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Caruso M, Lembo MA, Cozzi G. Girl with genital bleeding and dysuria. Arch Emerg Med 2022; 39:600-633. [PMID: 35858684 DOI: 10.1136/emermed-2020-210848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Mariangela Caruso
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Antonietta Lembo
- Department of Surgery, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
| | - Giorgio Cozzi
- Emergency Department, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy
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Iaquinto M, De Castro R, Scarpa MG, Cerrina A, Codrich D, Guida E, Pederiva F, Lembo MA, Murru FM, Schleef J. Incomplete duplex renal system with severe obstruction at the uretero-ureteral junction and minor obstruction at the common stem-vesical junction: Challenging diagnosis and conclusive laparoscopic treatment. j-pucr 2020. [DOI: 10.14534/j-pucr.2020461252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Scarpa MG, Perin G, Di Grazia M, Codrich D, Pederiva F, Guida E, Lembo MA, Giannotta A, Schleef J. Surgery for distal hypospadias: what about the catheter? Pediatr Med Chir 2017; 39:145. [PMID: 29034655 DOI: 10.4081/pmc.2017.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 08/09/2017] [Accepted: 08/22/2017] [Indexed: 11/23/2022] Open
Abstract
No agreed recommendations exist for timing of urethral stent removal, after distal hypospadias surgery. We compared our preliminary case series with outcomes from literature: 18/44 patients were treated with catheter and 26/44 without it. The surgical outcome was comparable in the two groups. After hypospadias surgery, the main advantage of the immediate postoperative catheter removal was the shorter hospital stay without negatively affecting the care and home management.
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Affiliation(s)
- Maria-Grazia Scarpa
- Pediatric Surgery, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste.
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Guida E, Di Grazia M, Cattaruzzi E, Bussani R, Rigamonti W, Lembo MA. When a lymphatic malformation determines a bowel volvulus: Are clinical status and images always reliable? Int J Surg Case Rep 2016; 25:192-5. [PMID: 27388707 PMCID: PMC4936329 DOI: 10.1016/j.ijscr.2016.06.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/04/2016] [Accepted: 06/18/2016] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION An acute abdomen in the form of small-bowel volvulus could be a presentation of a lymphatic malformation in childhood. CASE PRESENTATION A 5year old male was admitted to our Institute for an acute abdomen. Clinical aspects and radiological images were not specific for a certain diagnosis. Laparotomy revealed a big soft mass, with a milky content, completely involving about 50cm of ileus with a partial volvulus of the intestinal loop. A complete mass excision and also a bowel involved resection were performed. After a histological examination, a lymphatic malformation was diagnosed. DISCUSSION The diagnosis of a mesenteric lymphatic malformation could be intraoperative and a complete resection should be the treatment of choice. Sometimes it could be necessary to perform an involved bowel tract resection in the case of volvolus with ischemia. CONCLUSIONS Paediatricians and surgeons should bare in mind that an intrabdominal lymphatic malformation may present as a nonspecific an acute abdomen caused by a bowel volvolus and diagnosis may not be so simple preoperatively.
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Affiliation(s)
- Edoardo Guida
- Department of Paediatric Surgery and Urology, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.
| | | | - Elisabetta Cattaruzzi
- Department of Paediatric Radiology, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.
| | - Rossana Bussani
- Department of Pathology, University of Trieste, Trieste, Italy.
| | - Waifro Rigamonti
- Department of Paediatric Surgery and Urology, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy; University of Trieste, Italy.
| | - Maria Antonietta Lembo
- Department of Paediatric Surgery and Urology, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.
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Guida E, Pederiva F, Grazia MD, Codrich D, Lembo MA, Scarpa MG, Rigamonti W. Perforated appendix with abscess: Immediate or interval appendectomy? Some examples to explain our choice. Int J Surg Case Rep 2015; 12:15-8. [PMID: 25985296 PMCID: PMC4485681 DOI: 10.1016/j.ijscr.2015.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/04/2015] [Accepted: 05/04/2015] [Indexed: 11/28/2022] Open
Abstract
There are no clear guidelines in the treatment of a perforated appendicitis associated with localized abscess. Our team’s therapeutic choice, also with presence of coprolith, is the initial conservative case management followed by a routine interval appendectomy. Interval appendectomy should be performed not later than 4 months after discharge.
