RESUMEN
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood with persistence into adulthood. It has a multifactorial etiology. Its chronicity, if diagnosis is missed or delayed, will result in significant negative impact on the individual's overall functioning and development. With the revised diagnostic criteria released in 2013 by the American Psychiatric Association, established standards of clinical practice continue to be applicable and valuable in the diagnosis and management of ADHD. In older children and adolescents, it is important to differentiate what is developmentally appropriate from problematic as ADHD has high correlation with poor outcomes, comorbidities, and low quality of life.
Asunto(s)
Pediatras/educación , Pediatría/tendencias , Pautas de la Práctica en Medicina/tendencias , Caracteres Sexuales , Sexismo/prevención & control , Niño , Educación Médica/métodos , Femenino , Predicción , Identidad de Género , Humanos , Lactante , Recién Nacido , Masculino , Pediatría/métodos , Factores Sexuales , Conducta Sexual , Estados UnidosRESUMEN
BACKGROUND: The objective of the study was to identify the presence of hydrosalpinx in postmenarchal nonsexually active girls in a children's hospital and to review the available literature on hydrosalpinx in this population. CASES: In a tertiary care children's hospital, we performed a retrospective review of charts from January 1, 2000 to December 31, 2014 and identified six cases of hydrosalpinx in postmenarchal nonsexually active female adolescents ranging in age from 12 to 19 years old. The diagnosis of hydrosalpinx was made using imaging studies. Four of six patients were symptomatic at presentation, and two patients were diagnosed when seen for unrelated reasons. Five of these six girls had previous abdominopelvic surgery. Four girls were given empiric antibiotic treatment for presumed pelvic inflammatory disease related to hydrosalpinx. Two patients required surgical intervention that resulted in complete resolution of the hydrosalpinx. The oldest patient in the series underwent ultrasound-guided drainage of the pyo- and/or hydrosalpinx with subsequent recurrence with tubal ovarian abscess five months later. SUMMARY AND CONCLUSIONS: The presence of hydrosalpinx might be discovered in the workup of pelvic pain in nonsexually active adolescents or on routine follow-up in patients with previous abdominal surgery, some of whom are asymptomatic. The underlying pathophysiology for hydrosalpinx in this population remains unclear. Among our cases, postsurgical adhesions appeared to be the most likely predisposing factor for tubular obstruction. Early detection and prompt diagnosis will allow for appropriate conservative or definitive treatment.