Saccular aneurysm in arm secondary to accidental arterial puncture.

We present a rare case of saccular aneurysm localised in the arm of a breast-feeding baby, secondary to accidental arterial puncture. Colour Doppler echography showed a cystic lesion with turbulent arterial flow related to the humeral artery. Complete surgical resection of the aneurysm was achieved.

[Recto-sacral fixation in the treatment of rectal prolapse refractory to conservative treatment].

Introduction: The clinical cases of 20 patients submitted to Reifferscheid intervention (fixation of rectum to promontorium) between 1967 and 1997 are presented.

Patients And Methods: Twenty patients have been treated by means of the operation of Reifferscheid. They were divided in two groups: from 1967 to 1972, ten patients were submitted to this technique (group A).

[The superficial midline cervical cleft].

Given the anatomy and the histology of the 4 cases of children with a midline cervical cleft presented in this work, and after reviewing the specific literature, an etiologic relationship between: this congenital malformation and the subcutaneous midline cervical bronchogenic cyst can be established. The presence of pseudostratified ciliated columnar epithelium in both entities and their anatomic relationship are determinant. The anatomic differences with the thyroglossal duct cyst indicated that their embryological origins were different, in spite of the presence of ciliated epithelium.

[Surgical stress and hypophyseal-adrenal activation in childhood].

Introduction: The study on the physiological alterations due to surgical aggression (surgical stress), widely investigated in adults, is less known in paediatric age.

The Objective: Of this work is to quantify surgical stress (evaluated by means of Oxford Scale as high or low depending on its value bigger or lower than 6), after determining changes of plasmatic concentrations of ACTH, beta-endorphin and cortisol in operated children.

Patients And Methods: Observational analytic design of a prospective cohort with internal comparison of the groups.

[Efficiency of ultrasonography in the diagnosis of acute appendicitis].

Unlabelled: Importance of the problem. Atypical or precocious presentation of acute appendicitis in children causes false diagnosis.

Objectives: To determine internal and external validity of ultrasonography for confirmation diagnosis of acute appendicitis.

[Cancer-cryptorchism meta-analysis].

Introduction: Testicular cancer in adult and young patients with cryptorchidism (operated or not operated on) has been reported previously, but its epidemiological impact (as concept to profile cancer and/or therapeutical result of cryptorchidism based on quantitative dates) is not defined actually.

Objective: Determination by quantitative meta-analysis of the strength of relation (relative risk = RR) cancer and cryptorchidism and by qualitative meta-analysis of factors of cryptorchidism (anatomical position of teste, age of intervention, testicular biopsy) associated to cancer.

Results: Case-control and cohort studies of medical literature have been included in this report.

[Alterations of nuclear maturity in spermatozoids of males with antecedents of cryptorchidism].

The association between infertility and cryptorchidism is an accepted fact, usually attributed to the oligozoosperm, asthenozoosperm or teratozoosperm presented in ejaculation products of males with this antecedent. The nuclear maturity in a sample of men with antecedents of cryptorchidism have been studied and these results have been compared to those of a control group. The results of this work show the deficient transformation of nuclear proteins to protamines in males with antecedents of cryptorchidism compared to the control group, due to the remaining of immature histones.

Hormonal response to surgical stress in schoolchildren.

Purpose: To determine hormone concentrations (ACTH, cortisol, beta-endorphin) in children before and after surgery, to assess the correlation between any hormonal changes and to study the influence exercised on them by the severity of surgical stress and the elective/emergency nature of the surgery.

Patients And Methods: Prospective cohort of 78 children (age= 10+/-2.6 years, range 6-13 years) undergoing elective or emergency surgery.

Cardiac injury from an air gun pellet: a case report.

Air guns are tools which each day become more powerful serious or even fatal accidents are caused by them. We report the clinical case of a 10-year old patient who received an accidental shot puncturing the right auricle, with generation of an important hemopericardium. A favorable evolution followed conservative treatment.

Scrotal lymphangioma in children.

The intrascrotal localization of lymphangioma in children is uncommon, especially when the lymphangioma does not depend on testicular structures. We present the case of a 13-year-old male who started with a right intrascrotal mass unconnected with the testicle, clinically and ultrasonically compatible with cystic lymphangioma. The mass was excised because of progressive growth over the previous 5 months, and at surgery a scrotal lymphangioma was disclosed projecting towards the umbilical area through the subcutaneous cell tissue of the anterior abdominal wall.

[Deferred appendectomy in a case of appendiceal mass].

The treatment of acute appendicitis when appendix is technically impossible to remove, remains controversial. The clinical case of a 12-years-old child diagnosed of acute appendicitis in which appendectomy was not initially performable is presently described. After treatment with antibiotics, he was submitted to appendectomy five months later.

[Macrostomia secondary to transverse facial cleft of Tessier No.4].

A case of bilateral macrostomia type transverse facial cleft of Tessier n. 4 is reported, which was operated on with good results when had ten months of age, repaired using suture of three planes of three embryonic folds. A treatment plain precocious is recommended and pathogenic theories about this uncommon entity are exposed.

[Gonadal, hormonal and spermatic function in patients treated for cryptorchidism].

This paper studies the gonadal-hormonal and spermatic function of 48 adults (over 18 years old) who were treated in childhood for cryptorchidism by medical, surgical or both treatments. We measure plasmatic levels of FSH, LH, testosterone and prolactin of 34 patients and sperm samples of 31 patients. The testicular hormonal function was not disturbed except in four patients with high levels of prolactin (> 20 ng/ml) without symptoms.

[The usefulness of ultrasonography in the diagnosis of acute appendicitis in children].

The main objective of the present report was the evaluation of the utility of echography as a diagnostic method in abdominal pain suspicious of acute appendicitis. A control-case study was performed in 165 children hospitalized for abdominal pain. Appendicitis histologically confirmed were considered cases (n = 110) while control (n = 55) were the not-operated patients (46 children) or the not-confirmed appendicitis after laparotomy (n = 9).