Morgagni-Larrey hernia correction by laparoscopic surgery.

A new method of closure of Morgagni-Larrey hernia by video-assisted surgery is described in a child. Laparoscopy could in our opinion be an advantageous method for treatment of diaphragmatic defects.

[Pulmonary decortication through thoracoscopy in pediatric age].

The authors present the case of a 14 year old child who was successfully treated by pulmonary decortication with video-assisted thoracoscopy. Thoracoscopy caused less postoperative pain then open thoracoscopy, although it allows visualization of the entire pleural cavity. In our opinion an early use is indicated.

[Gastric volvulus in childhood].

Gastric volvulus in children might be observed both as an acute form, characterized by gastric necrosis with sudden perforation and patient's death and as an idiopathic or chronic form with a less severe insurgence that causes epigastric pain, vomit and gastric distension. The latter could resolve spontaneously but recurs frequently. The acute form rises in newborns and toddlers and is often associated with a diaphragmatic defect; the idiopathic forms are correlated on the opposite to a fixation deficit of the stomach which is held in place by the gastro-colic, gastro-hepatic, gastro phrenic and gastro-splenic ligaments.

Malignant melanoma in a three-year-old child.

Malignant melanoma is an uncommon tumor in childhood. We report on a case occurring in a 3-year-old child with congenital multiple melanocytic nevi.

[Transplantation of the left lung in a 2-month-old piglet. The Study Group for Lung Transplantation].

Experimental surgery in animals remains an irreplaceable model for the clinical application of a new technique. We performed a single lung allotransplantation in young pigs. The pigs were organized into groups: 1) 6 to assess the surgical anatomy; 2) 10 to receive left transplantation; 3) 3 to study the pathophysiology of the transplanted lung.

Postnatal ultrasound screening of urinary malformations.

We performed routine neonatal ultrasound screening on 3,454 neonates in the first week of life to establish the real incidence of congenital uropathy. Pronounced anomalies were found in 36 cases (1.04%) and mild renal pelvis dilatation in 159 (4.

Effectiveness of partial splenic embolization as treatment for hypersplenism in thalassaemia major: a 7-year follow up.

Partial splenic embolization is an alternative procedure to total splenectomy in patients with hypersplenism, and was performed in 10 patients with beta-thalassaemia major who were then followed for 5 to 7 years. The results were compared with those of a 7-yr follow-up of 6 splenectomized thalassaemics. The blood consumption decreased and the leucocyte counts increased in both groups of patients.

[Sickle cell anemia in surgical patients. Significance and problems].

Drepanocytosis, a disease notoriously widespread among blacks, is surprisingly frequent in certain Italian islands. Surgical aspects of the disease are discussed: erythrocyte sequestration attacks, pigmentary cholelithiasis, priapism, malleolar ulcers and vaso-occlusive attacks. A knowledge of such aspects is considered fundamental for the purposes of a reasoned differential diagnosis in the field of paediatric pathologies requiring surgery.

[Anesthesia and sickle cell disease].

Sickle cell anaemia is the most common hereditary haemoglobin pathology. It is found in either a homozygous or heterozygous form, associated in the latter case with other haemoglobinopathies. In view of the pathogenesis and the various related imbalances, amply confirmed by others, which can well prove disastrous, the pre, per and post-operative precautions to be adopted in such patients are assessed.

[Experimental intrauterine surgery. Morphological study of lung development in the sheep fetus with congenital diaphragmatic hernia].

Experimental comparison of the lungs of 7 sheep foetuses with surgically induced CDH and 7 controls permitted an assessment to be made of the changes that take place in lung growth, generally described as hypoplasia, through a study of their morphology and histology, and the lung: lamb weight ratio. Changes increased in gravity in function of the duration of hernia. They included: reduced alveolar expansion, fewer generations of bronchi and alveoli, and septal thickening.

[Muscle transplantation as a means of achieving continence in ano-rectal atresia].

Correction of incontinence as the sequel of a pull-through operation for anorectal atresia, leaving aside cases due to a mistake of the surgical technique, is based on the construction of a new sphincter. This can be done in several ways, using striped, pedicled, denervated, free, or, more recently, smooth muscle. The techniques, objectives, and results are described with reference to the latest data in the literature.

[Adrenal hemorrhage in the newborn. Diagnostic problems and presentation of a case].

Adrenal haemorrhage is not an exceptional event in the newborn. The probable predisposing factors are difficult delivery, fetal hypoxia, trombocytopenia and coagulation defects. The recommended therapeutical approach is conservative, even if some Authors prefer surgical evacuation of the haematoma.

[Experimental intrauterine surgery: the creation of a congenital diaphragmatic hernia in a sheep fetus].

Up to 50% of the neonates operated during the first hours of life for a congenital diaphragmatic hernia die. The presence of a severe lung hypoplasia, which is at the origin of hypoxia, acidosis, increased pulmonary vascular resistance and right to left shunt, explains the poor clinical results, in spite of surgical success and intensive therapy. A modern approach to the problem includes treatment with pulmonary vasodilator drugs, whose effects are still discussed.

[Hirschsprung's disease in adolescents and adults].

Megacolon must be considered as a diagnosis in any case of intractable constipation also in the adult. Besides the Hirschsprung's disease and the idiopathic megacolon, which have no apparent organic cause, many other pathologic conditions may produce a marked dilatation of the large bowel. The differential diagnosis depends, after a valuation of the clinical and radiologic features, also from enzymatic, histologic and functional tests.

Suprarenal abscess in a newborn.

A case report of a new born with unilateral suprarenal abscess extending in to the right kidney is represented. Both the adrenal gland and the kidney had to be surgically removed. Early diagnosis is important, so the surgical intervention, the only successful therapy, can be kept as conservative as possible.

Ureterosigmoidostomy and cancer of the colon. Report of a case.

A possible and quite frequent complication of uretero-sigmoidostomy can be the late development of a colic cancer at the site of the ureteric reimplantation. On the basis of the literature and of a personal observation, the accent is put on what can be done to discover the tumor in any early phase; the possibility that the increased risk of cancer should limit the colic urinary diversions for an exstrophy of the bladder is also discussed.

Duodenal obstruction due to a preduodenal portal vein in a newborn.

Intestinal obstruction due to a preduodenal portal vein is rare. A case report illustrates the possibility that in the newborn this vascular anomaly, which is often symptomless, may lead to intestinal obstruction requiring surgical correction.

[Scintiscanning with technetium-99m pertechnetate in the diagnosis of Meckel's diverticulum].

Personal experience with technetium99m pertecnetate scanning in the diagnosis of Meckel's diverticulum is reported. The data reported indicate that the scan can be considered positive when the lower right quadrant of the abdomen shows a definite accumulation of radioactivity. Of 12 children examined, 4 responses were positive.