KLIPPEL-TRENAUNAY SYNDROME: CASE REPORT.

Introduction: Klippel- Trenaunay Syndrome (KTS) is characterized by a series of malformation concemig lymphatic vessels, capillaries and veins, without evidence of arterial-venousos shunt, that mainly involve one side. Typical pathological aspects are: cutaneous capillary malformations; regarding soft tissues or limbs bones hypertrophy; abnormal development of deep and superfici al veins and persistence of embryonal veins. Clinical case: We refer 11 months old patient's experience with a diagnosis of KTS, both for clinical picture, and for age was performed a conservative therapy with pressure bandage. Discussion: KTS is a rare congenital pathology. Its etiology is still unknown, but there are several embryo-genetic theories trying to explain altered angiogenesis, as VEGF (Vascular Endothelian Grow Factor) is considering the main responsible factor. The sintomathology is related to extension and site of the hypertrophy and vascular malformations. Presence of ulcer and edema at the limb, with or without pain is typical. Diagnostic protocol foresees: dermatological, orthopaedic and vascular evaluation; Rx of injuried limb; Color-Doppler; RMN; preoperative and intra-operative flebology. Regarding KTS treatment, it was proposed in literature a marginai veins "stripping", a binding of varicosity, abscission of lymphatic malformations, photocoagulation or sclerotherapy. However, the therapeutic approach remains related to the age of the patient and to the symptomatology and complications that eventually occurred. Surgical treatment, during paediatric age, is not properly opportune because of the high percentage offailure. For this reason children affected by KTS, we consider more useful a conservative treatment with pressure bandage and annual revaluation of clinical picture

Traumatic gut perforation (seat belt syindrome): a case report

Le cinture di sicurezza hanno drasticamente ridono l'entità e la gravità dei traumi da incidente stradale. Per contro, si è assistito alla comparsa di lesioni specifiche legate alloro utilizzo, definite con il termine "seat belt syndrome". Gli Autori descrivono una perforazione intestinale medio-ileale indotta dalla cintura in un bambino. L'intervento chirurgico, ha risolto completamente il quadro, senza alcuna sequela

Laparoscopic diagnostic exploration of the vaginal processus in the pediatric age

Background. Laparoscopic surgical procedures, employed even in the paediatric age, bearing both diagnostic and therapeutic value, are currently used in the evaluation of peritoneal-vaginal duct patency during surgery for controlateral inguinal hernia or other diseases requiring opening of abdominal wall. Methods. From January 1996 to December 2000, at the Department of Pediatric Surgery of the University of Siena a prospective study protocol has been performed to evaluate the effectiveness of laparoscopyversus traditional surgery in showing patency of peritoneal-vaginal duct. Results. From our study we have been able to see how this laparoscopic procedure is well tolerated by children and parents, and is lacking in clinical complications. Patency of peritonealvaginal duct has been pointed out in 21.73% of cases. This result is in Unewith the internationalliterature; in fact, the majority of authors have found a negative controlateral exploration in 50-80% of patients examined, thus confirming the uselessness of routine surgical controlateral inguinal exploration in hernia cases. Conclusions. The use of diagnostic laparoscopy in the study of peritoneal duct patency is a rapid and relative1y easy technique, practically without intra- and peri operative risks. It allows an easy solution of the diagnostic doubt, without the need to necessarily perform a traditional exploratìve surgical procedure

Laparoscopic diagnostic exploration of the vaginal processus in the pediatric age. Preliminary experiences.

Laparoscopic surgical procedures, employed even in the paediatric age, bearing both diagnostic and therapeutic value, are currently used in the evaluation of peritoneal-vaginal duct patency during surgery for controlateral inguinal hernia or other diseases requiring opening of abdominal wall.From January 1996 to December 2000, at the Department of Pediatric Surgery of the University of Siena a prospective study protocol has been performed to evaluate the effectiveness of laparoscopy versus traditional surgery in showing patency of peritoneal-vaginal duct.From our study we have been able to see how this laparoscopic procedure is well tolerated by children and parents, and is lacking in clinical complications. Patency of peritoneal-vaginal duct has been pointed out in 21.73\% of cases. This result is in line with the international literature; in fact, the majority of authors have found a negative controlateral exploration in 50-80\% of patients examined, thus confirming the uselessness of routine surgical controlateral inguinal exploration in hernia cases.The use of diagnostic laparoscopy in the study of peritoneal duct patency is a rapid and relatively easy technique, practically without intra- and peri operative risks. It allows an easy solution of the diagnostic doubt, without the need to necessarily perform a traditional explorative surgical procedure