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Biomedical subjects

F Cappellari

Publications and source records attributed to F Cappellari.

14 recordsLinked to original sources
PubMed1992

[Echographic features of urachal cysts].

The authors discuss the anatomical, clinical, and US patterns of 5 cases of urachal cysts observed in pediatric patients (average age: 9.2 months) over the last 4 years. All cases had surgical confirmation. Linear and convex probes with 3.75, 5, and 7.5 MHz frequency were employed. Most of the observed lesions were oval in shape, their size ranging 3-6 cm; they were found in ventral-epivesical regions and had no mobility. Liquid echotexture with hyperechoic deposits on the lower layers was observed in 2 cases, and inhomogeneous solid or complex mass-like echotexture in 3 cases (suppurated cysts). Differential diagnosis includes mesenteric cyst, simple and teratomatous ovarian cyst, bladder diverticulum and hydrometrocolpos. Echotomography exhibited high accuracy in detecting this kind of lesion and allowed guidance of percutaneous drainage for the preoperative treatment of infected cysts. Both cystography and CT appeared to be useless.

Child, Preschool↗
PubMedDate not supplied

[Renovascular hypertension in childhood].

One to two per cent of children and up to 11% of adolescent have arterial hypertension. In most cases children and adolescent are not recognized to be hypertensive because physicians do not routinely measure blood pressure. Often the diagnosis is recognized only when the pediatric patients develop a complication: seizure, stroke, heart failure or paraplegia. Renovascular hypertension in children and adolescents is more common than all of the other causes combined, except for coarctation of the aorta. The diagnosis is not so easy and includes the usual history, physical examination (signs and symptoms of coarctation of the isthmic or abdominal aorta or of an abdominal mass or of one of the adrenal causes of hypertension), laboratory studies, abdominal ultrasound study and chest x-ray. Sometime a CAT can be usefull. The next steps are the early and rapid-sequence IVP, renal angiography and peripheral and renal renin activity. The management of renovascular hypertension in children and adolescent includes a conservative approach (percutaneous transluminal renal angioplasty or renal embolization), rarely used in pediatric age, and the surgical treatment. This latter includes all the surgical procedures of renal revascularization and, in unilateral renal parenchymal diseases, the nephrectomy or a partial nephrectomy. The postoperative results are very good in a high percentage of cases. In bilateral cases, the revascularization surgical procedures improve or normalize also the impaired renal function.

Angioplasty, Balloon↗
PubMedDate not supplied

[Esophageal atresia, today].

In recent years there have been remarkable improvements in the treatment of babies with congenital esophageal atresia. This improvement in survival and in preservation of esophagus is due: to progress in neonatal anesthesia and in preoperative and postoperative intensive care; to progress in surgical management of associated anomalies (mainly congenital malformations of the heart); to progress in surgical management of the malformation. Esophageal anastomosis may be performed in the majority of babies with "long gap" esophageal atresia by operative techniques for lengthening of the upper esophageal segment or by elongation of the upper and lower pouches by means of bougienage or mercury-filled bag. Today the indications for replacement of the esophagus by colon interposition or reversed gastric tube are limited.

Esophageal Atresia↗
PubMedDate not supplied

[Retrotendinous ureter. An exceptional cause of obstruction in the upper urinary tract].

Retrotendineus ureter is an exceptional anomaly presenting, in our experience, without clinical signs of urinary infection and obstruction. The radiological diagnosis was retrocaval ureter. The Authors report a case of a 9 years old boy who was successfully treated by ureteral section, excision of the obstructed ureteral segment and uretero-ureteral anastomosis. It seems that the case is the first reported in the medical literature of this anomaly.

Anastomosis, Surgical↗
PubMedDate not supplied

[Ectopic ureter].