Introduction There are no clear guidelines in the treatment of a perforated appendicitis associated with periappendiceal abscess without generalized peritonitis. Presentation of cases We retrospectively studied six examples of treated children in order to discuss the reasons of our team’s therapeutic approach. Some children were treated with a conservative antibiotic therapy to solve acute abdomen pain, planning a routine interval appendectomy after some months. Others, instead, underwent an immediate appendectomy. Discussion By examining these examples we wanted to highlight how the first approach may be associated with shorter surgery time, fewer overall hospital days, faster refeeding and minor complications. Conclusion Our team’s therapeutic choice, in the case of a perforated appendicitis with an abscess and coprolith is an initial conservative case management followed by a routine interval appendectomy performed not later than 4 months after discharge.
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Affiliation(s)
- Edoardo Guida
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.
| | - Federica Pederiva
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | | | - Daniela Codrich
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | | | - Maria Grazia Scarpa
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Waifro Rigamonti
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy; University of Trieste, Italy
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Codrich D, Lembo MA, Schleef J. Thoracoscopic removal of a bulky cystic mediastinal mature teratoma in a 4-year-old child: report of one case and few surgical tricks. Eur J Pediatr Surg 2012; 22:318-20. [PMID: 22576302 DOI: 10.1055/s-0032-1308697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Daniela Codrich
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
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Pelizzo G, Barbi E, Codrich D, Lembo MA, Zennaro F, Bussani R, Schleef J. Chronic inflammation in congenital cystic adenomatoid malformations. An underestimated risk factor? J Pediatr Surg 2009; 44:616-9. [PMID: 19302868 DOI: 10.1016/j.jpedsurg.2008.10.064] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 10/16/2008] [Accepted: 10/17/2008] [Indexed: 11/30/2022]
Abstract
PURPOSE Congenital cystic malformations of the lung are more frequently diagnosed before birth, but guidelines for surgical management of asymptomatic cases are lacking. The aim of this article is to review our 10-year results with antenatally diagnosed congenital cystic adenomatoid malformations (CCAMs) to debate indications for early postnatal surgical management in asymptomatic patients. METHOD Twenty-four cases were reviewed; of these, 18 were operated on before 15 days of life for respiratory distress or mediastinal shift, whereas 6 were submitted to elective surgery at 3 months of age. RESULTS Twenty lobectomies and 4 atypical resections were performed. Two of the latter required a second surgery for incomplete primary perinatal resection. No postsurgical complications were reported. Nineteen (19/24) of the resected specimens showed signs of chronic inflammation. In the perinatal period, 100% (8 cases) of CCAM type II and 50% (8 cases) of CCAM type I resulted to be inflamed. Of the asymptomatic cases, 50% (3/6) were also found to be affected. No infections were detected at bacteriologic culture and bacterial debris was stained in 3 specimens. CONCLUSION In this series, a 79% incidence of pulmonary inflammation was detected. The CCAM type II resulted to be always involved in this process of inflammation. This was an unexpected finding, particularly in cases without mediastinal shift or respiratory distress. In light of these results, early postnatal treatment, at around 3 to 6 months of age, could be considered even in asymptomatic patients.
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Affiliation(s)
- Gloria Pelizzo
- Department of Pediatric Surgery, IRCCS Burlo Garofolo, 34137 Trieste, Italy
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Steyaert H, Al Mohaidly M, Lembo MA, Carfagna L, Tursini S, Valla JS. Long-term outcome of laparoscopic Nissen and Toupet fundoplication in normal and neurologically impaired children. Surg Endosc 2003; 17:543-6. [PMID: 12582764 DOI: 10.1007/s00464-002-9058-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2002] [Accepted: 09/12/2002] [Indexed: 11/29/2022]
Abstract
BACKGROUND Laparoscopic fundoplication is a commonly performed procedure in children. This report describes the incidence of long-term recurrence and complications after laparoscopic Nissen or Toupet fundoplication in neurologically impaired and normal children. METHODS Fifty-three children operated on before 1999 were reviewed. All children were evaluated clinically and with a barium meal study thereafter. Symptomatic children and those with abnormal barium meal underwent 24 h pH monitoring. RESULTS A total of 45 patients were included in the study. The mean follow-up was 4.5 years. All, except one asymptomatic child that declined, had a barium meal. Four were abnormal (2 parahiatal hernias and 2 slight episodes of reflux). Four patients had symptoms related to the operation and 2 to clinical recurrence. Only 1 asymptomatic child with slight reflux at barium meal revealed abnormal 24 h pH monitoring. Finally, 6.6% patients were found to have late recurrence (2 clinical and 1 pHmetry). There was an obvious increase in children's weight, especially in neurologically impaired patients. CONCLUSION Laparoscopic antireflux surgery is of value in children with gastroesophageal reflux disease. The long-term results are comparable with open surgery, and there was no difference in term of wrap failure between neurologically impaired and normal children.
