Bronchial foreign body: should bronchoscopy be performed in all patients with a choking crisis?

The aspiration of a bronchial foreign body (FB) remains a common pediatric problem with serious and sometimes fatal sequelae. The diagnosis is often delayed or overlooked. With the aim of determining a reliable clinical and/or radiologic finding to indicate the requirement for bronchoscopy, 100 patients admitted to our hospital because of FB aspiration who underwent rigid bronchoscopy were retrospectively studied.

[Treatment with Ethibloc of lymphangiomas and venous angiomas].

Lymphangioma and venous angioma are a group of pathological entities which have required surgical treatment since years. Extension, localization and poor delimitation of some lesions have resulted in technical difficulties and serious complications. Our group began the sclerosing therapy with an injection of fibrin adhesive and, due to the lack of response in the first patient, a program with Ethibloc as an alternative substance was developed.

[Outcome of hypertrophic pyloric stenosis after pyloromyotomy].

Twenty four patients diagnosed and operated of hypertrophic pyloric stenosis were examined by ultrasonography at diagnostic and sequential after pyloromyotomy. We measured pyloric diameter, thickness and length of the muscle and we calculated the pyloric volume. The overall configuration of the pylorus is more important than specific pyloric dimensions for diagnosis.

Recurrent tracheoesophageal fistula treated with fibrin glue.

Recurrent tracheoesophageal fistula (RTF) after repair of esophageal atresia with tracheoesophageal fistula is a serious complication, with the need for a second operation. The mortality rate is high. The authors report on the eradication of RTF using fibrin glue.

[A new method for the measurement of the anatomical development of the muscle complex of the anus in children with anorectal malformations].

We present a new method for the measurement of the anorectal muscle complex. We studied 40 children with anorectal malformation (14 low and 16 high). Taking the perineal TAC with a rectal probe and quotient called "C": [formula: see text] A "C" value less than 0.

[Whole gut irrigation in pediatric patients: a comparative study].

The observation of hydroelectric and pH changes, as well as the diminishing incidence of postoperative infections in pediatric patients, subjected to digestive irrigation (D.I.) before surgery, was the reason for carrying out this paper, fundamentally directed at two objectives: Firstly, to determine the hydro-ionic and clinical repercussions by means of a comparative study of the two most used irrigations solutions and secondly, to analyze the modifications that the D.

[The treatment of esophageal achalasia in children by endoscopic pneumatic dilatation. A report on 4 cases].

Four patients underwent pneumatic endoscopic dilatation of achalasia at the La Fe Children's Hospital have been studied. Endoscopic pneumatic dilatation has been performed in only one session with four dilatation maneuvers. In the absence of complications, the patients were only hospitalized for twenty-four hours.

[Caustic burns of the stomach secondary to ingestion of acid in infants: importance of fibro-endoscopy].

Two cases of corrosive burns of the stomach after the ingestion of acid by children are presented. Both patients were the same sex and of a similar age (19 and 20 months). The chemical nature of the caustic substance ingested (hydrochloric acid) and the lack of initial symptoms were also similar.

Study of appendicitis in children treated with four different antibiotic regimens.

This is a prospective and randomized study of 100 patients with acute appendicitis who were less than 10 years old, in which four different antibiotic regimens commonly in use against gram-negative and anaerobic bacteria were compared in terms of postoperative septic complications. The antibiotics were begun immediately preoperatively and continued for five days. Ten percent of the patients developed infection complications, with 4% requiring further surgery.

[Laparoscopy in pediatrics].

Laparoscopy has been performed in 68 infants and children. In 50 cases of non-palpable testis; 7 cases of liver diseases; 4 cases of abdominal trauma; 7 cases for various other indications. In our experience, laparoscopy was a considerable advantage in the diagnosis and management of a number of pediatrics disorders.

[Postoperative obstructive abdominal complications in children].

In the pediatric surgical Department of the "Le Fe" Hospital, from January 1971 to December 1982 2,350 laparotomies were performed in neonates, infants and children. In 67 patients abdominal surgery was complicated by bowel obstruction for which a second laparotomy had to be performed. In 86.

[Gastric duplication. Presentation of 4 cases localized in the antropyloric region].

Gastric duplications are very rare, especially those located at the pyloric region. Four cases are reported with gastric duplication in patients of two days, eight months, two and a half and three and a half years old, a review is made including symtomatology, diagnostic, treatment and anatomopathological studies. In all four cases post-operative evolution was satisfactory.

[Treatment of portal hypertension in children].

Esophageal transection by means of an anastomotic clip or button is a simple and useful approach to the management of haemorrhage due to esophageal varices. We have used this technique in four cases (three Prioton clips, and one autosuture) and completed the procedure with periesophageal, left gastric and fundal veins ligation. The patients have been followed up for periods ranging between five months and six years.

[Benign tumors of the spleen in pediatrics].

Primitive bening spleen tumors are very rare in pediatrics. They can be solid or cystic. Authors report two cases of spleen tumors: one hamartoma of red pulp in a 4 1/2 year old male, with symptoms of an enlarged spleen and immunological deficit; and the other case a simple cyst, that developed as an enlarged spleen, lined by mesotelium.

[Ovarian intestial syndrome. (authors transl)].

Authors report the case of a newborn with a sudden picture of abdominal distension, bilious vomiting and blood stools due to a twisted ovarian cyst with ileal volvulus. Patient cured after surgical excision of both ovary and necrotic bowel. A high perinatal gonadotrophic activity could be at the origin of neonatal ovarian cycts.

[Inguinal hernia and testicular feminization in childhood (author's transl)].

Three cases of Morris Syndrome were detected among 103 girls admitted to the hospital for inguinal hernia. Diagnosis was made possible by routine sexual chromatine study in oral mucosa smear, but it can also be suspected when familial antecedents of amenorrhea exist. An early diagnosis of this condition is imperative in order to provide the patient with an adequate medical and surgical management, including the conservation of the gonads until pubertal age.

[Neonatal necrotizing enterocolitis (author's transl)].

Authors present analysis of 31 cases of necrotizing enterocolitis, which where treated medically as well surgically. Etiology is discussed and perinatal accidents are considered. An analysis of symptomatology and radiological study is made, both being deciding factors as to whether a surgical intervention is necessary.

[Sequelae of necrotizing enterocolitis in newborns (author's transl)].

The authors report a new aspect of NEC which can be at the origin of symptoms appearing late in the clinical course. These sequelae, consisting of colic strictures, can be observed in all patients both medically and surgically treated. The five cases presented were observed among the 21 medically managed of which they represent 23.

[Digestive atresia and associated malformations (author's transl)].

The authors report a study on the associated malformations found among 143 cases of digestive atresia at various levels. They are classified as single, multiple, single with trisomy and multiple with trisomy. Malformations are analysed in quality and quantity depending on the organ affected and the digestive level bearing the atresia.