Browsing by Author "Ferreira de Lima, S"
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- Introdução pelo Próprio de Corpos Estranhos na Uretra e Bexiga - Relato de Três Casos PediátricosPublication . Ferreira de Lima, S; Cebola, A; Pereira, SC; Alves, RSelf-inserted urethrovesical foreign bodies are rare in children.We present three cases and discuss the clinical presentation, diagnosis and management of such patients. In case 1, a 16-year-old boy introduced a wire into the urethra and partially into the bladder three days before. In case 2, a 4-year-old boy introduced a hairpin in the urethra in the same day. In case 3, a 11-year-old boy introduced a sewing needle in the urethra a few hours before. Cystourethroscopy and suprapubic cystotomy were used to remove the foreign bodies. The presentation of urethrovesical foreign bodies can vary widely, as can the type of object inserted. Foreign body retrieval is determined by its morphology and the patient’s conditions with the aim to minimise urothelial trauma and preserve erectile function. Definitive treatment is usually the endoscopic removal, however sometimes surgical intervention may be required. It is advocated follow-up with long duration, which is necessary to diagnose the long-term complications including urethral stricture.
- Perivascular Epithelioid Cell Tumor: A Case Report of a Rare EntityPublication . Cardosa, MF; Ferreira de Lima, S; Knoblich, M; Afonso, I; Mendes, CPerivascular epithelioid cell tumor is a rare mesenchymal tumor with myomelanocytic differentiation. It mainly occurs in middle-aged females and can be found at any location. The differential diagnosis is broad but the immunohistochemical biomarkers establish the diagnosis. A 4-year-old girl was referred to a pediatric gastroenterology clinic due to recurrent umbilical pain and the workup revealed biliary lithiasis. She remained in follow-up, asymptomatic, no physical findings, and stable ultrasound. Six years later, a supra-umbilical mass was detected by ultrasound, and the magnetic resonance imaging revealed a highly vascularized intraperitoneal tumor with well-defined limits. Surgical mass resection was performed, and the histology revealed morphological and immunohistochemical aspects of a perivascular epithelioid cell tumor of the abdominal wall. Given the size of the lesion (> 5 cm) and admitting uncertain malignant potential, she was submitted to margin enlargement. Four years later, she remains asymptomatic without clinical or imagiological evidence of relapse.
- Stump Appendicitis in Two Adolescent Boys: Rare Presentations and Alternative Approaches in PediatricsPublication . Ferreira de Lima, S; Patena Forte, J; Castro, M; Morão, S; Alves, RStump appendicitis is a rare complication that results from reinflammation of the residual part of the appendix, after incomplete appendectomy. Factors that may contribute to inadequate identification of appendicular base are subserosal or retrocecal position, extensive inflammation or inadequate surgical exposure. The length of the appendiceal stump after ligation is likely a major predisposing factor. The presentation of stump appendicitis is similar to acute appendicitis, but this diagnosis is often dismissed because of the surgical history. Computed tomography and ultrasonography are the imaging modalities of choice. The usual recommended treatment for stump appendicitis is completion appendectomy. Stump appendicitis must be considered in the differential diagnosis of acute abdomen despite the patient’s appendectomy history. A delayed diagnosis may lead to an increase in morbidity. We present two cases of stump appendicitis in adolescents after laparoscopic appendectomies, one being a case of recurrent stump appendicitis. We report two alternative therapeutic approaches: interval appendectomy and non-operative management. We conclude that these alternative approaches may be suitable for some patients with stump appendicitis. A review of the pertinent literature was done.