Ectopic ureter is quite a rare malformation, and it can be more or less serious depending on its anatomy (monolateral or bilateral ectopy, duplicated ureter, single ureter) and the associated malformations. It's more common in female patients. Ectopic ureteral orifice can be either intravesical (bladder neck) or, more often, extravesical. Ectopia in women is more frequently found in the urethra and the vaginal vestibule; much less frequently in vagina and in uterus. In men it is mostly found in the posterior urethra; in the male genital tract is very rare. In most cases ectopic ureter is associated with pyelo-ureteral complete duplication: the upper kidney usually works badly or doesn't work at all, due to renal dysplasia or pyelonephritis. More rarely ureteral ectopia affects a single urinary system and can be monolateral or, in the most serious forms, bilateral. The main clinical signs are urinary incontinence accompanied by regular micturition (more exactly pseudoincontinence) in the female patients, and urinary infection. In the male there is no urinary incontinence. Authors report their experience about 54 ectopic ureters in 51 children. Treatment is always by surgery: the choice has to be made between conservative or radical attitude. 38 total exeresis of the ectopic excretory pathway (upper heminephroureterectomy or nephroureterectomy), 9 ureteral reimplantations, 1 uretero-pyeloanastomosis have been done. Outcome is always satisfactory in monolateral forms, more uncertain in bilateral forms with single ectopic ureter, due to incontinence and reduced bladder capacity problems and the possible associated renal failure.

Female↗
PubMedDate not supplied

[Transureteroureteroanastomosis in children. Indications and results].

Transureteroureterostomy is a method of internal urinary diversion available to maintain the integrity of the urinary system, when the lower ureter is compromised. The usual requirements are a donor kidney with a minimal renal function on one side and a normal contralateral recipient kidney and ureter. From January 1972 to October 1988 in our Division transureteroureterostomy has been done in 52 children. In some cases the procedure was used simultaneously with reimplantation or cutaneous ureterostomy. The majority of patients had been referred with previous failed ureteral reimplantation or with unilateral reflux or ureteral obstruction in neurogenic bladder with small capacity and compliance. Results (14 years to 6 months follow-up) are very good with excellent results for both kidneys in 98% of the cases. Our experience and that of other authors confirm that transureteroureterostomy is a technique simple with low morbidity and excellent results.

Adolescent↗
PubMedDate not supplied

[Treatment of urethral stenoses in children using a balloon catheter].

The management of the urethral strictures in children has involved dilatation, internal urethrotomy and urethroplasty. Each method of management has varying degrees of success and is associated with special problems. The authors describe their experience in the management of urethral strictures in 32 children by inflatable balloon catheter. The procedure involves atraumatic catheterization by an urethral catheter under radioscopic vision, followed by introduction of a balloon catheter on a flexible guide which is then filled by contrast medium. The stenosis is visible on the balloon and the rapidity with which it "yields" can readily be appreciated. Control of dilatation is effected by voiding urethrography. This method entails much less discomfort and more advantages than conventional urethral dilatation. No complication was observed. All patients underwent a second balloon dilatation, without radioscopy and 25 also a third prior to obtain a good and permanent result.

Catheterization↗
PubMedDate not supplied

[Hirschsprung disease. Results of surgical treatment].

The Authors report their experience in the treatment of 86 patients, in pediatric age, with Hirschsprung's disease: 40 with congenital rectosigmoid or subtotal megacolon, 8 with total colic or ileocolic aganglionosis and 38 with ultrashort aganglionic segment. Out of the patients 29% had necrotizing enterocolitis with 40% mortality rate in rectosigmoid or subtotal forms and with 75% mortality rate in total colic or ileocolic forms. In the last group the mortality was higher related also to difficulties and complications of surgical treatment. Necrotizing enterocolitis is the major cause of death in infants with Hirschsprung's disease. Early diagnosis and treatment can reduce the mortality rate.

Child, Preschool↗
PubMedDate not supplied

[The ureterocele in childhood. Type of treatment and results].

Ureterocele is an infrequent urinary malformation in pediatric age, but it is frequently clinically severe. Ureterocele in a duplex pyelo-ureteral system often presents very difficult treatment problems not uniformly dealt with. Authors report their experience with 79 ureteroceles observed in 72 children. 27 children were less than one year old. In the authors experience simple ureterocele with a single collecting system doesn't give any surgical problem. On the contrary ectopic ureterocele, almost always associated with a pyeloureteral duplication, frequently gives some problems of surgical treatment. Treatment is always individualized but in our experience the best results have been achieved with unroofing of the ureterocele and upper heminephroureterectomy in one stage, eventually associated with lower ureteral reimplantation. This treatment can be used successfully in the majority of ectopic ureteroceles in pediatric age.

Adolescent↗