We observed a marked female predominance (73.4% of cases), the diagnosis being made in the first decade of life in 90% of patients. The most prevalent clinical manifestation was jaundice (70% of cases) and the classic triad of choledochal cyst was not observed. Abdominal ultrasound was the first imaging examination performed, with a sensitivity of 56.6%, with diagnostic definition in 17 children. Two patients (6.6%) had prenatal diagnosis. All patients underwent surgical treatment, cyst resection with Roux-en-Y hepaticojejunostomy being performed in 80% of cases. The incidence of postoperative complications was 13.3% and the mortality rate was 6.6%, ie two patients were diagnosed with Caroli's disease. ConclusionConclusion Conclusion Conclusion Conclusion: The non-observance of the classic triad of choledochal cyst suggests that its incidence is lower than that reported in the medical literature. The surgical treatment of choledochal cysts, with resection and bilioenteric anastomosis, is safe even for small children.
To date, intrinsic obstructions of the duodenum have been explained by the "solid core" theory, described by Tandler in 1902 (Morphol Jahrb 29:187-216, 1902). This study aimed to evaluate the epithelial occlusion of rat duodenum during embryonic development, through optical microscopy and computerized three-dimensional reconstruction. The Wistar rat embryos used in this study had 13, 14, 15, and 16 days of gestation. This corresponds to human embryos with 33, 40, 44, and 52 days of development, which is between the fifth and eighth week. The study included 12 embryos studied by optical microscopy, and four by three-dimensional reconstruction (those with 13, 14, 15, and 16 days). Through optical microscopy, an intense epithelial proliferation was observed in the gestation embryo of 13 days, with no occlusion of the opening of the duodenum. In the embryos with 14, 15, and 16 days of gestation, an increase in diameter of the duodenum was observed along with intestinal development. Through three-dimensional reconstruction, it was observed that the opening of the digestive tube of rat embryos with 13-16 days of gestation is never obstructed by epithelial proliferation, although it may follow a sinuous path. This study concludes that the "solid core" phase described by Tandler does not occur in the embryonic development of rat duodenum.
Etiopathogenesis of biliary atresia remains unknown. Among several theories, one proposes that the disorder may be caused by the toxic effect of monohydroxy bile acids on fetal and neonatal hepatobiliary system. In this paper we evaluated toxic effects produced by ingestion of cholic acid, a trihydroxy bile acid, and lithocholic acid, a monohydroxy bile acid in the hepatobiliary system of a hamster during gestational and perinatal periods. A diet composed by 0.5% cholic acid and 0.25% lithocholic acid was administrated to pregnant hamsters. Liver and bile ducts of the adult and newborn animals were analyzed to point out the changes induced by these acids after birth. Because hamsters and humans have a similar bile metabolism, these animals were eligible for the study. The ingestion of 0.5% lithocholic acid, during hamster's gestation, caused maternal intense ductal/ductular proliferation, inflammatory signs, hepatic cells degeneration and regeneration, hyperplasia of extra hepatic ducts epithelium, and abortion. Both 0.5% cholic acid and 0.25% lithocholic acid ingested by pregnant hamsters, caused ductal/ductular proliferation and hepatobiliary inflammatory damage in a different degree of intensity in adult animals and mild intensity in the young; and also the number of the young was reduced in the litter. We found that the ingestion of these bile acids by hamsters, during gestational period caused different degrees of toxicity on maternal and neonatal hepatobiliary systems. The histopathologic findings observed in biliary atresia patients could not be found in newborn hamsters. New experimental models are needed in the attempt to establish a correlation of these acids with neonatal cholestatic diseases.
