RESUMO
La torsión del apéndice vermiforme es muy rara; en la literatura sólo han sido referidos 25 casos. El aquí informado es el primero asociado a invaginación intestinal. Se trató de una niña de dos meses de edad quien súbitamente dio muestras de dolor. En la exploración quirúrgica se encontró invaginación ileocecal apretada, que fue corregida. Cuatro días después fue necesario reoperar, encontrando torsión y perforación del apéndice cecal; se practicó apendicectomía. Por datos de obstrucción y peritonitis se requirió nueva exploración quirúrgica en la que se encontró dehiscencia del muñón y perforación cecal. Una vez corregidas estas complicaciones, la paciente evolucionó satisfactoriamente y fue dada de alta en buenas condiciones.
BACKGROUND: Vermiform appendix torsion is a rare condition, with only 25 cases recorded in the international literature. Our patient is the first case associated with intussusception. CASE REPORT: A 2-month-old female infant suddenly developed severe abdominal pain due to ileoceal intussusception. During surgical exploration, a tight intussusception was reduced. Three days later, a new laparotomy was required and we found torsion and perforation of the vermiform appendix. The patient underwent appendectomy, but there was dehiscence of the appendiceal stump and cecal perforation requiring a new surgical exploration. The patient had an uneventful recovery.
Assuntos
Humanos , Feminino , Lactente , Apêndice , Complicações Pós-Operatórias/cirurgia , Doenças do Ceco/complicações , Valva Ileocecal , Intussuscepção/complicações , Apendicectomia , Anormalidade Torcional/etiologia , Anormalidade Torcional/cirurgia , Apêndice/cirurgia , Complicações Pós-Operatórias/etiologia , Doenças do Ceco/cirurgia , Doenças do Íleo/complicações , Doenças do Íleo/cirurgia , Dor Abdominal/etiologia , Intussuscepção/cirurgia , Nutrição Parenteral , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Peritonite/etiologia , Peritonite/cirurgia , Reoperação , Deiscência da Ferida Operatória , Valva Ileocecal/cirurgiaRESUMO
A newborn male patient with trisomy-21 presented with bilious hemesis. The patient was icteric with slight hepatomegaly. Simple abdominal X-ray and upper gastrointestinal series with barium showed a dilated duodenal loop and inflammatory changes involving the duodenal mucosa. This image known as "double bubble" is characteristic of congenital duodenal obstruction. Simultaneously the gallbladder and choledochus were visualized. The former X-ray finding is very unusual. An uneventful Kimura procedure was performed.
Assuntos
Colangiografia , Obstrução Duodenal/congênito , Obstrução Duodenal/diagnóstico por imagem , Atresia Intestinal/diagnóstico por imagem , Humanos , Recém-Nascido , MasculinoRESUMO
Se presenta el caso de un recién nacido masculino con síndrome de Down, que presentó al nacimiento vómito biliar y al examen físico ictericia y hepatomegalia leve. Los estudios radiológicos simple de abdomen y la serie gastrointestinal mostraron al duodeno dilatado y cambios inflamatorios de la mucosa. Esta imagen es conocida como la imagen en doble burbuja y es común en la obstrucción duodenal congénita. Simultáneamente fueron visualizados la vesícula biliar y el colédoco, siendo este hallazgo poco usual. Se le efectuó corrección del defecto mediante el procedimiento de Kimura.
A newborn male patient with trisomy-21 presented with bilious hemesis. The patient was icteric with slight hepatomegaly. Simple abdominal X-ray and upper gastrointestinal series with barium showed a dilated duodenal loop and inflammatory changes involving the duodenal mucosa. This image known as [quot ]double bubble[quot ] is characteristic of congenital duodenal obstruction. Simultaneously the gallbladder and choledochus were visualized. The former X-ray finding is very unusual. An uneventful Kimura procedure was performed.
Assuntos
Humanos , Masculino , Recém-Nascido , Atresia Intestinal , Colangiografia , Obstrução Duodenal/congênito , Obstrução DuodenalRESUMO
BACKGROUND: Vermiform appendix torsion is a rare condition, with only 25 cases recorded in the international literature. Our patient is the first case associated with intussusception. CASE REPORT: A 2-month-old female infant suddenly developed severe abdominal pain due to ileoceal intussusception. During surgical exploration, a tight intussusception was reduced. Three days later, a new laparotomy was required and we found torsion and perforation of the vermiform appendix. The patient underwent appendectomy, but there was dehiscence of the appendiceal stump and cecal perforation requiring a new surgical exploration. The patient had an uneventful recovery.
Assuntos
Apêndice , Doenças do Ceco/complicações , Valva Ileocecal , Intussuscepção/complicações , Complicações Pós-Operatórias/cirurgia , Dor Abdominal/etiologia , Apendicectomia , Apêndice/cirurgia , Doenças do Ceco/cirurgia , Feminino , Humanos , Doenças do Íleo/complicações , Doenças do Íleo/cirurgia , Valva Ileocecal/cirurgia , Lactente , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Intussuscepção/cirurgia , Nutrição Parenteral , Peritonite/etiologia , Peritonite/cirurgia , Complicações Pós-Operatórias/etiologia , Reoperação , Deiscência da Ferida Operatória , Anormalidade Torcional/etiologia , Anormalidade Torcional/cirurgiaRESUMO
Schönlein-Henoch purpura is one of the most common forms of vasculitis in childhood, and intestinal perforation, necrosis and intussusception constitute the major surgical conditions. We present one recent case of spontaneous small bowel perforation without intussusception. An intestinal resection and ileostomy were performed. Perforation, usually ileal, frequently is accompanied by intussusception. We believe the the perforation is secondary to deep ischemic phenomenon of the bowel.