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Affiliation(s)
- H Steyaert
- Department of Pediatric Surgery, Fondation Lenval pour Enfants, 57, Avenue de la Californie, F 06200, Nice, France.
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Abstract
The diagnosis of a biliary duct transection after blunt trauma is difficult in children. Surgery is often performed late and therefore complicated. We present a case of mini-invasive approach for biliary duct transection in a 12-year-old child and review the literature. Transhepatic cholangiography is at the moment the most used technique to make the diagnosis but necessitates general anaesthesia. Stent placement is possible by the way. Endoscopic retrograde cholangiogram (ERCP) has been proposed even in children. Stent placement may be easier by this technique. For the diagnosis, Technetium 99m dimethylminodiacetic acid (HIDA) scanning seems interesting in terms of both sensitivity and specificity. Another promising diagnostic technique is MRI with 3D reconstruction.
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Affiliation(s)
- L Carfagna
- Service de chirurgie pédiatrique, Fondation Lenval, hôpital pour enfants, 57, avenue de la Californie, 06200, Nice, France
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Steyaert H, Juricic M, Hendrice C, Lembo MA, Al Mohaidly M, Guitard J, Valla JS. Retroperitoneoscopic approach to the adrenal glands and retroperitoneal tumours in children: where do we stand? Eur J Pediatr Surg 2003; 13:112-5. [PMID: 12776243 DOI: 10.1055/s-2003-39563] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Choosing the best way to approach adrenal gland and retroperitoneal tumours is still difficult. We reviewed our first 10 cases operated on by retroperitoneoscopy and compared this approach with other possible ways described in the literature. There were 2 intraoperative complications: 1 opening of the diaphragm and 1 bleeding. Tumour resection was always complete. There was no conversion. There were no postoperative complications. The retroperitoneoscopic approach for adrenalectomy and retroperitoneal tumour resection is increasingly being used. In children, operation is quite fast, without much blood loss and with spectacular postoperative recovery results. Even for the right side we advocate this approach, due to the particular anatomy (small tumour size, less fat, thinner muscle layers) in this age group. Trained surgeons are, of course, mandatory.
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Affiliation(s)
- H Steyaert
- Department of Paediatric Surgery, Fondation Lenval pour Enfants, Nice, France.
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Pelizzo G, Lembo MA, Civitelli S, La Riccia A, Franchella A. Prenatal management of inherited urogenital malformation: case report. CLIN EXP OBSTET GYN 2001; 28:31-2. [PMID: 11332585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Documentation of unique kidney renal function early in pregnancy can be helpful in defining prenatal management and therefore in improving prognosis. Antenatal diagnosis of a solitary kidney was performed at 20 weeks' gestation in a foetus with a 1,7 chromosome translocation. Because of the decreasing renal function and the increasing pelvic dilatation, an early in utero stenting was placed at 23 weeks' gestation. Optimal outcome occurred and the baby was delivered at 32 weeks. Complete assessment of the malformation showed a left hydronephrosis due to a megaureter, right renal agenesis with ipsilateral cryprorchidism and agenesis of the right vas deferens. The chromosomic translocation was inherited from the mother who was affected by uterus didelphys, obstructed right hemivagina and right renal agenesis. Renal function of the unique kidney with hydronephrosis can be early diagnosed and promptly treated. This condition should also increase the index of suspicion of underlying genital and chromosomal anomalies.
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Affiliation(s)
- G Pelizzo
- Paediatric Surgery Deportment, University Medical School of Ferrara, Italy
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Pelizzo G, Lembo MA, Franchella A, Giombi A, D'Agostino F, Sala S. Gastric volvulus associated with congenital diaphragmatic hernia, wandering spleen, and intrathoracic left kidney: CT findings. Abdom Imaging 2001; 26:306-8. [PMID: 11429960 DOI: 10.1007/s002610000171] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We present an unusual case of gastric volvulus associated with wandering spleen, a delayed manifestation of congenital diaphragmatic hernia and left intrathoracic kidney. Gastric volvulus should be considered in any infant with unexplained vomiting and left diaphragmatic anomaly: in these patients, developmental disorders of the peritoneal visceral attachments of the left upper abdomen may coexist. The absence of ligamentous connections between the stomach, posterior abdominal wall, and spleen result in wandering spleen. We emphasize prompt surgical therapy to avoid gastric and splenic necrosis. Radiologic findings and the appearance of this complex congenital malformation are reported.
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Affiliation(s)
- G Pelizzo
- Department of Pediatric Surgery, Arcispedale S. Anna, Corso Giovecca 203, 44100 Ferrara, Italy
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