OBJETIVO: Comparar, em ratos, a eficiência das técnicas de Nissen e Boix-Ochoa no tratamento do refluxo gastroesofagiano (RGE) induzido pela operação de Heller. MÉTODO: Foram usados 30 ratos Wistar, com idades entre 40 e 60 dias de vida e peso corporal entre 210 g e 342 g. Os animais foram distribuídos em três Grupos (A, B, C) de 10 ratos. Em todos os animais realizou-se a operação de Heller. No Grupo B ela foi seguida de uma operação de Nissen e, no Grupo C, de uma operação de Boix-Ochoa. A pressão intra-gástrica necessária para produzir RGE foi medida em todos os animais: antes de qualquer procedimento; imediatamente após as operações de Heller, Nissen e Boix-Ochoa; e seis semanas depois, quando os animais foram mortos. RESULTADOS: Verificou-se que tanto a recuperação da perda de peso, que caracteriza o quadro de RGE, como a reconstituição mais fisiológica dos gradientes pressóricos gastroesofagianos são obtidos de forma mais eficiente pela técnica de Boix- Ochoa. CONCLUSÃO: As operações de Nissen e Boix- Ochoa são eficientes no tratamento do RGE induzido pela técnica de Heller, em ratos. A segunda, no entanto, restaurou, de forma mais adequada, os valores fisiológicos dos parâmetros estudados neste trabalho: o peso corporal e os gradientes pressóricos gastroesofagianos.
ResumoObjetivos: reproduzir, experimentalmente, em ratos, por meio do inibidor da enzima óxido nítrico sintase (ONS -L-NAME), os achados histopatológicos correspondentes a estenose hipertrófica do piloro da infância (EHPI).Métodos: para reproduzir o modelo de inibição de ONS na produção de EHPI, administrou-se L-NAME em ratas grávidas, a partir do 14º dia gestacional (grupo L-NAME), comparando-se com uma gestação de controle. Após o nascimento, todos os ratos do grupo L-NAME foram mantidos sob inibição da ONS até o 42º dia de vida, quando foram sacrificados. Os filhotes da gestação de controle, em que nenhuma droga foi administrada, foram também sacrificados com 42 dias de vida. Os animais e as vísceras foram analisados e pesados. A região pilórica foi preparada tecnicamente e observada em microscopia de luz.Resultados: em comparação com os animais de controle, os L-NAME tiveram peso corporal e intestinal menor e peso gástrico maior. Nos animais L-NAME a microscopia de luz evidenciou hipertrofia da camada circular do músculo liso do piloro.Conclusão: este trabalho reproduziu um modelo experimental de estudo da estenose hipertrófica do piloro e comprovou, neste modelo, a associação da ausência da ON sintase na musculatura do piloro.J Pediatr (Rio J) 2001; 77 (4): 307-12: estenose pilórica, óxidos de nitrogênio, L-NAME. AbstractObjective: to experimentally reproduce, in rats, the findings corresponding to the histopathology of infantile hypertrophic pyloric stenosis (IHSP), using nitric oxide synthase (NOS) inhibitor (L-NAME).Methods: L-NAME was administered to pregnant rats (L-NAME group), from the 14th gestational day on in order to reproduce the model of NOS inhibition in the production of IHSP. This group was then compared to control animals. After birth, all the animals in the L-NAME group were maintained under NOS inhibition until the 42nd day of life, when they were sacrificed. The control animals, which did not receive any kind of drug, were also sacrificed on the 42nd day of life. The animals and their internal organs were analyzed and weighed. The pyloric region was technically prepared and observed through light microscopy.Results: the L-NAME group presented lower body and intestinal weight and higher gastric weight than the control group. Light microscopy revealed hypertrophy of the circular smooth muscle layer of the pyloric muscle in L-NAME animals.Conclusions: this work reproduced an experimental model of an IHSP study, confirming the effect of NOS blockade on the pyloric musculature.J Pediatr (Rio J) 2001; 77 (4): 307-12: pyloric stenosis, nitric oxide synthase, L-NAME. Papel da óxido nítrico sintase na etiopatogenia da estenose hipertrófica do piloro na infância Role of nitric oxide synthase in the etiopathogenesis of hypertrophic pyloric stenosis in infants IntroduçãoA estenose hipertrófica do piloro na infância (EHPI) é uma afecção comum, com incidência de 0,3% em recém-natos. Ocorre, preferentemente, entre as 3ª e 6ª semanas de vida, caracterizada pela hipertrofia da camada circular da muscula...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.