Cirugía pediátrica : organo oficial de la Sociedad Española de Cirugía Pediátrica
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Comparative Study Clinical Trial Controlled Clinical Trial
[Hormonal response and two special techniques of postoperative analgesia in pediatric surgery].
We studied neuroendocrine response in the postoperative pain relief in pediatric patients treated with two analgesic techniques (conventional intravenous analgesia and patient controlled analgesia). ⋯ Both analgesic techniques were appropriate to postoperative pain relief in pediatric patients. Low pain score shows better conditions to attend these patients. We suggest PCA technique is better to treat postoperative stress response following pediatric surgery.
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We report the case of a six-year-old girl who suffer an isolated sternal fracture due to hyperflexion of the thorax (while she was playing on a jumping-bed). On clinical examination, only slight tenderness and pain with compression of sternum was found. ⋯ The patient was admitted, observed during 12 hours with ECG monitoring and discharged because no cardiac or pulmonary pathology appeared. We present this case because fracture of the sternum in a child is rare, especially if road-traffic accident with seat belt injury is not implicated as a cause.
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A seven year old boy, one week after surgical intervention for blunt liver trauma, presents an intrahepatic bilioma. Under ultrasonografic guidance, an external drainage is inserted. Contrast injection shows billiary fistula. ⋯ Ultrasonografic and CT Scan studies showed total resolution of intrahepatic collection. Intrahepatic billiary collections are a rare complication of the hepatic traumatism. Conservative management with external drainage, should be keept in mind like a first choice terapeutic option.
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Comparative Study
[Outcome of hypertrophic pyloric stenosis after pyloromyotomy].
Twenty four patients diagnosed and operated of hypertrophic pyloric stenosis were examined by ultrasonography at diagnostic and sequential after pyloromyotomy. We measured pyloric diameter, thickness and length of the muscle and we calculated the pyloric volume. ⋯ The pyloric volume is the most discriminating criterion. Sequential sonograms at one and four months showed that all measurements fell to normal levels within four weeks, except pyloric volume.
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Comparative Study
[Reduced-size liver transplants from cadaver and living donors: an alternative to waiting lists].
The ever expanding of indications of liver transplantation in children make pediatric donor pool unable to fulfill the needs. The reduced and partial transplants from cadaveric and living related donors reveal an effort to increase the number of pediatric grafts aid to reduce the mortality in the waiting list. Among 126 pediatric transplants performed in a 8-year period, 18 (15%) were reduced (n = 3) and partial livers (with preservation of the recipient vena cava) (n = 15). ⋯ The arterial complications in this group are limited to a single case of thrombosis. Despite our limited experience we conclude that reduced and partial transplants are useful to reduce the mortality in the waiting list with a survival similar to that of the whole grafts and with less vascular complications. The living-related transplant represents another step ahead that allows a further reduction of the shortage of organ available for the small children.