Secuestro pulmonar extralobar intradiafragmático / Intradiaphragmatic extralobar pulmonary sequestration

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Linfangioma quístico de localización inusual / Cystic lymphangioma in unusual location

Se describe el caso de una paciente con una masa tumoral benigna congénita, que fue detectada tras un cuadro febril agudo. La masa, de 7 cm de diámetro, estaba localizada en la región pectoral derecha y fue diagnosticada mediante resonancia magnética. Tras su extirpación, se observaba una masa quística de paredes gruesas y cubierta de tejido graso. El estudio anatomopatológico constató la existencia de quistes con contenido linfático, lo que confirmaba que se trataba de un linfangioma quístico (AU)

We report the case of a patient with a congenital benign tumor, which was incidentally discovered after acute fever. The tumor had a diameter of 7 centimetres, located in the right pectoral region and was diagnosed by MRI. The cyst was totally excised. The lesion consisted of a thick-wall cystic mass covered with fatty tissue. Histopathological examination revealed lymphatic cysts, which lead to the diagnosis of cystic lymphangioma (AU)

Nuestra experiencia en el paciente politraumatizado pediátrico con criterios de ingreso en UCI / Our experience in the poly-traumatized pediatric patient with criteria for admission to the ICU

Objetivo. Presentar nuestra experiencia en el politraumatizado grave con ingreso en UCI pediátrica. Material y método. Se ha realizado un estudio retrospectivo de 78pacientes pediátricos ingresados en UCI por politraumatismo entre 2000y 2008 recogiendo variables de edad, sexo, época del año, lugar, mecanismo, Glasgow e ITP, tipo de lesiones, complicaciones, días de ingreso y fallecimientos. Se lleva a cabo el estudio descriptivo y analítico utilizando el SPSS 15.0 aplicando Chi cuadrado y Correlación de Pearson. Resultados. La edad media de los pacientes es de 8,5 ± 4,2 años siendo el 70% varones. Ocurren más accidentes en verano (37%), el lugar más frecuente es la carretera (47%) y el mecanismo el accidente de tráfico (45%). Ha habido un 15% de éxitus, de los cuales el 75% ocurre en las primeras 24 horas. Existe relación entre trauma abdominal y tipo de mecanismo (p<0,05), siendo el más frecuente el accidente de (..) (AU)

Objective. To present our experience with severe pediatric trauma. The pediatric trauma is the leading cause of death in children under2 years. Methods. We achieved a retrospective study from 78 pediatric patients admitted to the Intensive Care Unit (UCI) for multiple trauma between 2000 and 2008. Age, sex, season, location, mechanism, Glasgow and ITP, type of injuries, complications, days of hospitalization and deaths were reviewed. It was performed descriptive and analytical study using the SPSS 15.0 and chi square and Pearson correlation were applied. Outcomes. The mean age of patients was of 8.5 ± 4.2 years with (..) (AU)

[Our experience in the poly-traumatized pediatric patient with criteria for admission to the ICU]. / Nuestra experiencia en el paciente politraumatizado pediátrico con criterios de ingreso en UCI.

OBJECTIVE: To present our experience with severe pediatric trauma. The pediatric trauma is the leading cause of death in children under 2 years. METHODS: We achieved a retrospective study from 78 pediatric patients admitted to the Intensive Care Unit (UCI) for multiple trauma between 2000 and 2008. Age, sex, season, location, mechanism, Glasgow and ITP, type of injuries, complications, days of hospitalization and deaths were reviewed. It was performed descriptive and analytical study using the SPSS 15.0 and chi square and Pearson correlation were applied. OUTCOMES: The mean age of patients was of 8.5 +/- 4.2 years with 70% boys. Most accidents occurred in summer (37%) and the most common site was the road (47%). There was 15% of mortality, which the 75% occurred in the first 24 hours. There is an association between abdominal trauma and type of mechanism (p < 0.05). The most common mechanism was the traffic accident (45%) followed by a direct hit. Both ITP as Glasgow score were associated significantly with mortality and complications and with the hospital stay in the UCI there was a weak association but significant and negative (p < 0.05). CONCLUSIONS: Mortality is higher than other series but it may be because that these series include minor injuries. The fall down is the most frequent in pediatric emergencies but it was the mechanism that involves less admission to the UCI. Both ITP as Glasgow score are good indicators of severity and if their values decrease, the hospital stay in UCI and the mortality increase.

