Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica最新文献_第3页

Trend in predictive factors of choledocholithiasis: the key to the management of pediatric patients with suspected gallstones. 胆石症预测因素的趋势：处理疑似胆结石儿科患者的关键。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.12

M A Capparelli, S Canestrari, R Ortiz, P D D'Alessandro, V H Ayarzabal, M E Barrenechea

{"title":"Trend in predictive factors of choledocholithiasis: the key to the management of pediatric patients with suspected gallstones.","authors":"M A Capparelli, S Canestrari, R Ortiz, P D D'Alessandro, V H Ayarzabal, M E Barrenechea","doi":"10.54847/cp.2024.03.12","DOIUrl":"https://doi.org/10.54847/cp.2024.03.12","url":null,"abstract":"Objectives: To reduce the overuse of magnetic resonance cholangiopancreatography and the rates of non-therapeutic endoscopic retrograde cholangiopancreatography in pediatric patients suspected of choledocholithiasis.Materials and methods: Retrospective study of patients suspected of choledocholithiasis between January 2010 and June 2023. Patients with cholangitis or two or more of the following predictive factors of choledocholithiasis in initial laboratory tests and ultrasound were categorized as high-risk group: total bilirubin level ≥ 2 mg/dl, common bile duct > 6 millimeters on ultrasound; and detection of choledocholithiasis by ultrasound. Patients were recategorized according to the results of the second set of laboratory and ultrasound analysis. Confirmatory modalities (magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and/or intraoperative cholangiography) were used to evaluate the presence of choledocholithiasis. Finally, we assessed the predictive capability of both the initial high-risk group and the group after recategorization.Results: A total of 129 patients were included. After initial studies, 72 (55.8%) patients were classified into the high-risk group. After recategorization, only 29 (22.5%) patients were included in this group. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the initial high-risk group were 89.3%, 53.5%, 34.7%, 94.7%, and 61.2%, respectively, while after recategorization, they were 82.1%, 94.1%, 79.3%, 95.0%, and 91.5%, respectively.Conclusions: Recategorization of the risk of choledocholithiasis would significantly improve the diagnostic accuracy of choledocholithiasis and help reduce the overuse of more complex and unnecessary studies/procedures.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"37 3","pages":"110-115"},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fortified milk: a rare cause of intestinal obstruction in pre-term patients. 强化牛奶：导致早产儿肠梗阻的罕见原因。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.17

R Ramírez Díaz, I Ibarra Rodríguez, G M Gavilanes Salazar, C Moreno Hurtado, M R Chamorro Juárez

{"title":"Fortified milk: a rare cause of intestinal obstruction in pre-term patients.","authors":"R Ramírez Díaz, I Ibarra Rodríguez, G M Gavilanes Salazar, C Moreno Hurtado, M R Chamorro Juárez","doi":"10.54847/cp.2024.03.17","DOIUrl":"https://doi.org/10.54847/cp.2024.03.17","url":null,"abstract":"Introduction: Intestinal obstruction secondary to the use of fortified milk is a rare cause in pre-term patients.Case report: We present the case of a female pre-term newborn admitted as a result of abdominal distension and rectal bleeding, which mimicked necrotizing enterocolitis. On abdominal X-ray, she had an obstruction pattern, and on ultrasonography, echogenic masses at the distal ileum were observed. Given the lack of improvement with conservative management, urgent exploratory laparotomy was decided upon. At surgery, compact milk masses at the level of the distal ileum were identified as the cause of intestinal obstruction. Appendicostomy and lavage with saline solution through the ileocecal valve were performed. This allowed milk masses to come out towards the colon, and a great amount of acholic stools to be expelled.Conclusion: The increase in \"milk curd syndrome\" cases should lead us to consider this cause in the differential diagnosis of intestinal obstruction in pre-term newborns fed with fortified milk.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"37 3","pages":"137-140"},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intralesional steroids in refractory caustic esophageal stricture. 治疗难治性腐蚀性食管狭窄的区域内类固醇。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.11

M Martínez Díaz, V Ibáñez Pradas, M Couselo Jerez, E Valdés Diéguez, I Viguria Marco

