Cirurgia Pediátrica
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Browsing Cirurgia Pediátrica by Subject "Abdominal Pain/etiology"
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- Chronic Gastric VolvulusPublication . Santos, E; Morão, S; Knoblich, M; Alves, R
- Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in ChildrenPublication . Martins, M; Cardosa, MF; Calhau, P; Caldas, G; Alves, RMalignant hepatic tumors are rare in children and hepatocellular carcinomas only represent 20% of cases. A previously healthy 10 year-old male was admitted for sudden abdominal pain. Ultrasound imaging showed an ileo-ileal intussusception with spontaneous resolution, but in the face of worsening pain, fever, and a palpable epigastric mass, abdominal magnetic resonance imaging was performed, showing a liver lesion. Laboratory tests presented elevated liver enzymes and C-reactive protein, so a liver abscess was considered and treated with metronidazole plus ceftriaxone. All of the microbiology tests as well as tumoral markers were negative. Despite clinical and laboratory improvement, the lesion persisted in the imaging. A liver biopsy confirmed a hepatocellular carcinoma, and the patient was submitted to surgical resection and chemotherapy. Contrarily to adults in whom most cases are secondary to chronic liver disease, children may not have risk factors for the disease, which makes it harder to make a prompt diagnosis.
- Valentino Syndrome: Case ReportPublication . Sacras, ML; Reino Pires, P; Ladeira, C; Knoblich, M; Pereira, S; Alves, RAbdominal pain is a common complaint in the pediatric emergency department. Perforation of a peptic ulcer is a rare occurrence in children and is a commonly overlooked etiology. This study presents a case of a previously healthy 16-yearold male presenting with right lower quadrant abdominal pain. Physical examination, laboratory test, and ultrasound results were suggestive of acute appendicitis. The laparoscopy results, which showed a normal appendix, and the following clinical findings, led to the diagnosis of a perforated pre-pyloric ulcer. Valentino syndrome occurs when a patient with a perforated ulcer presents with pain in the right lower quadrant, which mimics appendicitis, a far more common condition.