Cirurgia Pediátrica
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Browsing Cirurgia Pediátrica by Subject "Adolescent"
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- Massive Blood Loss from Urethrorrhage in a 16-year-old boy: Case Report and Review of Two Rare CausesPublication . Ascensão, J; Sobral, MC; Lima, S; Vaz Silva, A; Pratas Vital, V; Cardoso, D; Alves, F; Alves, RUrethral varices and hemangiomas are rare, underreported conditions that can be asymptomatic or present with intermittent urethrorrhage that can start or worsen with erection, sexual intercourse and ejaculation. Diagnosis can be made with urethroscopy and there are a wide variety of possible treatments that can suit both conditions. We present a case of a pediatric patient with severe blood loss from urethral varices that was treated with electrofulguration after laser treatment with Holmium failed.
- 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.
- 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.