RESUMEN
Laparoscopic cholecystectomy has become the standard of care for cholecystectomy in adults and is rapidly gaining acceptance in children. However, its use in small children and infants had not been reported. Three young children (10, 15, and 25 months of age) underwent laparoscopic cholecystectomy without complication. Each child was discharged the morning after the procedure. No complications have been noted throughout the follow-up periods (2 months, 18 months, and 4 months, respectively).
Asunto(s)
Colecistectomía Laparoscópica , Preescolar , Colelitiasis/cirugía , Femenino , Humanos , Lactante , Recién Nacido , MasculinoRESUMEN
Initially the author began performing laparoscopic appendectomy in May 1988. From January 15, 1991 through June 1, 1992, 51 patients underwent laparoscopic appendectomy at Scottish Rite Children's Medical Center. The ages ranged from 3 to 16 years. There were 28 cases of acute appendicitis, eight of which were perforated. The remaining 23 appendectomies were performed for chronic abdominal pain with incidental appendectomy being performed during diagnostic laparoscopy.
Asunto(s)
Apendicectomía/instrumentación , Apendicitis/cirugía , Laparoscopios , Adolescente , Niño , Preescolar , Femenino , Humanos , Perforación Intestinal/cirugía , Masculino , Rotura Espontánea , Equipo Quirúrgico , Instrumentos Quirúrgicos , Técnicas de Sutura/instrumentaciónRESUMEN
Appendicitis remains the most common intraabdominal indication for surgery in children. Recently, barium enema has been helpful in increasing the accuracy of diagnosis in difficult cases. Experience with 202 barium enemas in children with abdominal pain entertaining the diagnosis of acute appendicitis revealed some of the problems encountered in using this procedure as a diagnostic tool. Of the 66 children who underwent surgery, there were 32 children who were felt to have a positive barium enema and 31 of these turned out to have acute appendicitis. In the group that had negative barium enemas, there were 3 false negatives and 2 of these children had early perforations by the time of their surgery. The third group were equivocal barium enemas and they pointed out the difficulty in obtaining a normal barium enema in a child who does not have appendicitis. It was felt that the use of barium enema as an adjunct was helpful especially if it were positive, but a negative barium enema could not be relied upon to delay surgery in the child with right lower quadrant peritoneal signs.
Asunto(s)
Apendicitis/diagnóstico por imagen , Sulfato de Bario , Enema , Enfermedad Aguda , Niño , Reacciones Falso Negativas , Reacciones Falso Positivas , Humanos , RadiografíaRESUMEN
Intussusception of the appendix is uncommon and an unusual cause of ileocolic intussusception. The pediatric age group is most often affected. Appendiceal intussusception may present as primary appendiceal invagination but more commonly leads to secondary intussusception. Two cases of partial appendiceal intussusception leading to secondary intussusception are presented. Classification, symptomatology, radiographic appearance, and differential diagnosis are discussed.