European Journal of Pediatric Surgery Reports最新文献

英文中文

Pyloric Mucosal Diaphragm Associated with Hypertrophic Pyloric Stenosis: An Unusual Combination in a Male Neonate. 幽门粘膜膈与肥厚性幽门狭窄相关:男性新生儿的不寻常组合。

IF 0.6 Q4 SURGERY

European Journal of Pediatric Surgery Reports

Pub Date : 2020-01-01 Epub Date: 2020-08-07 DOI: 10.1055/s-0040-1713809

Eugenie Chariot, Anna Poupalou, Julie Estievenart, Martine Dassonville, Erwin Vanderveken, Henri Steyaert

We describe herein the case of a 3-week-old baby with persistent nonbilious vomiting, due to a hypertrophic pyloric stenosis (HPS) associated with a congenital pyloric mucosal diaphragm. So far, an association between the two conditions has not been described. The diagnosis of a pyloric mucosal diaphragm was delayed because of its cooccurrence with HPS.

我们在此描述一个3周大的婴儿持续的非胆汁性呕吐，由于肥厚性幽门狭窄(HPS)与先天性幽门粘膜膈。到目前为止，还没有人描述这两种情况之间的联系。幽门粘膜膈的诊断被延迟，因为它与HPS的合并。

引用次数: 1

Combined Pre- and Postnatal Minimally Invasive Approach to Complicated Pulmonary Sequestrations. 复杂肺隔离的产前产后联合微创治疗。

IF 0.6 Q4 SURGERY

European Journal of Pediatric Surgery Reports

Pub Date : 2020-01-01 Epub Date: 2020-09-18 DOI: 10.1055/s-0040-1713901

Martina Ichino, Francesco Macchini, Anna Morandi, Nicola Persico, Isabella Fabietti, Andrea Zanini, Ernesto Leva

Abstract Pulmonary sequestration (PS) is mostly asymptomatic but there is a proportion of fetuses that develop hydrops, leading to fetal or neonatal death. Fetal treatments are available, but postnatal management of the residual lesions is not uniformly defined. We present two cases of combined pre- and postnatal minimally invasive approach to complicated extra-lobar PS. Patient 1 presented with complicated PS at 31 weeks of gestation. Ultrasound-guided laser coagulation of the anomalous artery was successful. The patient was born asymptomatic at 38 weeks. Neonatal magnetic resonance imaging (MRI) showed a residual mass, confirmed by computed tomography (CT) at 6 months. No systemic artery was described, but perfusion was present. We decided for thoracoscopic resection. A residual artery was identified and sealed. Patient 2 presented with complicated PS at 25 weeks of gestation, underwent laser coagulation of the anomalous artery and was born asymptomatic at 38 weeks. Neonatal MRI showed persistence of the lesion, confirmed by CT scan at 4 months. We proceeded with thoracoscopic resection. A residual vessel was ligated. The patients 1 and 2 are now 24 and 21 months old, respectively, and healthy. Prenatal treatment of complicated PS is a life-saving procedure. Postnatal thoracoscopic resection of the residual lesion is feasible and safe; we believe it is the best course of treatment to grant the complete excision of the malformation.

肺隔离(PS)大多无症状，但有一部分胎儿出现积水，导致胎儿或新生儿死亡。胎儿治疗是可行的，但产后对残余病变的处理没有统一的定义。我们报告了两例产前和产后联合微创入路治疗复杂的叶外PS。患者1在妊娠31周时出现复杂的PS。超声引导激光凝固异常动脉成功。患者在38周出生时无症状。新生儿核磁共振成像(MRI)显示残留肿块，6个月时通过计算机断层扫描(CT)证实。未见全身动脉，但有灌注。我们决定做胸腔镜切除。发现了一条残留的动脉并将其封闭。患者2在妊娠25周时出现了复杂的PS，对异常动脉进行了激光凝固治疗，38周出生时无症状。新生儿MRI显示病变持续存在，4个月时CT扫描证实。我们进行了胸腔镜切除。结扎了残留的血管。患者1和2现在分别是24个月和21个月，健康。产前治疗复杂的PS是一个挽救生命的过程。产后胸腔镜切除残留病变可行、安全;我们相信完全切除畸形是最好的治疗方法。

