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A patient who had received balloon atrioseptotomy and B-T shunt operation previously experienced recurrent episodes of supraventricular tachycardia, and was refractory to medical treatment since the age to 3. At 9 years, the patient underwent intraoperative electrophysiological mapping which confirmed the earliest breakthrough at the crux of posterior septal region. Rastelli's operation and division of posterior septal Kent was simultaneously performed successfully. Post operative ECG was normalized with abolition of delta wave, and PSVT was gone. We concluded that the division of Kent bundle should be simultaneously performed with operative reconstruction in patients with congenital heart disease and WPW syndrome on postoperative care for SVT.  相似文献   

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Compartment syndrome of the thigh in children is rare. We report a case of compartment syndrome of the thigh in an infant with a femur fracture resulting from suspected nonaccidental trauma. The delayed presentation of this injury may have been contributory to the development of compartment syndrome. The subtle physical findings in this case underscore the need for a high index of suspicion in making the diagnosis of compartment syndrome. The complete recovery of muscle function, even in the presence of significant tissue damage, is noteworthy and suggests that infants have a greater physiologic ability to recover in comparison with adults.  相似文献   

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A 40-year-old man with Down's syndrome was admitted to our hospital for complaint of painless, swollen right scrotum. Computed tomography revealed a right testicular tumor and mass of iliac fossa. Right high orchiectomy and extirpation of mass were performed. Histological diagnosis of right testicular tumor was seminoma and the mass was an external iliac lymph node metastasis of seminoma. After operation, radiation therapy was performed.  相似文献   

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INTRODUCTIONTailgut cysts or retrorectal cystic hamartomas are rare developmental anomalies that are believed to arise from the embryonic hindgut.PRESENTATION OF CASE9 months old male infant was presented with swelling in the right gluteal region. MRI lumbo-sacral spine showed well defined round to oval lesion which is brightly hypertense on T2W1 and hypotense on T1W1 posterior to sacrum and coccyx with no evidence of connection to the thecal sac indicating cyst. Complete excision of the cyst was done. Histopathology report shows cyst wall partially lined with stratified squamous epithelium and cyst wall shows spaces lined by cuboidal epithelium and nerve bundles with no evidence of malignancy suggestive of tailgut cyst.DISCUSSIONTailgut cysts are rare congenital anomalies. Most commonly located in the retrorectal space. They are thought to be derived from the remnants of the embryonic hindgut. Age ranges from 4 to 73 years but an average presentation is at 35 years. Female to male ratio is 3:1. MRI is a good diagnostic tool for diagnosis of tailgut cyst. Complete surgical excision is the treatment of choice as this provides a definite diagnosis and prevents possible complications such as infection, fistula formation and malignant degeneration.CONCLUSIONThe aim of presenting this case is its rarity. Complete surgical excision is the treatment of choice. Preoperative imaging with MRI is essential to plan the most appropriate surgical approach.  相似文献   

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The occurrence of both tricuspid atresia and WPW syndrome is quite rare. To our knowledge, only two operated cases have been reported. In this report, a 8-year-old boy with this combination was reported. Tachycardia via the right side accessory pathway was for the first time pointed out after Kreutzer's operation. Epicardial mapping showed the earliest excitation at the right free wall. When fatty tissue around this area was removed by CUSA, a large cardiac vein appeared. By holding this vein with a forceps, the delta wave disappeared temporarily. ACP seemed to be present near this vein. Permanent disappearance of the delta wave was obtained after ligation and division. Four months after surgery, he is free from tachycardia attacks.  相似文献   

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A newborn infant was diagnosed with an imperforate anus, and colostomy was performed one day after birth. He exhibited repeated episodes of poor oxygenation during intubation, and a CT scan revealed a bridging bronchus. He was scheduled to undergo sacroperineal repair in the prone position 8 months later. A tracheal tube, with its tip modified to widen the opening, was inserted through the nose. This led to normal oxygenation, even while in the prone position. The surgery was completed without any complications.  相似文献   

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A case of an infant poisoned with theophylline is described. Theophylline elimination was by first-order kinetics; the implications of this observation are discussed.  相似文献   

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