Aspiración de cuerpos extraños en la infancia / Foreign body aspiration in children

El objetivo de este trabajo es evaluar los datos de anamnesis, clínicos, radiológicos, terapéuticos y endoscópicos, analizando 420 casos de aspiración de cuerpo extraño (ACE) tratados en nuestro Hospital entre los años 1972 y 2005. De los 420 casos en 13 de ellos (3,21%) no se encontró cuerpo extraño (CE) y 16 presentaron una localización laríngea. La media de edad es de 33 meses. Los hallazgos de anamnesis, exploración, auscultación y radiología fueron positivos en el 91,4, 78,3, 91,6 y 81% respectivamente. El episodio aspirativo no es solamente infravalorado en cuanto a su frecuencia, sino que muchas veces es excluido, en principio, como posible diagnóstico, como lo demuestra el hecho de que sólo 218 (51,9%) de los pacientes, acudieron al Hospital en las primeras 24 horas tras el accidente aspirativo. Esto llama la atención dado que el cuadro clínico de inicio es claro en el 87,8% de los casos y tiene una relativa gravedad en el 75,4%. Además, el CE extraído por nosotros y el ya conocido o sospechado por la familia coincide en el 82,95% de los casos. Creemos que ante la sospecha de ACE se impone la realización de una broncoscopia. La broncoscopia ha sido realizada por cirujanos pediátricos (AU)

The aim to this study is evaluate the history, symptoms, radiographic and endoscopic findings in 420 children who were admitted for suspected foreign body aspiration in our hospital between 1972 and 2005. In 13 children we didn´t find foreign body and in 16 children the foreign bodies were lodged in larynx. The mean age was 33 months. The medical history, phisical exploration, auscultation and radiological findings were positive in 91,4%, 78,3%, 91,6% and 81%. The frecuency or foreign body aspiration is undervaluate and sometimes is excluded as diagnosis. Only 218 (51,9%) patients went to the hospital in the first 24 hours, although 87,8% of patients presented symptoms and 75,4% presented severe symptoms. Moreover the removed foreign bodies and suspected foreign bodies are the same in 82,95%. We think that bronchoscopy should by performed in all children who have had a choking episode (AU)

[Thyroglossal duct cysts. Do prior inflammatory episodes influence the number of recurrences?]. / Quistes del conducto tirogloso. Influyen los episodios inflamatorios previos en el número de recidivas?

INTRODUCTION: The most common complication in the treatment of thyroglossal duct cysts (TDC) is the high index of relapses. An analysis of this index and the influence of previous inflammatory episodes are presented. PATIENTS AND METHODS: A retrospective study of 120 consecutive TDC cases operated on during a period of 23 years, from 1972 to 1994, is presented. The statistical study was done using the Chi square test and the contrast of hypothesis for two proportions. RESULTS: The mean age of the patients was 4.9 years, with 93 cases (77%) being operated before 7 years of age. An inflammatory episode before surgery occurred in 57 cases (47%). Treatment was the Sistrunk technique in 112 cases (93%) and a simple excision of the cyst in 8 cases, with a relapse occurring in 4 of the latter cases (50%). Those cases where the Sistrunk technique was performed were divided into two groups: Group I (56 cases) those patients which had suffered an inflammatory episode before surgery and group II (56 cases) those that had not. Five relapses (8.9%) were found in group I and 2 (3.5%) in group II. CONCLUSIONS: TDC are fore frequent during early childhood, occurring most frequently before 7 years of age. The number of relapses are dramatically reduced when the Sistrunk technique is used, but no significant differences were found in those that had suffered previously an inflammatory episode.

[Neuroblastoma with bone marrow invasion. A multicenter study. Work Group of the Spanish Society of Pediatric Surgery]. / Neuroblastomas con médula ósea invadida. Estudio multicéntrico. Grupo de Trabajo de la Sociedad Española de Cirugía Pediátrica.

By means of a retrospective study made of multiple centres, it was aimed to determine which variables could be influential at the moment of diagnosis in the prognostic of patients suffering neuroblastoma and medullary bone affection. Fifty four cases of patients belonging to a total of ten hospital centers have been revised in a period of five years. The ages under study spanned from three months to eight years of age (mean = 2.83 years). For the analysis of the patients, they were divided into two groups: one being composed of the deceased patients and the other of the surviving. The deceased patients were of a more advanced age, the delay in the diagnosis was greater, the primitive tumor was found to be more frequently located in the adrenal glands, the metastasis appeared more readily in multiples, and the effectiveness of the treatment was less, resulting in lower cases of remission and a less radical surgery. The only difference with respect to other publications is that in the case of surviving patients, the number of cases of enolase and ferritin is more frequently pathological.

[Clinical and anatomopathologic study of 800 cryptorchid testis]. / Estudio clínico y anatomopatológico de 800 testes criptórquidos.

662 children (800 cryptorchid testes) has been studied in order to check if the age and location were important factors in the degree of the lesion found in the biopsy. We have related in this survey the tubular fertility index (IFT) and tubular diameter (DT) to the age and location of the testes and we have not proved statistically their relationship, for which reason we do not advise to plan the age of surgery in terms of possible anatomopathologic damage.