Phlegmon of the hand

Hand phlegmons are infections that are localized to a hand lodge but can also be diffused. Often they are caused by a complicated panaritium, but they can also result from trauma to the hand or direct inoculation. Because of the gravely evolution the general manifestations of disease predominate over the local manifestations.

Classification of the hand phlegmons

1. Deepening on the location

Panaritium

A panaritium is an acute or chronic infection of the finger or toe, it can superficial, deep or located around the nail. The cause of infection can be either bacteria or fungi, the germs create a cavity in which  pus is collected. Left untreated panaritium either open to the skin and eliminate pus (fistulizing) or extend into the deep tissue.

Germs associated with panaritium development

Panaritium is most commonly associated with  Staphylococcus aureus which is found in 50 % of cases, producing a creamy, thick and odorless pus. Other germs that can be isolated from the lesion are:

Hypertrophic pyloric stenosis

Congenital disease, characterized by a thickening (hypertrophy) of the pyloric muscular layer, forming a obstacle in the way of the alimentary bolus between the stomach and duodenum

Incidence vary between countries: In Europe and North America there are 1-3 cases of hypertrophic pylric stenosis in1000 births. For the Asian and African populations the incidence is 1case of hypertrophic pyloric stenosis in 2000 births. There are 4 males affected by the disease for every 1 female affected. Also 1 in every 14 children whose parents suffered from the disease develop the disease. Given the data it results that the disease has a sex related genetic transmission pattern. 

Duodenal stenosis and duodenal atresia

1. Causes 2. Classification 3.Clinical findings 4.Differential diagnosis 5.Treatment 6.Complications

Causes of duodenal stenosis and duodenal atresia

1 in every 5000 newborns suffer from either duodenal stonosis or duodenal atresia and in 85 % of the time the defect is located distal to the ampulla of Vater
According to Tandler's  theory the disease is caused by failure of the primordial duodenum repermeabilization process during weeks 8-10 of intrauterine life
Another cause may be compression of the duodenum by adjacent organs, such as in annular pancreas or biliary tract malformations
 

Hirschsprung's disease

What is hirschsprung's disease

Hirschsprung disease is characterized by a narrowing of a intestinal segment, in which the ganglion cells are absent from the intestinal wall, and an enlargement in the segment situated proximal to it.
The disease affects 1 in every 5000 newborns, males having an increased predisposition

What causes Hirschsprung disease?

 There is a genetic factor involved in the development of hischsprung disease, which also influences the clinical form of disease:

Small intestine malformations

Which are the main intestinal malformations ?

1 in every 5000-10000 newborns suffer from intestinal malformations
The main intestinal malformations are:

1. intestinal aplasia: the lack of continuity between two segments of theintestine
2. intestinal atresia: two segments of the intestine that are conected by an impermeable fibrous cord
3. intestinal diaphragm: thin membrane that determines stenosis in the intestinal lumen

Meconium ileus

What is meconium ileus ?

Meconium ileus is represented by a accumulation of viscous meconium, adherent to the wall of the small intestine which is frequently associated with mucoviscidosis . The disease is caused by a fibrocystic degeneration of the exocrine glands in structures derived from the primitive intestine:

1. Pancreas
2. Trachea and its ramifications 
3. Pulmonary alveoli  

Intestinal linvagination

Definition

Telescoping of the superior intestinal loop into the inferior one, leading to intestinal occlusion.

Epidemiology

Mainly affects eutrofic male newborns in the first 4-12 months of life. There are no prior sings or symptoms, the main manifestation being intestinal bowel movement disruption. There is a higher risk of developing after abdominal surgery.

Pathogenesis