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引用次数: 4

A Hirschsprung Pull-through, "with a Twist". Hirschsprung pull through，“with A Twist”。

IF 0.6 Q4 SURGERY

European Journal of Pediatric Surgery Reports

Pub Date : 2020-01-01 Epub Date: 2021-01-09 DOI: 10.1055/s-0040-1717128

Hira Ahmad, Devin R Halleran, Raquel Quintanilla, Alessandra C Gasior, Richard J Wood, Marc A Levitt

Hirschsprung disease is the most common neurocristopathy in children, resulting in the congenital loss of enteric ganglia. Surgery, which involves resecting the aganglionic segment and restoring bowel continuity, usually results in a good outcome; however, some patients suffer from multiple episodes of enterocolitis and other obstructive symptoms. A contrast enema, examination under anesthesia, and rectal biopsy can identify the cause of obstruction in many cases, including a rare explanation, a twist of the pull-through, a case of which we present here.

先天性巨结肠疾病是儿童最常见的神经系统疾病，导致先天性肠神经节缺失。手术，包括切除神经节段和恢复肠的连续性，通常会产生良好的结果;然而，有些患者会出现多次小肠结肠炎和其他阻塞性症状。对比灌肠、麻醉下检查和直肠活检可以在许多情况下确定梗阻的原因，包括一种罕见的解释，扭曲的拉通，我们在这里介绍的一个病例。

引用次数: 3

An Unusual Case of Syringohydromyelia Presenting with Neurogenic Bladder 以神经源性膀胱为表现的脊髓脊髓水肿1例

IF 0.6 Q4 SURGERY

European Journal of Pediatric Surgery Reports

Pub Date : 2019-01-01 DOI: 10.1055/s-0039-1697925

A. Geljić, S. Abdovic, Fran Štampalija, Lana Lončar, B. A. Tripalo, M. Cuk

Abstract We report the case of a 4-year-old boy who first presented with acute pyelonephritis at the age of 6 months. Diagnostic workup revealed high-grade bilateral vesicourethral reflux (VUR). At the age of 18 months, a bulking agent was used to treat bilateral VUR. Since the VUR persisted, an open bilateral Lich-Gregoir procedure was done at the age of 3 years. Immediately after surgery, he developed acute urinary retention with hydronephrosis that resolved with the placement of dwelling urinary catheter. After removal of the catheter urinary retention relapsed so placement of suprapubic urinary catheter was indicated since he did not have sensory loss. He was started with tamsulosin (α − 1-blocker) and prophylactic antibiotics. Urodynamics were performed and suggested bladder outlet obstruction. On the basis of previous urethroscopy and the absence of neurological sequelae, the differential diagnosis of Hinman syndrome was made. After removal of the suprapubic catheter, clean intermittent catheterization was started and α-blocker continued. However, magnetic resonance imaging of the brain and the spinal cord revealed syringohydromyelia extending from thoracic spine (Th5) to conus medullaris with 6 to 7 mm in diameter. Electromyoneurogram was normal. After a follow-up of 3 years, the hydronephrosis has resolved. The patient is on clean intermittent catherization and has no urinary tract infections.

摘要我们报告的情况下，一个4岁的男孩谁首次提出急性肾盂肾炎在6个月大。诊断检查显示高度双侧膀胱尿道反流(VUR)。在18个月大时，使用填充剂治疗双侧VUR。由于VUR持续存在，在3岁时进行了开放的双侧Lich-Gregoir手术。手术后，他立即出现急性尿潴留伴肾积水，并在放置留置导尿管后得到缓解。拔管后尿潴留复发，由于患者无感觉丧失，需放置耻骨上导尿管。患者开始使用坦索罗辛(α−1阻滞剂)和预防性抗生素。行尿动力学检查，提示膀胱出口梗阻。在既往尿道镜检查及无神经系统后遗症的基础上，对Hinman综合征进行鉴别诊断。拔除耻骨上导管后，开始清洁间歇置管，继续使用α-阻滞剂。然而，脑和脊髓的磁共振成像显示脊髓积水从胸椎(Th5)延伸到髓圆锥，直径6至7mm。肌电图正常。经过3年的随访，肾积水已经消失。患者进行清洁间歇导尿，无尿路感染。

