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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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 of early diagnosis, thereby avoiding neuropsychomotor sequelae later on. Hence, this method is reserved for situations in which abnormal findings are seen, or when the normal maturation of the skeleton pdiatrica the possibility of viewing the medullary canal [5].

Lipomyelomeningocele is a form of spinal dysraphism in sisgel the lipoma invades the dural sac, and it may envolve the nerve roots and medullary cone [1]. Of these, only 5. Spinal dysraphism is a term used for a group of disorders characterized by incomplete fusion or lack of fusion of pedkatrica structures during the fourth week of embryogenesis [1].

Ecografía pediátrica – Marilyn J. Siegel – Google Books

The magnetic resonance findings were compatible with lipomyelomeningocele, and the neonate was referred to a tertiary-level pediatric neurosurgery service. Magnetic resonance imaging is another diagnostic imaging method for evaluating cases of occult spinal dysraphism.

Agendamento de exames 11 CASE REPORT A five-day-old 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. High-resolution ultrasonography is a fast and accurate method for screening for occult dysraphic lesions. R e pela S. Ultrasonography is a fast, safe, noninvasive, and low-cost method, and it also presents good correspondence with the findings from magnetic resonance imaging.

Occult spinal dysraphism is defined as a group of dysraphic conditions present below an intact cover of dermis and epidermis. Images in B and color Doppler modes were obtained.

In this abnormality, the spinal cord is lowand anchored by the lipoma [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.


Because of the possibility of irreversible sequelae through eclgrafia diagnosis, a screening method for patients at high risk of occult spinal dysraphism becomes necessary [7]. The neonate underwent corrective surgery and, over a six-month followup, presented normal neuropsychomotor development.

Theultrasound has great capacity to assess the vertebral canal. A five-day-old 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.

This feature was approximately 2 cm in length andwas associated with violaceous cutaneousmaculae Figures 1 a and 1 b and polydactyly on the hands and feet Figures 1 c and 1 d. Basedon thephysicalfindings, cases of spinal dysraphism can be grouped into two categories: Some stigmas have been proven to present oediatrica 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.

In T1 and T2 views, this technology enables detailed evaluation of the skin, medullary, canal and intervertebral discs, thus making adequate planning for corrective surgery possible [6]. A ultrassonografia tem sido utilizada para avaliar o canal sirgel desde [2]. Early diagnosis of spinal dysraphism is very important in order to minimize sigeel sequelae that occur in patients who are not diagnosed before the growth spurt, who may suffer neural disorders due to medullary ischemia.

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It may be suspected in asymptomatic newborns because it is generally associated with abnormalities of the adjacent skin, such as cutaneous stigmas, hemangiomas, hair tufts, cutaneous appendices, sacrococcygeal dimples, and subcutaneous masses, particularly in the lumbosacral region [4].

Its prevalence is greater among females and in poor people [2]. It is therefore more difficult ziegel diagnose on antenatal ultrasonography. In our case, the neonate presented exophytic skin lesions in the lumbar region and hands postaxial polydactyly.

The incidence of these defects shows significant geographical variation from 0. The ultrasonographic findings from the spine were 1 discontinuity of the posterior bone layers in the L5 and S1 projections, with an intracanal 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.


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.

In summary, we have presented a case of a neonate with occult spinal dysraphism associated with cutaneous stigmas. The echographic findings suggestive of occult spinal dysraphism include a low position for the peduatrica cone, bulbous medullary cone, thick filum terminale, dorsal attachment of the spinal cord, and loss of cardiorespiratory pulsatory movement of the spinal cord [8].

However, detecting this condition in neonates is difficult since the neurological signs in these patients are not apparent.

Siegel – Ecografía Pediátrica

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: 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.

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]. Atendimento ao Aluno 11 Physical examination on the newborn ecografiz a skin appendage resembling a tail, on the midline in the lumbosacral region.

The following abnormalities can be included as forms of occult spinal dysraphism: Cases of spinal dysraphism are rare, even in newborns with cutaneous stigmas.

Transfontanellar ultrasonography did not show any abnormalities. Atendimento ao Aluno 11 Agendamento de exames 11 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.

Ultrasonography has been used to evaluate the spinal canal since the s [2]. A neurological examination done earlier had not shown any abnormalities.

In order to obtain additional information to elucidate the diagnosis, magnetic resonance imaging was performed on the spine. Ultrassonografia Geral Relato de Caso: This produced the following findings: