Massive hemorrhage from spontaneous rupture of a retroperitoneal lymph node in patient with metastatic mixed germ cell tumor.

Spontaneous hemoperitoneum secondary to metastatic foci of testicular germ cell tumor is a rare finding and is usually precipitated by the beginning of chemotherapy treatments. This acute presentation is usually due to the rupture of hepatic or gastrointestinal metastasis. We present the case of a 16-year-old boy who was admitted to the emergency room with acute abdominal pain and unstable vital signs, 10 days after a left orchiectomy for a testicular mixed nonseminomatous tumor.

Hereditary multiple intestinal atresia: thirty years later.

Background: Hereditary multiple intestinal atresia (HMIA) is an unusual form of intestinal atresia with a presumed autosomal recessive mode of inheritance. The aim of this study was to review the authors' experience with this disease, 30 years after its first description.

Methods: All cases of HMIA treated at the authors' institution were reviewed with a particular focus on presence of close consanguinity in the families, prenatal diagnosis, radiologic and surgical findings, pathology report, and outcome.

Laparoscopic appendectomy in children: A favorable alternative in simple and complicated appendicitis.

Background/purpose: The laparoscopic treatment of pediatric appendicitis remains controversial, particularly in complicated cases (gangrene and perforation). This study evaluates outcomes of open (OA) and laparoscopic appendectomy (LA).

Methods: The 391 cases of pediatric appendectomy performed between January 1998 and January 2001 were reviewed for age, sex, weight, type and length of intervention, operative description, antimicrobial therapy, analgesia, complications, length of hospitalization, and histopathology.