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引用次数: 2

Pullthrough Operation for Hirschsprung's Disease: Importance of a Circumferential (Donut) Biopsy at the Level of the Anastomosis 先天性巨结肠的拔出术：吻合口层面环形（环形）活检的重要性

IF 0.6 Q4 SURGERY

European Journal of Pediatric Surgery Reports

Pub Date : 2019-01-01 DOI: 10.1055/s-0039-1693494

Susan Jehangir, S. Soundappan, Micheal Krivanek, S. Arbuckle, N. Graf

Abstract Hirschsprung's disease is characterized by the absence of ganglia in the distal colon, resulting in a functional obstruction. It is managed by excision of the aganglionic segment and anastomosis of the ganglionated bowel just above the dentate line. The level of aganglionosis is determined by performing multiple seromuscular biopsies and/or full thickness biopsy on the antimesenteric border of the bowel to determine the level of pullthrough. The transition zone is described as being irregular, and hence a doughnut biopsy is recommended so that the complete circumference can be assessed. Herein, we described a child in whom there was a selective absence of ganglion cells in 30% of the circumference of the bowel along the mesenteric border for most of the transverse colon. This case defies the known concept of neural migration in an intramural and transmesenteric fashion and emphasizes the importance of a doughnut biopsy of the pulled-down segment.

摘要先天性巨结肠的特点是远端结肠缺乏神经节，导致功能性梗阻。它是通过切除无神经节段和吻合齿状线上方的神经节肠来治疗的。无神经节细胞病的水平是通过在肠道的抗肠间边界进行多次血清肌活检和/或全厚活检来确定牵拉水平。过渡区被描述为不规则，因此建议进行甜甜圈活检，以便评估整个周长。在此，我们描述了一名儿童，该儿童的大部分横结肠在肠系膜边界的30%肠周选择性缺失神经节细胞。该病例以肌内和跨句子的方式挑战了已知的神经迁移概念，并强调了下拉节段环形活检的重要性。

引用次数: 1

Laparoscopic Distal Pancreatectomy of a Solid Pseudopapillary Tumor (SPT) Achieves Long-Term Oncologic Safety and Multiorgan Preservation 腹腔镜下实性假乳头状肿瘤远端胰腺切除术可实现长期肿瘤安全性和多器官保存

IF 0.6 Q4 SURGERY

European Journal of Pediatric Surgery Reports

Pub Date : 2019-01-01 DOI: 10.1055/s-0039-1693999

Ahmed Elhaddad, P. Gasparella, C. Castellani, G. Singer, E. Sorantin, Klara Zach, H. Till

Abstract The oncological safety of a laparoscopic approach for solid pseudopapillary tumors (SPTs) of the pancreas remains a matter of debate. We present the long-term follow-up of an adolescent girl with an SPT in the pancreatic tail. A multimodality workup including magnetic resonance imaging (MRI) revealed a complex, spherical mass of 4.4 cm × 3.6 cm × 4 cm most likely located in the pancreatic tail. All routine laboratory investigations and tumor markers were within normal limits (alpha fetoprotein [AFP], cancer antigen 125 [CA125], CA 19–9, carcinoembryonic antigen [CEA], adrenocorticotropic hormone [ACTH]). Diagnostic laparoscopy was performed to verify the origin of the tumor in the pancreatic tail. In a three-port technique the tumor was mobilized of the splenic vessels until a distal pancreatectomy could be completed. Histopathological examination confirmed the complete resection of a low-grade malignant SPT. The postoperative course was unremarkable. Regular pediatric oncological follow-up examinations for 3 years, including MRI every 6 months, ruled out recurrence and confirmed preservation of splenic and pancreatic functions. While data about the technical feasibility of a laparoscopic approach to pancreatic SPT are already available, this pediatric case report adds a long-term oncological and functional success to the available literature.

摘要腹腔镜入路治疗胰腺实性假乳头状肿瘤（SPTs）的肿瘤学安全性仍然存在争议。我们介绍了一名少女胰腺尾部SPT的长期随访。包括磁共振成像（MRI）在内的多模态检查显示，一个复杂的球形肿块为4.4 厘米 × 3.6 厘米 × 4. cm最有可能位于胰腺尾部。所有常规实验室检查和肿瘤标志物均在正常范围内（甲胎蛋白[AFP]、癌症抗原125[CA125]、CA 19-9、癌胚抗原[CEA]、促肾上腺皮质激素[ACTH]）。进行了诊断性腹腔镜检查，以验证胰腺尾部肿瘤的起源。在三端口技术中，将肿瘤从脾血管中取出，直到完成远端胰腺切除术。组织病理学检查证实完全切除了低度恶性SPT。术后病程不明显。3年的定期儿科肿瘤学随访检查，包括每6个月进行一次MRI检查，排除了复发，并证实了脾脏和胰腺功能的保留。虽然已经有关于腹腔镜方法治疗胰腺SPT的技术可行性的数据，但这份儿科病例报告为现有文献增加了长期的肿瘤学和功能成功。

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引用次数: 4

Intravesical Oxybutynin for Urgent Bladder Rescue in a Newborn with Posterior Urethral Valves 膀胱内注射氧丁炔用于后尿道瓣膜新生儿紧急膀胱抢救

IF 0.6 Q4 SURGERY

European Journal of Pediatric Surgery Reports

Pub Date : 2019-01-01 DOI: 10.1055/s-0039-3399565

A. M. Molina Caballero, A. Pérez Martínez, C. Goñi Orayen, G. Sierra Colomina, A. Lavilla Oiz, Y. Armendariz Cuevas

Abstract Posterior urethral valves are the most common cause of bladder outlet obstruction in male newborns. Initial catheter drainage alleviates the urethral obstruction before definitive management by valve ablation. Newborns with posterior urethral valves often present with hypercontractile bladders that may inhibit upper tract drainage despite bladder catheterization. Anticholinergic agents are commonly used to treat detrusor hyperactivity, with oxybutynin being the most commonly used. We report the first case of a newborn with posterior urethral valves and ureterovesical junction obstruction caused by detrusor hypertrophy who underwent urgent intravesical instillation of oxybutynin at high doses in an attempt to avoid a diversion procedure.

摘要后尿道瓣是男性新生儿膀胱出口梗阻的最常见原因。在通过瓣膜消融进行最终治疗之前，首次导管引流可缓解尿道梗阻。有后尿道瓣的新生儿经常出现高收缩性膀胱，尽管进行了膀胱导管插入术，但可能会抑制上尿路引流。抗胆碱能药物通常用于治疗逼尿肌过动，其中最常用的是氧丁炔。我们报告了第一例因逼尿肌肥大导致后尿道瓣和输尿管膀胱连接部梗阻的新生儿，为了避免分流手术，他们接受了高剂量的氧丁炔紧急膀胱内滴注。

引用次数: 0

Testicular-Epididymal Dissociation: Vas and Vessels May "Lead up the Garden Path". 睾丸-附睾分离:输精管和血管可能“通向花园小径”。

IF 0.6 Q4 SURGERY

European Journal of Pediatric Surgery Reports

Pub Date : 2019-01-01 Epub Date: 2019-12-13 DOI: 10.1055/s-0039-1688485

Eleni Papageorgiou, Alberto Mantovani, Elena Monti, Caroline Brain, Naima Smeulders, Abraham Cherian

The vas deferens and spermatic vessels entering the inguinal canal through the internal inguinal ring is thought to exclude an intra-abdominal testis. We present a case of high bilateral intra-abdominal testes on a 46,XY boy despite the vas deferens and good-sized vessels passing through the deep rings. Data were collected from clinical records, radiology (ultrasound, magnetic resonance imaging [MRI]), and endocrine blood tests. This case underlines the importance of following the pathway of embryological descent of the testis cranially as well as caudally during diagnostic laparoscopy, to avoid missing this rare anatomical variant.

