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Three cases of extravaginal torsion of the spermatic cord with infarct of the testicle in the newborn are presented. All three cases had acute fetal distress. They had in common being the products of multiparous women, born in a distocic fashion with a prolonged labor without prenatal control. One of the had a shoulder impaction with required forceps use. Two of them were delivered on vaginal way and the other one by cesarean section. In all three cases, torsion was present at birth. Diagnosis was made between third and fifth day of life; the clinical findings were: enlargement of the right scrotal bag, purple discoloration of the skin, a painless hard mass that did not permit the passage of light (transillumination) and the absence of cremasteric reflex. A right resolution ultrasound was useful in determining the inflammatory tumoral mass. A right orchidectomy and pexy of the contralateral testicle were done in the three cases with nonabsorbable sutures and no testicular implants. The following diagnoses should be discarded prior to a definitive diagnosis: scrotal edemas, hydrohematocele, strangled inguinal hernia with infarct and testicular neoplasia.

The appendicitis in infants, including premature and newborn are exceptional. In smallers of three years is few frequently and plenty they are driving to fulfill the laparotomy. Diagnostic is hard for the atypical clinical picture and the rapid evolution toward appendicular boring and generalized peritonitis, modified or not for antibiotics use. The main symptoms of appendicitis finding in this study were: fever, vomitus, pain and abdominals distention. To research the muscular resistance become generalized, the McBurney signs and bonce. There were leucocytosis, urine alterations and the "X"-rays films showed occlusion signs and paralytic ileo. The ultra-sound scan were of great utility in the diagnostic of acute appendicitis and its complications, abscess of walls of intraperitoneal. There surgery was be urgent. The insiction for right half supra and infraumbilical become more frequently, next with appendicectomy of Oschner. Were utilized drain pipe in perforating or abscess cases. The post-operative complications more frequent seen were infection on the surgical hurt. The supured and gangrened appendicitis and perforated and abscessed walls were treated with antibiotics. The mortality rate were zero in this analyzed group.

The bronchogenic cyst is a congenital malformation of the tracheobronchial tree. It is not frequently seen in the pediatric population and had its origin around the sixth week of gestation when the bronchial development stops. Two cases of intraparenchymal bronchogenic cyst with lobar involvement of the right lung is presented. It was suspected after carefully examining and X-ray of the thorax and it was confirmed with ultrasonography and CT scan. There were no other associated malformations. The clinical and radiological diagnosis is extremely important for achieving the correct surgical procedure. This 2 patients was treated by thoracotomy and pulmonary lobectomy.

The articles includes eight cases of congenital atresia of the vagina seen and studied at the Pediatric Surgery Department. All cases were congenital five of them corresponded to the Mayer-Rokitansky-Kuster-Hauser Syndrome an the remaining three to congenital adrenal hyperplasia. No other malformations were associated to any of the cases. The karyotype, hormones and secondary sexual characteristics were normal in those cases of Mayer-Rokitansky-Kuster-Hauser Syndrome. In the other three cases of congenital adrenal hyperplasia the karyotype was found to be 46XX, the 17-ketosteroids and pregnanediol were high and the patients were found to have hirsutism and were virilized. The ultrasonography, CAT and magnetic resonance scans showed excellent anatomical information on the congenital vaginal atresia and the intrapelvic organs. No other invasive study was needed to confirm its existence. Six of the patients were operated using the McIndoe and Bannister technique while on the other two the Tobin and Day technique was used. Post-surgical complications included vaginal stenosis in two cases within the first three months. The article includes an analysis of the complications and both the anatomical and functional results obtained.

The difficulty of knowing the percentage of newborns and infants who have been circumcised in our medium, and the presence in the Surgical Pediatric Ward of our hospital, during the last five years, of patients with total denudation of the penis--secondary to a circumcision with plastibel, drove us to research and share our experience in the use of a free skin graft for its correction, the postoperative care needed and the follow-up of those patients. Circumcision is a surgical procedure which is not totally innocuous and which should be performed by surgically experienced personnel to obtain good results. It is recommended that general practitioners and pediatricians be informed that the denudation of the penis is an infrequent but severe complication, and how to avoid its occurrence. Complications of plastibel circumcision in pediatrics.

We report a case of simple ureterocele which was diagnosed in utero using prenatal ultrasonography at 32 weeks and subjected to serial observations in order to spot hydronephrosis and hydroureter. The diagnosis was confirmed at birth using ecosonography and the newborn was submitted to corrective surgery during the immediate neonatal period, obtaining excellent results.

Six patients with achalasia of the esophagus were submitted to an abdominal esophagomyotomy which extended two centimeters in width and six to eight centimeters in length, descending one or two centimeters from the esophagealgastric union without having to remove the mucosa in 50% of the esophageal circumference while also performing total funduplication of the floppy Nissen type. The clinical evaluation showed the disappearance of all symptoms. Both the endoscopic as well as the X-rays studies showed the obsence of obstructive symptoms or reflux of any sort. The manometry showed a decrease in the pressure exerted by the inferior esophageal sphincter. No complications arose during or after the surgeries. The results were excellent in all cases and mortality was zero.

The authors report a case of brachial paralysis and paralysis of the right hemidiaphragm which followed a favorable course. Comments are made on the symptomatology and course of the disease.

Congenital choledochal cyst (CChC) has a very low frequency in our population; it is more frequent among females and its pattern of inheritance is multifactorial. The frequency of CChC in our population was 1 per 20,000 to 1 per 30,000 hospitalized patients in the pediatrics department of the Hospital Juarez and Hospital Infantil de Tacubaya, respectively. Four new cases of CChC are reported, two school children and two teenagers. Pre-operative diagnosis was accomplished clinically, which is the most precise non-invasive method. The most effective actual diagnostic methods include ultrasonography, CAT scan, and basic laboratory data, which can corroborate the clinical diagnosis of CChC with 100% certainty. The surgical treatment of CChC is controversial, but the surgical procedures of choice are choledochocystojejunostomy with total cyst removal, Roux's Y, and cholecystectomy. One case was treated with latero-terminal choledochocystojejunostomy and 3 cases with total removal of the cyst. The results were excellent.

The study included 58 cases of liver abscess draining into the thorax, seen at the Hospital Infantil de Mexico from January, 1963 to December, 1973. These 58 complicated cases represent 16.2% from a total of 358 patients with liver abscess seen through the same period of time. The clinical picture, period of evolution, methods of diagnosis, treatment and results are analyzed finding that out of 50 cases draining into pleura or lungs, 44 were admitted with this complication already present, the same as 5 out of the 8 cases to pericardium. From the 58 cases, 24 died and 34 recovered. An early diagnosis of uncomplicated amebic liver abscess and adequate treatment constitute the basis to prevent the high morbilethality subsequent to complications.

The congenital cystic dilatation of choledochal is a congenital malformation with little frequency in Mexico. It is of multifactorial etiology and it is known with different names. The work present its frequency, pathology, etiology, its clinic manifestations, the actual methods of cabinet and laboratory there are most frequently to be used in the preoperative diagnosis of the disease. It is proposed an algorithm for to study the icteric syndrome in infants and childhood who has suspicion of congenital cystic dilatation of choledochal. It is describe the surgical treatment and the mortality.