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Biomedical subjects

Luis Manuel García-Cabello

Publications and source records attributed to Luis Manuel García-Cabello.

12 recordsLinked to original sources
PubMedDate not supplied

[Renal trauma in childhood. Second-level hospital experience].

UNLABELLED: The leading cause of death in children is accidents. Severe craniocerebral trauma and injuries to the heart or major vessels are mainly responsible for immediate death. This phenomenon is also reflected in the increasing number of pediatric admissions for renal trauma. MATERIAL AND METHODS: From 1990 to 2000, the charts of 132 patients with renal injuries secondary to blunt and penetrating trauma in childhood are reviewed. RESULTS: A total of 88 were male patients and 126 sustained blunt trauma (motor accidents, falls, etc.). Gross and microscopic hematuria were the most important finding at the time of presentation, and correlated with severe renal injury, and both were present in 122 cases. Intravenous pyelography and CT scan were the most useful diagnosis tools. Only 27 patients were managed operatively, the majority because of associated intra-abdominal injury. CONCLUSIONS: Intravenous pyelography remains the most cost-effective means of investigating renal injuries in a second-level hospital. Renal contusion and most laceration should be managed conservatively. Only few a renal transactions should be managed operatively.

Accidents↗
PubMedDate not supplied

[Hirschsprung in children over 6 years of age].

INTRODUCTION: Hirschsprung's disease or colonic agangliosis is a rare condition in schoolchildren and adolescents. It is common in infants and chronic constipation is the usual symptom. MATERIALS, METHODS, AND RESULTS: In a period of 5 years, 11-years-old patients were diagnosed and treated for Hirschsprung's disease. We studied six male patients; mean age was 8.6 years. All patients had classic disease and nine, severe chronic constipation, and two were admitted with encopresis. One had 10 kg of feces in 40 cm of colon. Diagnosis was established with barium enema and tissue biopsy. All patients had colostomy. In eight patients, Duhamel procedure was performed with good results. CONCLUSIONS: This disease is a rare condition in older patients and Duhamel procedure is a good surgical option.

Adolescent↗
PubMedDate not supplied

[Testicular necrosis resulting from torsion in children. Perspective of a second level hospital].

INTRODUCTION: The disaster of a testicular torsion leading to the possible loss of a gonad within a few hours is a well known occurrence and it is discouraging. Clinical examples emphasizing torsion of the testis as the most important differential diagnosis in children with acute scrotal pain and swelling, as well as the need for early exploration, have been reported with increasing frequency. MATERIAL AND METHODS: Seventy cases of clinically diagnosed unilateral torsion of the testis have been admitted to our pediatric surgical unit over a period of 8 years. There were 46 cases between 13 and 15 years of age; 34 were admitted after 24 ho and 25 after 3 days of multilating disease. Left side was involved in 46 cases and 61 testicles were removed. CONCLUSIONS: In order to avoid initiation procedures, early diagnosis is very important.

Adolescent↗
PubMedDate not supplied

[Intestinal ischemia resulting from previous laparotomy].

INTRODUCTION: Acute adhesive obstruction of the small intestine is a surgical emergency in which there is a risk of intestinal ischemia. By delaying diagnosis and institution of appropriate treatment for ischemic obstruction, morbidity and mortality increase. MATERIAL, METHOD AND RESULTS: The hospital records of 63 patients with diagnosis of intestinal obstruction and regional ischemia due to fibroadhesive peritonitis were reviewed in an attempt to identify criteria that could be used to separate patients who would require an emergency operation; 39 (61.9%) were male and three (4.7%) newborn. This complication was seen after 3 years of age in 39 patients (69.1%). Appendicitis was first cause with 26 cases (41.2%). Range of time of appearance after operation was from 1 week to 15 years (median 10 months). In 87% of patients the operation was a second procedure. All had gangrene and an enterostomy was constructed. General morbidity rate was 80%. Four children died. CONCLUSION: It is mandatory to identify which patients require non conservative management.

Child↗
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[Retroperitoneal hematoma in children].

