[Iconographic rubric. Epidermoid cyst of the spleen].
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Biomedical subjects
Publications and source records attributed to M Gruner.
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The authors report about four cases of urinoma detected during the neonatal period in three boys and one girl with congenital uropathy. It appeared as an infravesical obstruction in three cases (2 posterior urethral valves, one anterior urethral diverticulum) and as an obstruction of the pyeloureteral junction in the last case. The examination was prompted by the detection of a mass in the side during the clinical examination. The diagnosis is based on ultrasound, which evidences the liquid and extrarenal character of the urinoma and often allows demonstrating the underlying uropathy. The kidney may be difficult to localize if the urinoma is very large. IVP or radionuclide scanning may contribute to the diagnosis as they allow assessing the functional value of the kidney. The urinoma protects the kidney from the consequences of uropathy by allowing a relative decompression of the pyelocaliceal structures.
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Eight children with pseudo-Hirschsprung's disease are reported. They can be divided into three groups: alimentary ganglioneuromatosis, schwann cell hyperplasia and those with normal appearance by stantard histology. In view of the heterogeneity, histology cannot predict the extent or the prognosis of the disease. Several biopsies at various levels of the alimentary tract and the use of advanced techniques are necessary to assess fully the extent and the type of the lesion and whether it is congenital or acquired. The majority of pseudo-Hirschsprung's disease tend to affect most of alimentary tract, which may lead to the formation of stagnant loops with all their risks. Treatment includes ileostomy, continuous hypoallergenic oral feeding, and manual expression several times a day.
The short term prognosis of the esophageal atresia has been improved by the progress of diagnosis and surgical techniques. The long term prognosis still depends upon the occurrence of bronchopulmonary complications. Having investigated fourteen cases and a review of the literature, the authors studied the cause of these respiratory complication. Two factors seem to play an important role: the gastroesophageal reflux and the tracheomalacia. This has important therapeutical implications: treatment of the gastro-esophageal reflux and long term respiratory kinesitherapy. The authors suggest for these patients a management plan over several years.
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