{"title":"Intralesional steroids in refractory caustic esophageal stricture.","authors":"M Martínez Díaz, V Ibáñez Pradas, M Couselo Jerez, E Valdés Diéguez, I Viguria Marco","doi":"10.54847/cp.2024.03.11","DOIUrl":"https://doi.org/10.54847/cp.2024.03.11","url":null,"abstract":"Objective: To analyze the efficacy of intralesional steroid treatment in refractory caustic esophageal stricture.Materials and methods: An analytical, retrospective study of patients receiving intralesional steroid treatment with triamcinolone acetonide as a result of refractory caustic esophageal stricture was carried out. Demographic variables, stricture characteristics, number of dilations, steroid injections, and dilation score (no. of dilations/follow-up period in months) pre- and post-treatment were collected. Stricture characteristics (diameter and length) and dilation score pre- and post-treatment were compared using the T-Test or Wilcoxon test.Results: N= 5. Median age: 5 years (17 months-7 years). Follow-up: 6.60 ± 2.70 years. Swallowed products included NaOH, KOH, and ClH. Zargar classification at follow-up initiation was IIb (n= 2), IIIa (n= 1), and two chronic strictures. 6.6 ± 9.23 esophageal dilations were carried out before steroid treatment initiation. The mean number of intralesional therapy sessions was 11.20 ± 6.14. Stricture length decreased by 3.60 ± 2.63 cm (t= 3.06; p= 0.019). No differences were found in terms of diameter increase: -1.60 ± 3.58 mm (t= -1.00; p= 0.187). The dilation score diminished from 1.47 ± 0.86 to 0.47 ± 0.18 dilations per month of follow-up (Z= -2.02; p= 0.043).Conclusions: Even though there is limited evidence available in the pediatric population, intralesional triamcinolone treatment is seemingly useful in the treatment of refractory caustic esophageal stricture, since it reduces length and dilation score.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"37 3","pages":"104-109"},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Indwelling-tunneled-central-venous-catheter-related early bacteremia and preoperative prophylaxis: a case and control study. 与留置导管相关的早期菌血症和术前预防：一项病例和对照研究。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-07-09 DOI: 10.54847/cp.2024.03.10

I Planas Díaz, M Molina Mata, I Casal Beloy, R Cabello Laureano

{"title":"Indwelling-tunneled-central-venous-catheter-related early bacteremia and preoperative prophylaxis: a case and control study.","authors":"I Planas Díaz, M Molina Mata, I Casal Beloy, R Cabello Laureano","doi":"10.54847/cp.2024.03.10","DOIUrl":"https://doi.org/10.54847/cp.2024.03.10","url":null,"abstract":"Introduction: The indication of preoperative prophylaxis in the insertion of indwelling tunneled central venous catheters (ITCVC) has a low level of evidence. Our objective was to assess risk factors of ITCVC-related early bacteremia in oncological pediatric patients and to determine the need for preoperative prophylaxis.Materials and methods: A univariate and multivariate retrospective analysis of patients in whom an ITCVC was placed from January 2020 to July 2023, according to whether they had ITCVC-related early bacteremia (EB) in the first 30 postoperative days, was carried out. Demographic variables, leukopenia, neutropenia, use of preoperative antibiotic prophylaxis, and history of central venous catheter (CVC) or bacteremia were collected. Calculations were carried out using the IBM SSPS29® software.Results: 176 patients with a mean age of 7.6 years (SD: 4.82) were analyzed. 7 EB cases were identified, with a greater frequency of neutropenia (p= 0.2), history of CVC in the 48 hours before insertion (p= 0.08), and intraoperative CVC (p= 0.04). The presence of intraoperative CVC increased the risk of EB 9-fold [OR: 9.4 (95%CI: 1.288-69.712) (p= 0.027)]. The lack of preoperative prophylaxis did not increase the risk of EB [OR: 2.2 (CI: 0.383-12.669) (p= 0.3)]. The association with other variables was not significant.Conclusions: The intraoperative presence of CVC was a risk factor of EB in our patients. Preoperative prophylaxis had no impact on the risk of EB, which in our view does not support its use. However, further studies with a larger sample size are required. Leukopenia or neutropenia at diagnosis were not associated with a greater prevalence of infection.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"37 3","pages":"99-103"},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Benefits of standardization in the management of acute appendicitis. 急性阑尾炎标准化管理的益处。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-01-01 DOI: 10.54847/cp.2024.01.10

