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Biomedical subjects

E Esteves

Publications and source records attributed to E Esteves.

4 recordsLinked to original sources
PubMedDate not supplied

Crossed testicular ectopia.

Crossed testicular ectopia (CTE) is a rare anomaly, characterized by migration of one testis towards the opposite inguinal canal. Presented here is a case of crossed ectopia of the right testis, treated by extraperitoneal transposition of the gonad and right orchiopexy. Embriology and surgical findings suggest that CTE is a common consequence of many unclear ethiologic factors, specially mechanical ones, and can be associated with Muller duct persistence. Review of literature suggests a classification of CTE into 3 types: I--associated with inguinal hernia alone; II--associated with persistent mullerian remnants; III--associated with other anomalies without mullerian remnants. Treatment includes transeptal orchiopexy or extraperitoneal transposition of the testis, research for mullerian remnants and other anomalies, and long term postoperative follow-up, due to the risk of becoming malignant.

Child, Preschool↗
PubMedDate not supplied

[Applications of videolaparoscopic surgery in children]

OBJECTIVES: To present the videolaparoscopies performed by the Childreńs Surgery Service, and study the main indications for pediatric laparoscopic surgeries, considering advantages and disadvantages over conventional open procedures. METHODS: Retrospective analysis of 612 videolaparoscopies in children aged between 8 days and 17 years treated from November/95 to 2000. Basic principles of videolaparoscopy and the postoperative management of several pediatric diseases are described. The results, advantages, and complications were analyzed after a 5-year follow-up period. RESULTS: Laparoscopic surgery allowed for a wide series of abdominal procedures conventionally carried out through open surgery, mainly for the treatment of gastroesophageal reflux disease, inflammatory acute abdomen, adhesive intestinal obstruction, biliary lithiasis, tumors, cryptorchidism, ovarian diseases, splenectomies, aganglionosis, trauma and others. Morbidity was low (1%), and mortality due to laparoscopy was nonexistent. Conversion to laparotomy occurred in only 14 cases (2.3%), mainly because of trauma. The principal advantages included minimal surgical trauma, pain and reflex ileum, short hospital stay, almost no incisional hernias and better cosmetic scars. CONCLUSIONS: Videolaparoscopy seems to be a great advance in modern pediatric surgery, allowing safer and less invasive treatment of a wide series of abdominal diseases at all pediatric ages.

Journal Article↗
PubMedDate not supplied

[Hepatic mesenchimal hamartoma in neonates].

OBJECTIVES: To approach the diagnosis and management of two different features of hepatic mesenchymal hamartoma (HMH) in the neonate. METHODS: Report of two cases of HMH in newborns and review of the literature (MEDLINE and LILACS). RESULTS: Two cases of newborns with huge abdominal masses are presented, one of them complicated by rupture and hemorrhage during ultrasound manipulation, leading to hypovolemic shock. Urgent operation showed a ruptured giant hepatic cyst containing hemorrhagic yellowish fluid. The cyst was removed by edge resection at the level of hepatic segment 6 and the postoperative period was uneventful. The pathological analysis of the cyst including immunohistochemical tests revealed HMH. In case 2, with prenatal diagnosis of hepatic tumor, the mass progressively enlarged after birth, and a left hepatectomy was performed. The macroscopic appearance suggested hemangioma but the histopathological aspect indicated mesenchymal hamartoma with endothelial predominance. Nowadays both children are healthy and asymptomatic. CONCLUSIONS: The management of HMH is surgical treatment, because it does not disappear spontaneously. Some cases evolve to giant forms even in the neonatal period leading to fatal complications. Preoperative differential diagnosis from hemangioma is quite difficult for cystic types, and immunohistochemical analysis is important for pathological confirmation.

English Abstract↗