old boy. Due to the characteristics of the palpation and its eventual transillumination, it may be confused with a hydrocele. They stress its rarity and on the basis of a review of the literature, they explain its histological peculiarities and refer to its prognosis, usually benign, when it is diagnosed at about 2 years of age, providing that a very careful examination of the histological sections rules out the presence of anaplastic cells. Finally there is a short discussion on the possibilities of complementary therapy when there are metastases.