I Planas Díaz, L Díaz Menéndez, R Cabello Laureano, M Molina

{"title":"Benefits of standardization in the management of acute appendicitis.","authors":"I Planas Díaz, L Díaz Menéndez, R Cabello Laureano, M Molina","doi":"10.54847/cp.2024.01.10","DOIUrl":"10.54847/cp.2024.01.10","url":null,"abstract":"Objective: Acute appendicitis (AA) is the most frequent urgent surgical pathology in the pediatric population, but postoperative management is variable, with protocols minimizing variability. We present our results following the optimization of the management protocol in our institution in order to establish its efficacy in terms of number of infectious complications and optimization of resources in our environment.Materials and methods: An observational, retrospective study of patients undergoing AA surgery from January 2018 to August 2022 was carried out. Two cohorts were compared, both before (1) and after (2) the implementation of the new protocol. They were divided according to severity in order to conduct a subgroup-based analysis -phlegmonous (PH), gangrenous (G), and perforated (P) appendicitis.Results: 771 patients (1: 390; 2: 381) were included, with a homogeneous distribution and a median age of 9.3 ± 2.8 years. Blood tests requested prior to discharge experienced a significant reduction (PH: 3.9% vs. 0.5%; p= 0.026; G: 97.6% vs. 13.4%, p< 0.001). Days of hospital stay decreased in the PH (1.2 IQR: 0.7 vs. 1 IQR: 0.36; p< 0.001) and G (4 IQR: 1 vs. 3 IQR: 1 days; p< 0.001) subgroups. No differences in the number of abscesses were found between groups (41 vs. 43; p= 0.73), but they were noted within subgroup G (9 vs. 2; p= 0.029). A reduction in resource expenses was detected in PH and G appendicitis.Conclusions: In our study, the most widely benefited subgroup following protocol optimization was the gangrenous appendicitis subgroup, with a significant reduction in the number of complications and the use of hospital resources.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"37 1","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparative study of cystoscopic control vs. radiological control in the endoscopic treatment of primary obstructive megaurater. 原发性梗阻性巨结肠症内镜治疗中膀胱镜控制与放射学控制的比较研究。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-01-01 DOI: 10.54847/cp.2024.01.13

J González Cayón, A Parente Hernández, A Ramírez Calazans, V Vargas Cruz, A Escassi Gil, R M Paredes Esteban

{"title":"Comparative study of cystoscopic control vs. radiological control in the endoscopic treatment of primary obstructive megaurater.","authors":"J González Cayón, A Parente Hernández, A Ramírez Calazans, V Vargas Cruz, A Escassi Gil, R M Paredes Esteban","doi":"10.54847/cp.2024.01.13","DOIUrl":"10.54847/cp.2024.01.13","url":null,"abstract":"Objective: High-pressure balloon pneumatic dilatation for the treatment of primary obstructive megaureter (POM) was initially described under cystoscopic and radiological control. However, some groups use cystoscopic control only, in an attempt to avoid the ionizing radiation associated with the procedure.Materials and methods: A retrospective study of POM patients treated with pneumatic dilatation in our unit from 2008 to 2021 was carried out. Success rates, complications, and follow-up were compared between two groups -dilatation under cystoscopic control alone (CS) vs. dilatation under radiological control only (RX).Results: 23 patients -9 CS and 14 RX- underwent surgery. Both groups were demographically comparable. Mean hospital stay was significantly shorter in the CS group (1 vs. 2 days; p = 0.009). Operating time was longer in the RX group (78 vs. 30 min; p = 0.001). Ureterovesical junction (UVJ) dilatation was successful in 100% of CS vs. 79% of RX cases; RR: 3.87 (0.51-26.99). Postoperative complications were similar in both groups; RR: 3.87 (0.51-26.99). Double J stent migration occurred in one case in both groups; RR: 0.64 (0.05-9.03). In the long-term, treatment success rate was higher in the CS group (100% vs. 71%); RR: 3.87 (0.51-26.99).Conclusion: POM pneumatic dilatation under cystoscopic control alone is faster, without increasing the risk of complications. Based on our experience, we suggest ionizing radiation be removed, since we consider it to be unnecessary.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"37 1","pages":"22-26"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Negative pressure device used in pediatric patients with Hostile abdomen. Case series. 负压装置用于腹部有敌意的儿科患者。病例系列。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-01-01 DOI: 10.54847/cp.2024.01.16

