Sr. Editor: La perforación del tracto gastrointestinal en el neonato en el duodeno es una entidad extremadamente infrecuente. Existen algunos casos que afectan a recién nacidos sanos cuya etiología permanece desconocida y para los que se reserva el término de perforación duodenal espontánea. Se presenta uno de estos casos, comunicando la clínica, las imágenes radiológicas y la revisión bibliográfica de la casuística.

Perforación duodenal neonatal espontánea

The bladder hamartoma is an extremely rare entity. We report on its presence in a 5-year-old boy with Goldenhar syndrome. Most probably, this is the first report of a bladder hamartoma presenting with obstruction of the bladder outlet resulting in urinary retention. The obstructive lesion was resected endoscopically. This proved to be curative for the lesion, since the follow-up voiding cysto-urethrogram revealed only a negligible post-void residual volume. Although urogenital anomalies have a well-known correlation with the Goldenhar syndrome, the existence of the bladder hamartoma found in association with this syndrome, according to the best of our knowledge, has not been previously reported in the world literature. With this report being only the 11 th described case of bladder hamartoma, we highlight on the management options for this exceptional histological finding. The incidence, screening, treatment decisions and important urogenital associations of the Goldenhar syndrome are also discussed.

Bladder hamartoma: a unique cause of urinary retention in a child with Goldenhar syndrome.

Duodenal perforation in neonates is a rare surgical emergency. In the cases reported, most perforations are localised to the anterior duodenum and a few at posterior aspect. We present a case of duodenal perforation in the second part of the duodenum in a 26-day-old healthy male neonate.

/pdf/duodenal-perforation-in-a-neonate-an-unusual-presentation-4hnotqo6cp.pdf

Duodenal perforation in a neonate: an unusual presentation and analysis of the cause.

A male neonate born at 29 weeks of gestation by emergency cesarean section due to preeclampsia, small for gestational age, with a birth weight of 800 grams and length of 34.5 cm. APGAR scores were 4,6,7 at 1,5 and 10 minutes, respectively. The mother was 31-year-old, who had chronic arterial hypertension treated with Methyldopa and Nifedipine. Antenatal scans showed intrauterine growth restriction. At 24 weeks of gestational age, the mother received steroids for fetal lung maturation. The baby had severe respiratory failure thus shifted to the neonatal intensive care unit (NICU) on mechanical ventilation. On the 9th day of life, the patient was extubated and shifted to non-invasive ventilation (CPAP: continuous positive airway pressure). Orogastric tube feeding was started with the mother’s breast milk and the baby had good tolerance and several bowel movements.

/pdf/spontaneous-duodenal-perforation-in-a-neonate-92058ogrfg.pdf

Spontaneous duodenal perforation in a neonate

Spontaneous duodenal perforation in neonates (SDPN) is a rare surgical emergency. Only few cases have been reported. A neonate presented with abdominal distension investigated with imaging modalities which gave suspicion of a duodenal duplication or choledochal cyst. At surgery, a duodenal perforation with local collection, was encountered simulating a duodenal duplication cyst.

Duodenal Perforation Simulating as Duodenal Duplication Cyst in a Neonate: A Case Report

A full-term 4-day-old male baby presented with spontaneous duodenal perforation into the lesser sac. Exploration revealed a perforation in the posteromedial wall of the second portion of the duodenum. The perforation was closed and the baby recovered uneventfully.

Spontaneous duodenal perforation in a newborn.

The Goldenhar syndrome (oculo-auriculo-vertebral syn­drome or 1st and 2nd branchial arch syndrome) is a com­plex of craniofacial anomalies. It has been associated with anomalies in other systems and with abnormalities of the urogenital system. We present a case of Goldenhar syn­drome with multiple renal anomalies and a urogenital si­nus, which has not been reported before.

Goldenhar syndrome and urogenital abnormalities

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Spontaneous duodenal perforation in a newborn.

Goldenhar syndrome and urogenital abnormalities