Biomedical subjects
Publications and source records attributed to A Martínez Caro.
Spigelian hernia (SH) is rare in children, it occurs primarily en adults the mean age of presentacion is 50 years. We present two patients with hernia associated to cryptorchidism one of them bilateral.
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The usefulness of echography in the diagnosis and tracing down of an intestinal intussusception is discussed. An abdominal ecograph was done in 29 children with suspected intestinal intussusception. In 31 cases (63%) the diagnosis was confirmed by the typical "target" image. In 17 cases (34%) the picture of intussusception was not detected, all children evolved favourably except for one case which, upon revision of the ecograph, showed the "target" picture not properly interpreted in the first place. We find the abdominal ecograph a useful means for diagnosis of intestinal intussusception. We present the diagnostic-therapeutic routine in our centre in cases of possible intestinal intussusception.
A 14-years revision (1972-1986) is made of 3,600 children attended to after ingesting some type of caustic agent. Only 81 were admitted to hospital. We found a predominance in the 1-3 year age group. Bleach was the caustic most frequently present but lye accounted for most major lesions. The more relevant symptoms were oropharyngeal lesions (85%), vomiting (26%) and sialorrhea (20%). Oropharyngeal burns was the sign most often found in esophageal lesions (45%). The ingestion of ordinary household bleach did not result in serious esophageal lesions nor posterior complications, and does not require esophagoscopy if no other symptom except vomiting is present. Esophagoscopy is the ideal means for evaluating esophageal lesions, as are esophageal dilatations with Rehbein dilators for stenosis due to scarring. With the use of corticosteroids in the acute phase, there were 8 cases (22%) of esophageal stenosis out of 36 with lesions.
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Three cases of torsion of normal the uterine adnexa in premenarcheal girls are reported. The possible etiopathogenic mechanisms are commented, and the operative management is discussed. The value of ultrasonography in early diagnosis is pointed out.
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Eight cases of neonatal adrenal haemorrhage are reported, four of which were necropsy findings, two were treated conservatively and the remaining two underwent exploratory and evacuation laparotomy. The four latter patients recovered. Diverse clinical pictures which may be present at the onset of adrenal haemorrhage in newborns are reviewed and particularly the indications for surgery. In this report, one laparotomy was done to establish a differential diagnosis of retroperitoneal mass, and the other after onset of intense hemoperitoneum and signs of hypovolemic shock. Different pathogenic hypotheses about this entity are contemplated, particularly traumas and circumstances surrounding birth; one of the reported cases coincided with a known birth-injury. The various diagnostic methods in use today and their degree of usefulness or risk also come into discussion. Special mention is made about calcifications of the adrenal glands in this disease and they are compared to calcifications found in other pediatric problems.
Authors present two cases of rhabdomyosarcoma of the bladder treated previously to surgery with chemotherapy (protocol T-2) and radiation therapy. In one of these patients surgery consisted only in a partial cystectomy, and in the other only a few biopsies were taken from the most suspicious zones, and these were all negative. Three years and four months after diagnosis and 15 months after completion of treatment, both children are alive and free of detectable disease.
Three cases of the rare malformation pyloric atresia are presented, two of which are associated with epidermolysis bullosa, a rare malformation by itself. First two cases had a great pneumoperitoneum which suggested perforation of digestive tract. All three cases belonged to type I of pyloric atresia.
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In 67 patients with esophageal atresia we have found associated congenital anomalies in over 80% and 10 children could be considered as carriers of Vater association. The various malformations are reported and their etiopathogenic factors considered.
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One hundred and seventy three cases of ingestion of foreign bodies by children are reported. Their nature and evolution inside the organism is discussed. Laparotomy was required in only one case.