RESUMO
INTRODUCTION: Acute adhesive obstruction of the small intestine is a surgical emergency in which there is a risk of intestinal ischemia. By delaying diagnosis and institution of appropriate treatment for ischemic obstruction, morbidity and mortality increase. MATERIAL, METHOD AND RESULTS: The hospital records of 63 patients with diagnosis of intestinal obstruction and regional ischemia due to fibroadhesive peritonitis were reviewed in an attempt to identify criteria that could be used to separate patients who would require an emergency operation; 39 (61.9%) were male and three (4.7%) newborn. This complication was seen after 3 years of age in 39 patients (69.1%). Appendicitis was first cause with 26 cases (41.2%). Range of time of appearance after operation was from 1 week to 15 years (median 10 months). In 87% of patients the operation was a second procedure. All had gangrene and an enterostomy was constructed. General morbidity rate was 80%. Four children died. CONCLUSION: It is mandatory to identify which patients require non conservative management.
Assuntos
Enteropatias/etiologia , Intestinos/irrigação sanguínea , Isquemia/etiologia , Laparotomia/efeitos adversos , Peritonite/etiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Obstrução Intestinal/etiologia , Masculino , Aderências Teciduais/etiologiaRESUMO
INTRODUCTION: Retroperitoneal hematoma is frequently due lo blunt trauma and is a challenging problem. Incidence of this complication in adults is high, but in childhood is uncommon. MATERIALS AND METHODS: Analysis of 30 cases is presented. PTS was found between 10 and 12 points, zone II, 12, zone III, 17, and zone I, only one. We observed 33 associated injuries: 17 were pelvic fractures and nine, ureteral rupture. Three patients underwent hepatic or splenic laceration. Seventy-three percent of patients had exploratory laparotomy, but did not have exploration of retroperitoneum. CONCLUSIONS: Retroperitoneal hematoma in infancy should be treated conservatively.
Assuntos
Hematoma/cirurgia , Espaço Retroperitoneal , Adolescente , Criança , Pré-Escolar , Feminino , Hematoma/diagnóstico , Hematoma/etiologia , Humanos , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
INTRODUCTION AND OBJECTIVES: For decades, prestigious authors of surgical texts have established that intraperitoneal abscess should be managed by laparotomy, drainage of pus, and antibiotics. However, availability of new and more powerful antimicrobials have allowed for other therapeutic modalities. MATERIAL AND METHODS: Thirty children in whom clinical or sonographic presence of purulent collection in peritoneal cavity as consequence of appendectomy were studied. With Ethical Committee and parental consent, we filled out the corresponding protocol. We decided to carry out pre-and post-test sonogram and administration of gentamycin 5-7 mg/kg/day or cefotaxime 100 mg/kg/day IV for 10-14 days. RESULTS: There was improvement in all cases within the first 72 h and curing during the second week. No patient required laparotomy. Employment of antimicrobials was curative.
Assuntos
Abscesso/tratamento farmacológico , Abscesso/etiologia , Antibacterianos/uso terapêutico , Apendicectomia/efeitos adversos , Doenças Peritoneais/tratamento farmacológico , Doenças Peritoneais/etiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos ProspectivosRESUMO
Introducción. Debido a la elevada frecuencia de este fenómeno en las grandes ciudades, este tipo de heridas representa un serio problema para los servicios de urgencias de los hospitales. Las lesiones genitales, por otro lado, son muy frecuentes y las laceraciones y caídas son la causa y efecto más comunes; sin embargo, las heridas testiculares de escroto y prepucio como consecuencia del ataque por un perro son raras. Material y métodos. Estudio retrospectivo y observacional realizado a través de expedientes de varones no mayores de 15 años en los que se integró en forma completa el caso y con diagnóstico definitivo de afección de genitales externos secundaria a agresión por un perro, en el que se analizaron entre otras variables: edad, procedencia, circunstancias, sitio y tipo de lesión. Resultados. Se estudiaron 8 pacientes entre los 6 y los 12 años de edad en quienes se encontró lesión testicular, escrotal o prepucial debido a mordedura por perro. Cinco de los animales fueron mestizos y tres de raza rotweiller. Las circunstancias fueron diversas, en todos fue suficiente la reparación primaria y no hubieron complicaciones. Conclusiones. El grupo de pacientes es pequeño, sin embargo, se puede concluir que este tipo de eventos son de presentación dramática, de fácil manejo y buen pronóstico.