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Biomedical subjects

R Luque Mialdea

Publications and source records attributed to R Luque Mialdea.

30 records · Page 2Linked to original sources

Segmentary splenectomy of the lower tip because of spontaneous rupture of a splenic hemangioendothelioma in a new-born child--a case report.

We present the first exceptional case of splenic hemangioendothelioma, an infrequent and generally asymptomatic benign vascular tumor, here triggering hypovolemic shock through spontaneous rupture of the spleen without prior injury. Conservative treatment of the spleen led us to perform a segmentary splenectomy of the lower tip with total extirpation of the vascular tumour and the acute splenic bleeding was controlled. One year later, splenic functions are normal.

Hemangioendothelioma↗

[Renal adenocarcinoma in children. Report of a case].

Description of the accidental finding of a renal adenocarcinoma in a 10-year old boy, after abdominal trauma and with a good evolutive behaviour. The clinical, diagnostic, therapeutical and survival aspects are analyzed, including a literature update of a renal neoformation which shows lower paediatric incidence than Wilm's Tumour or Neuroblastoma.

Adenocarcinoma↗

[Femoral hernia in children].

Femoral hernia is rare in adults and even less common in children, to the point that expert surgeons have limited experience with it. Eleven patients with femoral hernia have been operated upon in our service during the past 15 years. Preoperative diagnosis was made in 6 cases (54.5%), and we underline that the ideal therapy began with this early diagnosis. We review the etiologies, clinical findings and treatment of femoral hernia in children.

Age Factors↗

[Urodynamic study of bladder dysfunction in recurrent vesico-ureteral reflux].

In the last 5 years we have treated in our service 98 patients suffering vesicoureteral reflux (VUR) with 148 refluyents units (RU) in total. The VUR recurred in 9 ureters (6.08%) in children neurologically normal. A urodynamic study was made in them getting the following diagnosis, in 5 R. U. vesical dysfunction: 4 R. U. vesico-sphinteric dyssynergia and in 1 R. U. vesical hyperreflexia with uninhibited bladder contractions. In the remaining 4 R. U. the urodynamic study was normal.

Child↗

[Conservative treatment of urethral stenosis in childhood].

During a 19 years period (1969-March 1988) 22 children presented for treatment of urethral strictures. The patients ranged in age from neonatal period to 13 years old, 20 of them were boys and 2 girls. We have found 3 congenital cases, 5 traumatic cases, 9 inflammatory (versus infections) cases and 5 iatrogenic cases. Diagnosis can be suspected from the history and physical examination (voided stream), and confirmed radiographically and endoscopically; we have employed urodynamics studies in 2 cases, and those have seem of much important the follow-up. Treatment is controversial between different authors. In ours series progressive dilatation procedure have been elective (retrograde swelling catheter versus anterograde swelling catheter with cytostomy), with 86.3% of good results.

Adolescent↗

[Sternal cleft. Surgical treatment in the newborn].

The lack of total sternal fusion without other anomalies of the chest wall is extremely rare. We present the case of one 24 h. old female, clinically asymptomatic with complete sternal cleft without other symptoms. She was operated on within the first week of life, a sternal primary suture with costal condrotomy and alternate costal suture were performed. Good thoracic stability was obtained. We agree with other authors about the need for surgical correction during the neonatal period.

Female↗

[Ectopic vaginal ureterocele in ureter from the middle caliceal group and homolateral triplication].

We present the case of a 12-year old girl that presented during a four month period urinary incontinence alternating with normal micturitions, vaginal flow and bacteriuria. IVP shows a pyeloureteral duplication in the right side. The superior and inferior calyceal groups meet in a normal ureter whereas the middle calyceal group is open in one megaureter with ureterocele in medial and extravesical situation, probably vaginal or uterine. During operation a third blind ureter was found connected to the "ureterocele" and medial to the ectopic megaureter. A bibliographical survey is made and surgical and embriological data are commented.

Child↗

[Prostatic utricle cysts (Müllerian duct cysts) (author's transl)].

Authors report two cases of prostatic utricle cysts, one of which was operated. They collect from literature 20 other cases in children aged ten years or less. Natural history of patients is reported. They also comment on the symptoms and associated anomalies and conclude discussing diagnostic and operative procedures available in these patients.

Cysts↗

[Urinary retention in a child secondary to urethral uric lithiasis].

Urinary lithiasis in children is less frequent than in adults. The incidence of uric acid lithiasis in adult population is between 5 to 39% of all lithiasis. Only a third part of the urinary calculi in infancy are compound of uric acid. The most frequent uric lithiasis is that so called endemic. Usually appears in the lower urinary tract and it is not related to metabolic disturbances. We present the exceptional case of an Arabian boy 4 years old who came to the Hospital because he suffered urinary retention secondary to the fixation of uric acid stone in bulbous urethra. The treatment performed was the external urethrotomy and we could removed the stone. We emphasize that the postoperative control was done by uroflowmetry. After one year, the result is satisfactory.

Child, Preschool↗

[Functional changes in the bladder of children with primary bladder diverticulum].

OBJECTIVE: Primary vesical diverticulum is generally diagnosed during urological evaluation for recurrent urinary tract infection that are frequently associated with the symptoms of urinary dysfunction. A urodynamic study was performed in children with primary vesical diverticulum to confirm or discard the presence of vesicourethal dysfunction, its relationship with vesicoureteral reflux, which is associated with diverticulum, and the results achieved by surgical versus medical treatment. METHODS/RESULTS: A urodynamic study was carried out in 11 children (7 boys and 4 girls), aged 6 to 13 years, with primary vesical diverticulum. The diverticulum was parameatal in 7 cases (4 with reflux), posterolateral in 2 cases (1 with reflux), anterolateral in 1 patient and 1 patient had multiple bladder diverticula without neurological disorder. Surgery was indicated in 8 cases and 3 were managed conservatively. Vesicourethral function, at the time the diverticulum was diagnosed, was normal in 3 (27%) and pathological in 8 (73%) patients. The urodynamic study disclosed uncoordinated vesicosphincteric function (4 pts), vesical instability (3 pts) and vesical hypotony (1 pt). Of these 4 cases with urodynamic disorders, diverticulum was associated with vesicoureteral reflux. Of the 8 children submitted to surgery, 6 had a functional pathology preoperatively; following surgical treatment of the diverticulum, vesicourethral function returned to normal in all cases. Of the 3 cases managed conservatively, 2 had persistent urodynamic disorders despite drug therapy; one of them had clinical features of urinary incontinence. CONCLUSIONS: These fundings suggest that alterations of bladder function might arise from the anatomic changes in the detrusor muscle causing the diverticulum and contribute to the onset or persistence of reflux, and should be considered an additional criterion for indicating surgery. It is therefore suggested that a urodynamic study for its diagnosis be included in the protocol for evaluation of children with primary vesical diverticulum.

Adolescent↗