经腹股沟内环进入腹股沟管的输精管和精管被认为可排除腹内睾丸。我们报告一例46,xy男孩的双侧高腹内睾丸，尽管输精管和大血管穿过深环。数据收集自临床记录、放射学(超声、磁共振成像[MRI])和内分泌血液检查。本病例强调了在诊断腹腔镜检查中遵循睾丸颅侧和尾侧胚胎学下降路径的重要性，以避免遗漏这种罕见的解剖变异。

引用次数: 1

Currarino Triad: Importance of Preoperative Magnetic Resonance Imaging Currarino Triad：术前磁共振成像的重要性

IF 0.6 Q4 SURGERY

European Journal of Pediatric Surgery Reports

Pub Date : 2019-01-01 DOI: 10.1055/s-0039-3399533

A. AbouZeid, S. Mohammad, M. Seada, Khaled Khiamy, R. Gamal

Abstract Currarino triad is a rare syndrome that may be occasionally encountered during managing cases of anorectal anomalies. The triad consists of anorectal anomaly, sacral bony defect, and a presacral mass. It may be familial or sporadic, with a reported female predominance. Identification of the characteristic notched sacrum (sacral scimitar) in plain X-ray (anteroposterior view) is considered the key for the diagnosis; however, not infrequently, this radiological sign is overlooked, especially with a small sacral defect. Excision of the presacral cyst is usually performed concomitantly during anorectoplasty. The prone position is the standard approach for posterior sagittal anorectoplasty (PSARP) in males; however, in females, the supine position can be used as an alternative (anterior sagittal anorectoplasty). In this case report, excision of the presacral cyst took place in two steps: the first excision during the PSARP procedure in the prone position, and a second operation in the supine lithotomy position to remove a residual component of the lesion that was missed during the primary operation. It was clear that the supine lithotomy position provided better access to explore the presacral space than the prone position, especially with a deeply located cyst as in our case. The role of magnetic resonance imaging (MRI) in the identification of the exact nature and extent of the lesion before surgery is crucial and should be performed in all cases.

摘要Currarino三联征是一种罕见的综合征，在处理肛门直肠异常病例时偶尔会遇到。三联征包括肛门直肠异常、骶骨缺损和骶前肿块。它可能是家族性的或散发性的，据报道以女性为主。在平片（前后视图）中识别特征性的骶骨切口（骶骨弯刀）被认为是诊断的关键；然而，这种放射学征象经常被忽视，尤其是在骶骨小缺损的情况下。骶前囊肿切除术通常在肛门直肠成形术的同时进行。俯卧位是男性后矢状面肛门直肠成形术（PSARP）的标准方法；然而，对于女性来说，仰卧位可以作为一种替代方案（前矢状面肛门直肠成形术）。在本病例报告中，骶前囊肿的切除分两步进行：第一步是在俯卧位PSARP手术中切除，第二步是在仰卧位取石，以去除初次手术中遗漏的病变残余部分。很明显，仰卧位取石术比俯卧位能更好地探索骶前间隙，尤其是在我们的病例中，囊肿位置较深。磁共振成像（MRI）在手术前确定病变的确切性质和范围方面的作用至关重要，在所有情况下都应进行。

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引用次数: 4

Esophageal Lung in a Preterm Boy—Report on a Multidisciplinary Treatment 早产儿食管肺的多学科治疗报告

IF 0.6 Q4 SURGERY

European Journal of Pediatric Surgery Reports

Pub Date : 2019-01-01 DOI: 10.1055/s-0039-3400475

E. Villamizar, Maria Daniela Moreno Villamizar, Mauricio Pedraza Ciro, Jean A. Pulido, Maria Rodriguez, Juan Carlos Villamizar

Abstract Esophageal lung is a rare entity that results from embryological alterations during the formation of the ventral wall of the anterior intestine. The clinical manifestations of this pathology are vague, including respiratory or digestive symptoms, repetitive respiratory infections, dysphagia, or inability to swallow. The management is based on the exact anatomical and vascular abnormalities. We report the diagnostic and therapeutic approach in a preterm boy with esophageal lung. Also, we present a three-dimensional model for the classification of this pathology. In conclusion, the management relies on proper definition of the anatomy and the surgical strategy.

摘要食管肺是一种罕见的实体，由前肠腹壁形成过程中的胚胎改变引起。这种病理的临床表现是模糊的，包括呼吸道或消化系统症状、重复性呼吸道感染、吞咽困难或无法吞咽。管理是基于确切的解剖和血管异常。我们报告了一例患有食道肺的早产儿的诊断和治疗方法。此外，我们还提出了一个三维模型来对这种病理进行分类。总之，管理依赖于解剖结构和手术策略的正确定义。

引用次数: 3

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