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Objetivo: Relatar as diferentes formas de apresentação radiológica da necrose e da perfuração intestinal na Enterocolite Necrosante (ECN) em sete recém-nascidos internados em UTI neonatal. Detalhamento de Caso: Foram avaliados os RX Simples do abdome de sete RNs com ECN, sendo que todos estavam na fase 3 de Bell. Achados radiológicos: opacificação completa do abdome; bolha de ar acima do fígado; sinal da bola de futebol; imagens hipertransparentes sem o formato de víscera oca; Sinal de Rigler; e ar peritoneal livre destacando estruturas intraperitoneais. Considerações Finais: A ECN tem etiologia multifatorial, associado a três fatores principais: a imaturidade intestinal, proliferação bacteriana e dieta via oral com fórmula. O agravamento do quadro clínico, presença de sinais de instabilidade hemodinâmica, plaquetopenia e a acidose metabólica associados as alterações radiológicas específicas, podem propiciar o diagnóstico de uma ECN avançada. A indicação para a cirurgia de urgência é a presença de necrose e/ou perfuração intestinal. É fundamental reconhecer os diferentes modos de apresentação radiológica destas complicações, de forma rápida e precisa, pois, isso implicará na decisão terapêutica de uma cirurgia imediata e, consequentemente, terá impacto na qualidade de vida e na sobrevida desses neonatos.

Objetivo: Analisar os sinais, sintomas e os valores do hemograma inicial de crianças que tiveram posteriormente o diagnóstico definitivo, por meio do mielograma, de leucemia. Métodos: Foram avaliados prontuários de 31 indivíduos, de ambos os sexos, idade inferior a 18 anos, com diagnóstico de leucemia linfoide e mieloide no serviço de Oncologia de um hospital em uma Cidade do Estado de São Paulo. Foram avaliadas as frequências absolutas e relativas, média, desvio padrão, valores mínimos, máximos e mediana. O estudo foi aprovado por Comitê de Ética em Pesquisa. Resultados: Considerando as variáveis dos hemogramas dos pacientes analisados, observa-se que 80,64% apresentavam anemia no momento do diagnóstico, cerca de 61,29% cursavam com leucocitose e outros 16,13% com leucopenia, já linfocitose estava presente em 67,74% das crianças. Em 25,80% dos pacientes encontrou-se bastonetes aumentados e 58,06% linfócitos atípicos, além disso, foram encontrados 54,83% de blastos nos hemogramas e 83,87% de plaquetopenia. Conclusão: O hemograma demostrou ser um instrumento complementar valioso que associado ao quadro clínico e à perspicácia do médico, pode contribuir para diagnosticar a doença em estágios iniciais, proporcionando tratamento precoce e melhora do prognóstico.

Bilioduodenal and biliojejunal anastomoses are effective for the treatment of biliary obstruction. The objective of this study was to compare the effects of these anastomoses on hepatobiliary excretion and enterobiliary reflux. Enterobiliary reflux and biliary excretion were evaluated respectively after oral administration of techne- tium ( 99m Tc) in combination with sodium phytate and intravenous infusion of 99m Tc with diisopropyl-iminodi- acetic acid. Enterobiliary reflux occurred to an equal degree in the bilioduodenal and biliojejunal groups. Max- imum hepatic activity time (Tmax) and radiotracer clearance half-time (T 1/2 ) were similar in both groups. However, when compared with that found for the sham- operated group, Tmax, and T 1/2 were higher in the bili- ojejunal group (P = 0.02 and P = 0.01, respectively). Histopathological analysis showed marked reduction in ductal proliferation in both groups. These data undermine the theoretical advantages attributed to biliojejunal anas- tomosis and further the understanding of the pathophysiology of cholangitis that occurs even with patent anastomosis.

Galactoceles in children, either cystic or pseudotumors, are described in the literature as a rare cause of increasing breast size and can appear in males. We report a case of galactocele in a 15-month-old male, treated at our institution. The patient presented with a tumor in the right breast that had appeared 6 months earlier with no pain, signs of inflammation, or nipple secretion. Twelve cases found in the literature emphasize the importance of including galactocele in the differential diagnosis of benign breast masses in infancy.

A 10-year-old premenarchal girl was admitted to our hospital with moderate abndominal pain, although presenting no vomiting or abdominal rebound tenderness. A large abdominal mass was visible and palpable in the periumbilical and epigastric regions. Results of physical examination revealed that the general health status was satisfactory. Computed tomographic scan revealed a large, thin-walled cyst occupying nearly the entire peritoneal cavity. The other viscera were of normal aspect. A laparoscopic approach revealed a left ovarian cystic tumor that was twisted 360° in conjunction with the uterine corpus with hemorrhagic infarction. A partial hysterectomy and a left salpingo-oophorectomy were carried out. The tumor was classified as mature cystic teratoma of the ovary accompanied by hemorrhagic necrosis, not only of the cyst but also of the left uterine tube and the uterine corpus.

Visceral leishmaniasis (VL), also known as Kala-azar, is a systemic infection caused by a protozoan (Leishmania) and, in its classic form, is a serious illness associated with malnutrition, anemia, hepatosplenomegaly, infectious processes and coagulopathies. The effect of splenectomy in patients with visceral leishmaniasis is not well defined; however, it is known that the spleen is the largest reservoir of infected cells belonging to the reticulo endothelial system. Therefore, the surgical procedure is an option for the debulking of parasites, providing a cure for refractory VL and minimizing the complications of hypersplenism.