K Serrano Concha, H Morales Mayorga, D Acosta Farina, L Mendoza Saldarreaga, V Pólit Guerrero, J Oliveros Rivero, D Acosta Bowen

{"title":"Negative pressure device used in pediatric patients with Hostile abdomen. Case series.","authors":"K Serrano Concha, H Morales Mayorga, D Acosta Farina, L Mendoza Saldarreaga, V Pólit Guerrero, J Oliveros Rivero, D Acosta Bowen","doi":"10.54847/cp.2024.01.16","DOIUrl":"10.54847/cp.2024.01.16","url":null,"abstract":"Introduction: Hostile abdomen is a surgical condition characterized by loss of space between organs and structures in the abdomen. Negative pressure therapy use has been widely described in adults; the case is not the same for pediatric patients. The goal of this study is to present short-term results of negative pressure therapy use in pediatric patients with hostile abdomen due to different etiologies.Material and methods: Pediatric hostile abdomen patients (< 18 years) who were treated Negative pressure therapy using ABTHERA were identified and retrospectively reviewed.Results: 7 patients were included in this study. Median age was 16 (range: 9-17 yo). 5 (71.4%) were male and 2 (28.6%) females. 3 (43%) had significant past medical/surgical history (Systemic Lupus Erythematosus, complicated appendectomy and ventriculoperitoneal-shunt). The device was set at a continuous pressure ranging from -50 to -125 mmHg. Pre and post-surgical findings were reported using Bjork's classification. Devices were replaced every 4-7 days (median 5 days). Total amount of replacements was 1-4 (median 3). 5 (71.4%) patients required invasive mechanical ventilation during use of Negative pressure therapy based on clinical status. 4 (57%) patients received enteral nutrition. 1 (14%) patient required re-intervention posterior to definitive closure due to retroperitoneal abscess development. Outcome, evaluated by (oral tolerance, bowel movement and absence of pain), was favorable in all patients.Conclusion: Negative pressure therapy devices generate favorable results in hostile abdomen in pediatric population but further information is needed to assess pressure settings and device replacement frequency.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"37 1","pages":"37-41"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Usefulness of cell ratios and the derived neutrophil-to-lymphocyte ratio in the diagnosis of pediatric acute appendicitis. 细胞比率和衍生中性粒细胞与淋巴细胞比率在诊断小儿急性阑尾炎中的实用性。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-01-01 DOI: 10.54847/cp.2024.01.11

J C Moreno-Alfonso, A Molina Caballero, A Pérez Martínez

{"title":"Usefulness of cell ratios and the derived neutrophil-to-lymphocyte ratio in the diagnosis of pediatric acute appendicitis.","authors":"J C Moreno-Alfonso, A Molina Caballero, A Pérez Martínez","doi":"10.54847/cp.2024.01.11","DOIUrl":"10.54847/cp.2024.01.11","url":null,"abstract":"Objective: To analyze the accuracy of cell ratios in the diagnosis of pediatric acute appendicitis while introducing a new one -the derived neutrophil-to-lymphocyte ratio (dNLR).Materials and methods: An observational, retrospective study of patients aged 0-15 years old diagnosed with acute appendicitis (AA) and with non-surgical abdominal pain (AP) treated in our institution from 2021 to 2022 was carried out. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and dNLR were compared between groups.Results: 98 AA patients (30% of whom were female; age: 10 ± 3.3 years) and 97 AP patients (53% of whom were male; age: 9.3 ± 3.7 years) were included. NLR, MLR, PLR, and dNLR values were higher in AA patients than in AP patients: 9.6 IQR (interquartile range) 9.5 vs. 3.3 IQR 5.3: p< 0.0001; 0.7 IQR 0.6 vs. 0.46 IQR 0.7: p< 0.023; 199.8 IQR 163.9 vs. 134.0 IQR 129.2: p< 0.0001; and 5.29 IQR 3.9 vs. 2.39 IQR 2.7; p< 0.0001, respectively. Sensitivity, specificity, positive-negative predictive value, area under the ROC curve, and dNLR cut-off point for AA diagnosis were 70%, 78%, 77-72%, 0.811, and 3.98, respectively.Conclusions: Cell ratios are useful and cost-effective inflammatory parameters in the diagnosis of pediatric acute appendicitis. The results of this study suggest dNLR has the greatest clinical accuracy.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"37 1","pages":"11-16"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Results of transanal irrigation in intestinal dysfunction associated with anorectal malformations. 经肛门灌洗治疗与肛门直肠畸形有关的肠道功能障碍的结果。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-01-01 DOI: 10.54847/cp.2024.01.12

