Purpose This study was undertaken to compare the effectiveness of ultrasound-guided Hartmann's solution enema (US-E) and radiological liquid enema (RX-E) in reducing idiopathic ileocecocolic ...intussusceptions in relation to patient age and symptom duration. Materials and methods The study group consisted of 42 patients with idiopathic ileocecocolic intussusception treated with US-E (20 patients) or RX-E (23 patients), with one patient undergoing both procedures owing to recurrence. Patients were divided into subgroups according to age (<6 months, 6--12 months, >12 months) and symptom duration (<12 h, 12--24 h, >24 h). Results Complete reduction was achieved in 15/20 patients treated with US-E (75%) and in 10/23 treated with RX-E (43.5%) (p=ns). Recurrence was observed in 1/20 US-E and 0/23 RX-E (p=ns) patients. No complications were encountered. US-E had a significantly higher success rate than RX-E in patients >12 months (p=0.0063) and with symptom duration >24 h (p=0.0361). No differences were found in the other subgroups (p=ns). Conclusions US-E and RX-E are procedures of comparable value and safety in reducing idiopathic intussusception. US-E seems to be more effective in patients >12 months or with symptom duration >24 h. As US-E avoids radiation exposure, it should be considered the first-choice procedure for reducing idiopathic ileocecocolic intussusception, particularly in these two subgroups of patients. Obiettivo Scopo del presente lavoro e stato confrontare l'efficacia del clisma eco-guidato con soluzione di Hartmann (US-E) e del clisma radiologico liquido (RX-E) nella riduzione dell'invaginazione idiopatica ileo-cecocolica, in rapporto all'eta e al tempo d'insorgenza della sintomatologia. Materiali e metodi Sono stati inclusi nello studio 42 pazienti ricoverati consecutivamente per invaginazione idiopatica ileo-ceco-colica e sottoposti a US-E (20 casi) o a RX-E (23 casi), con 1 paziente trattato con entrambe le procedure per recidiva dell'invaginazione. La popolazione e stata divisa in sottogruppi per eta (<6 mesi, 6--12 mesi, >12 mesi) e per durata della sintomatologia (<12 ore, 12--24 ore, >24 ore). Risultati La riduzione completa dell'invaginazione e stata ottenuta in 15/20 US-E (75%) e in 10/23 RX-E (43,5%) (p=ns). L'invaginazione e recidivata in 1/20 US-E e 0/23 RX-E (p=ns). Non sono state osservate complicanze. Il US-E e risultato piu efficace del RX-E nei pazienti di eta maggiore di 12 mesi (p=0,0063) e nei casi in cui c'e stato esordio della sintomatologia da meno di 24 ore (p=0,0361). Conclusioni Il US-E e il RX-E sono procedure di efficacia e sicurezza sovrapponibili nella riduzione dell'invaginazione intestinale idiopatica. Il US-E risulta piu efficace nei pazienti di eta superiore ai 12 mesi e nei casi in cui c'e stato esordio della sintomatologia da piu di 24 ore. Poiche il US-E non comporta esposizione radiologica, e da considerarsi metodica di prima scelta per la riduzione dell'invaginazione idiopatica ileo-ceco-colica, in particolare in questi due sottogruppi di pazienti.
Purpose:
This is a collaborative study carried out by Pediatric Surgeons of the “G.D'Annunzio” University and the Regional Association of Down Children of Abruzzo (Italy).
Methods:
Data were ...collected of malformations combined with Down Syndrome (DS) during a 10-year period in a population of defined age to look for a possible improvement of the patients' life conditions. Reportedly, 50% of these patients may reach an age of about 60 years.
Results:
One hundred twenty-seven DS subjects from this region were evaluated, 54% of whom had associated malformations (13% cardiac, 41% extracardiac, and 13% both). Seventeen patients of 53 underwent surgery for extracardiac malformations, with gastrointestinal malformations prevailing. The largest number of DS babies were born from mothers under 30 years of age; this is attributed to the largest birth rate and the least prevention at this age. Mothers older than 38 years gave birth to DS babies with the lowest rate of associated malformations.
Conclusion:
The role of the pediatric surgeon in multidisciplinary assistance for DS patients is stressed.
Ectopic location of the vas deferens is a rare congenital anomaly with multiple variations. The frequent association with ano-rectal abnormalities and hypospadias is well known. We report two cases ...of a newborn and a 3-year-old child with ectopic vas deferens coupled with a left multicystic kidney without any ureteral structure. Furthermore, the latter had a contralateral vesicoureteral reflux and anal agenesis with recto-bulbar fistula. Our attempt with this report is to explain the development of such anomalous deferential outlet into the multicystic kidney, according to the most qualified theory of the Wolffian duct embryology.
Cisti ovariche Chiesa, P. Lelli; Lisi, G.
Videochirurgia pediatrica
Book Chapter
L’eziologia delle cisti ovariche varia in funzione dell’età — fetale/neonatale, prepubere, adolescenziale — determinando differenze diagnostico-terapeutiche.
Anterior chest wall deformities in children are the expression of some congenital malformation such as Poland's syndrome and pectus excavatum. The surgical treatment of these malformations affecting ...children is aimed at correcting large wall defects and stabilizing the chest wall, assuring at the same time chest harmonious growth and postoperative functional assessment. We present the results of the treatment of 2 cases of Poland's syndrome, 20 cases of pectus excavatum and 2 cases of pectus carinatum, with a follow-up of 6 months--9 years.