INTRODUCTION: Retroperitoneal hematoma is frequently due lo blunt trauma and is a challenging problem. Incidence of this complication in adults is high, but in childhood is uncommon. MATERIALS AND METHODS: Analysis of 30 cases is presented. PTS was found between 10 and 12 points, zone II, 12, zone III, 17, and zone I, only one. We observed 33 associated injuries: 17 were pelvic fractures and nine, ureteral rupture. Three patients underwent hepatic or splenic laceration. Seventy-three percent of patients had exploratory laparotomy, but did not have exploration of retroperitoneum. CONCLUSIONS: Retroperitoneal hematoma in infancy should be treated conservatively.

Adolescent↗
PubMedDate not supplied

[Battered child syndrome. Surgical implications].

INTRODUCTION: Major trauma, specially abdominal and thoracic trauma due to child abuse is a serious, but fortunately infrequent problem which carries unacceptably high mortality. MATERIAL AND METHODS: We reviewed our experience with childhood trauma due to battered child syndrome in our hospital to learn the extent, circumstances, presentations, and consequences of this kind of events. Our hospital is the most important center for traumatized child care in Mexico. RESULTS: After our study, mild trauma due to child abuse accounted for 35 and major trauma accounted for 50 cases. In the former group, 10 patients with fractures were observed; 21 were male patients. Children were abused by father or stepfather in the 21 cases, and by the mother in six. There was delay in seeking immediate medical attention treatment in all patients. In the second group, there were ruptures of small bowel in 27, of the colon in four patients, pancreas in three, and esophagus in two. Lung, pleura, bladder, spleen and other anatomic structures also were affected. Five patients died. Similarity between the two patient groups studied indicates both the widespread nature of child abuse and the need to suspect this diagnosis whenever a child is present with unexplained shock or peritonitis, specially if there is anemia or bilious emesis. Delay in diagnosis contributed to mortality.

Battered Child Syndrome↗
PubMedDate not supplied

[Congenital transmesenteric hernia].

INTRODUCTION: Acute intestinal obstruction due to congenital defects in the mesentery of the small bowel are quite uncommon. The most frequent location of the defect is the mesentery of the terminal ileum. MATERIAL AND METHODS: Five cases of small bowel obstruction caused by congenital transmesenteric hernia was reviewed. RESULTS: Four were male and all patients had an intestinal obstructive disease, small bowel gangrene and peritonitis. Two patients died. DISCUSSION AND CONCLUSIONS: Diagnosis is difficult and most cases recorded until today are incidental findings on laparotomy and surgical treatment is mandatory.

Adolescent↗
PubMedDate not supplied

[Intrauterine necrosis in closed gastroschisis].

INTRODUCTION: Strangulation of the intestine as the result of compression of its blood supply in a tightly closed gastroschisis defect is a very rare occurrence. CLINICAL CASES: We present the cases of two newborn patients who had extra-abdominal infarcted bowel and intra-abdominal jejunal atresia due to vascular compression for gastroschisis defect. One was associated with colonic, probably acquired aganglionosis. Both had similar clinical courses. CONCLUSIONS: This association is very uncommon. Prognosis of this complex is very poor.

Colon↗
PubMedDate not supplied

Surgical aspects of intussusception secondary to Peutz-Jeghers syndrome.

Peutz-Jeghers syndrome (PJS) is a familial condition characterized by the presence of pigmented mucocutaneous spots and intestinal polyposis. Intussusception is the most frequent abdominal complication, but it is very rare. In our country, this is the second known report. In this article we present four cases of PJS associated with intussusception. All the patients were female and all underwent a surgical procedure. The intussusception was located in the ileum and colon. There are no more than 20 reported cases in the world where these two entities are associated. Children with PJS have a high risk of suffering from ileo-ileal or jejuno-ileal intussusception that will frequently require a special surgical procedure.

Adolescent↗
PubMedDate not supplied

[Fibromatosis infantile. Report of an aggressive disease].

This rare entity is characterized by multiple nodular lesions largely composed of collagen-forming spindle cells and involving the subcutis, skeletal muscle, bone and viscera of newborns and infants that occurs in either a solitary or multicentric form. The clinical course of a case is presented. The patient is a 2-year-old male who was brought to our hospital because of a large cervical mass. On physical examination a firm, subcutaneous, immobile painless mass measuring 4.5x6 cm was palpated at right side of neck. After the first admission, 13 complete surgical resections were performed. This patient is the eleventh familial case in the literature. The patient died 10 years after the first surgery.

Child↗
PubMedDate not supplied

[Torsion of the vermiform appendix associated with intussusception].

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.

Abdominal Pain↗