P L Roumieu, J Siffredi, V Di Benedetto, L Alvarez, M M Bailez

{"title":"Results of transanal irrigation in intestinal dysfunction associated with anorectal malformations.","authors":"P L Roumieu, J Siffredi, V Di Benedetto, L Alvarez, M M Bailez","doi":"10.54847/cp.2024.01.12","DOIUrl":"10.54847/cp.2024.01.12","url":null,"abstract":"Introduction: There are multiple tools available to optimize defecation in patients with anorectal malformation (ARM), such as habits, laxatives, and retrograde or anterograde irrigations, which are usually adapted in a progressive and combined fashion. The objective of this study was to assess the incorporation of transanal irrigation (TAI) to constipation and fecal incontinence treatment in patients with ARM.Materials and methods: A retrospective study of ARM patients with indication of TAI according to the colorectal pathology unit's intestinal management protocol from 2015 to 2022 was carried out. Following use for over 3 months, patients or their guardians completed a phone survey of our own approved by the ethics committee.Results: 39 ARM patients participated in the study. Pathologies included 11 rectourethral fistulas, 6 rectovesical fistulas, 16 cloacae, 2 rectovaginal fistulas, 2 perineal fistulas, and 2 vestibular fistulas. 44% of them had a sacral index < 0.4. 62% had constipation, and 38% had incontinence. Thanks to TAI, confidence and safety improved in a very high and a high degree in 89% of the patients, whereas time devoted to intestinal management decreased a lot in 68% of them. 79% reported a 9- and 10-point quality-of-life improvement. 92% rated overall satisfaction with TAI with a score of 8, 9, and 10 - 10 meaning \"completely satisfied.\" 100% recommend TAI.Conclusion: TAI is a good alternative for the intestinal management of fecal incontinence and constipation.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"37 1","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Infrequent associations of cutis marmorata telangiectatica congenita: a two-case report. 先天性毛细血管扩张症：两例报告。

Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Pub Date : 2024-01-01 DOI: 10.54847/cp.2024.01.15

J C Moreno-Alfonso, A Molina Caballero, A Pérez Martínez

{"title":"Infrequent associations of cutis marmorata telangiectatica congenita: a two-case report.","authors":"J C Moreno-Alfonso, A Molina Caballero, A Pérez Martínez","doi":"10.54847/cp.2024.01.15","DOIUrl":"10.54847/cp.2024.01.15","url":null,"abstract":"Introduction: Cutis marmorata telangiectatica congenita (CMTC) is a rare capillary malformation characterized by persistent reticular and violaceous erythema. We present two cases of CMTC.Clinical observation: The first case involved a 13-month-old male with a reticular violaceous macule on the left gluteal region and a brownish papule with Darier's sign on the inner malleolus of the left foot, which was biopsied, revealing > 15 mast cells per field, leading to a diagnosis of CMTC and solitary cutaneous mastocytoma. The second case involved a newborn with a characteristic CMTC lesion without other malformations at birth, who subsequently developed two cutaneous tumors consistent with infantile hemangiomas during follow-up.Discussion: CMTC is a benign condition. However, approximately 50% of cases exhibit associated anomalies. When CMTC is suspected, musculoskeletal, ophthalmological, and cutaneous malformations should be ruled out. To the best of our knowledge, this is the first report of CMTC associated with mastocytoma and one of the few cases associated with infantile hemangioma.","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":"37 1","pages":"33-36"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0