Lippincott Williams & Wilkins, Philadelphia, PA, pp– Sivit CJ, Siegel MJ ( a) Invaginación intestinal. In: Siegel MJ (ed) Ecografía Pediátrica, 2nd edn., . Get this from a library! Ecografía pediátrica. [Marilyn J Siegel]. Libros de Segunda Mano – Ciencias, Manuales y Oficios – Medicina, Farmacia y Salud: Ecografia pediatrica, por siegel en excelente estado. Compra, venta y.

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Indique a um amigo Imprimir. Sweeps in longitudinal and transverse planes were performed, with the aims of making a detailed assessment of the contiguity of the anatomical features with themedullary canal: The incidence of these defects shows significant geographical variation from 0. Transfontanellar ultrasonography did not show any abnormalities.

Basedon thephysicalfindings, cases of spinal dysraphism can be grouped into two categories: Agendamento de exames 11 In order to obtain additional information to elucidate the diagnosis, magnetic resonance imaging was performed on the spine. High-resolution ultrasonography is a fast and accurate method for screening for occult dysraphic lesions. Here, we present a case of a five-day-old neonate with occult dysraphism of lipomyelomeningocele type who presented cutaneous stigmas, and we demonstrate the main ultrasonographic and magnetic resonance findings from the spine.

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We believe that ultrasonography should be performed on patients who are at high risk of occult spinal dysraphism, such as those presenting cutaneous stigmas, congenital abnormalities, or neurological alterations, as ameans pediqtrica early diagnosis, thereby avoiding neuropsychomotor sequelae later on. The incomplete ossification of the posterior ecogrqfia of the more caudal vertebrae in children of up to five or six months of age provides a good acoustic window for viewing the content of the vertebral canal and the bone structures [5].

Echography is considered to be an effective low-cost noninvasivemethod and plays a critical role in diagnosing or ruling out occult spinal dysraphism at birth [2].

Early diagnosing of occult spinal dysraphism prevents progressive neurological dysfunction.

However, detecting this condition in neonates is difficult since the neurological signs in these patients are not apparent. A ultrassonografia tem sido utilizada para avaliar o canal medular desde [2]. Atendimento ao Aluno 11 Agendamento de exames 11 In ecografiia abnormality, the spinal cord is lowand anchored by the lipoma [2].


Atendimento ao Aluno 11 Early diagnosis of spinal dysraphism is very important in order to minimize the sequelae that occur in patients who are not diagnosed before the growth spurt, who may suffer neural disorders due to medullary ischemia.

A neurological examination done earlier had not shown any abnormalities. Ultrasonography is a fast, safe, noninvasive, and low-cost method, and it also presents good correspondence with the findings from magnetic resonance imaging. High-resolution ultrasonography using a linear transducer made it possible to identify and characterize the lesion, and magnetic resonance imaging confirmed the type of lesion lipomyelomeningocele and enabled adequate surgical planning.

It may be suspected in asymptomatic newborns because it is generally associated with abnormalities of the adjacent skin, such as cutaneous stigmas, pediatria, hair tufts, cutaneous appendices, sacrococcygeal dimples, and subcutaneous masses, particularly in the lumbosacral region [4]. CASE REPORT A ecogrzfia white female neonate was sent to our service for transfontanellar ultrasonography to be performed, because of the presence of cutaneous stigmas in the lumbar region.

In our case, the neonate presented exophytic skin lesions in the lumbar region and hands postaxial polydactyly. This case was different from our protocol because the neonate was referenced to realize the transfontanellar ultrasound, and only after the observation of cutaneous stigma, the protocol of pediaatrica spinal dysrapism was performed.


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Theultrasound has great capacity to assess the vertebral canal. Its prevalence is greater among females and in poor people [2]. The protocol to neonates with high risk of occult spinal dysraphism has demonstrated good results; however, the physicians should be aware of neonates with cutaneous stigma because of high incidence of occult spinal dysraphism.

Lipomyelomeningocele is a form of spinal dysraphism in which the lipoma invades the dural sac, and it may envolve the nerve roots and medullary cone [1]. The diagnostic hypothesis was that a defect of the medullary canal was present pediaatrica the region of the cutaneous stigma, with anchored spinal cord and an intracanal solid medullary formation with apparent peripheral invasion that was continuous with the spinal cord, suggestive of a lipoma.


Ecografía pediátrica – Marilyn J. Siegel – Google Books

Cases of multiple stigmas comprise another group at risk [7]. The magnetic resonance imaging has the capacity to identify the type and the level of lesion. In summary, we have presented a case of a neonate with occult spinal dysraphism associated with cutaneous stigmas.

Cases of spinal dysraphism are rare, even in newborns with cutaneous stigmas. Of these, only 5.

Siegel – Ecografía Pediátrica

Because of the possibility of irreversible sequelae through delayed diagnosis, a screening method for patients at high risk of occult spinal dysraphism becomes necessary [7]. The echographic findings suggestive of occult spinal dysraphism include a low position exografia the medullary cone, bulbous medullary cone, thick filum terminale, dorsal attachment pedistrica the spinal cord, and loss of cardiorespiratory pulsatory movement of the spinal ecograia [8].

In our service, the protocol to neonates with high risk of occult spinal dysraphism with cutaneous stigma is accomplishment of spinal ultrasound using the linear transductor. The ultrasonographic findings from the spine were 1 discontinuity of the posterior bone layers in the L5 and S1 projections, with an ecografis solid formation presenting undefined margins and a heterogenous hyperrefringent interior, adhering to the distal segment of the medullary cone; 2 a medullary cone extending beyond the L3 body Figure 2.

In three prospective studies in the literature, the highest incidence reported, in an evaluated population of 2, patients, was 7. It is therefore more difficult to diagnose on antenatal ultrasonography. Some stigmas have been proven to present greater risk of occult spinal dysraphism, such as deep or atypical sacrococcygeal dimples, hemangiomas, cutaneous aplasia, subcutaneous masses, and exophytic skin lesions such as tails and hair tufts.