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Haematoxylin-eosin staining: (A) ×20 (B) ×40. Immunohistochemistry: (C) Cytokeratin AE1/AE3, (D) CD4+, (E) CD8+.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Javier Aubán-Pariente, Jorge Santos-Juanes, Blanca Vivanco-Allende, Cristina Galache-Osuna" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Javier" "apellidos" => "Aubán-Pariente" ] 1 => array:2 [ "nombre" => "Jorge" "apellidos" => "Santos-Juanes" ] 2 => array:2 [ "nombre" => "Blanca" "apellidos" => "Vivanco-Allende" ] 3 => array:2 [ "nombre" => "Cristina" "apellidos" => "Galache-Osuna" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403320305427" "doi" => "10.1016/j.anpedi.2020.12.019" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403320305427?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287924000863?idApp=UINPBA00005H" "url" => "/23412879/0000010000000004/v1_202404250845/S2341287924000863/v1_202404250845/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2341287924001169" "issn" => "23412879" "doi" => "10.1016/j.anpede.2024.03.050" "estado" => "S300" "fechaPublicacion" => "2024-04-01" "aid" => "3067" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "An Pediatr (Barc). 2024;100:e24-e25" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Paediatrics</span>" "titulo" => "Diffuse subarachnoid haemorrhage with obstructive hydrocephalus in a 4-year-old girl" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e24" "paginaFinal" => "e25" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemorragia subaracnoidea difusa con hidrocefalia obstructiva en niña de 4 años" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3574 "Ancho" => 1352 "Tamanyo" => 379811 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) The CT scan showed subarachnoid haemorrhage and obstructive hydrocephalus.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cerebral angiogram. Left vertebral artery series: (B) lateral view and (C) anteroposterior view. Giant fusiform aneurysm in the two lower thirds of the basilar artery. Treatment options like parent artery sacrifice or stent-assisted reconstruction were ruled out on account of the age of the patient and anatomical considerations.</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">T1-weighted and FLAIR (fluid-attenuated inversion recovery) MRI images: (D) and (E) immediate postoperative period, and (F) and (G) 6 months after surgery. The images show a progressive reduction of the aneurysmal pouch and partial resolution of mass effect and obstructive hydrocephalus.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Gutiérrez-Vélez, Clara Ferrero García-Loygorri, Mariano Del Valle Diéguez, Juan Vicente Darriba Alles" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ana" "apellidos" => "Gutiérrez-Vélez" ] 1 => array:2 [ "nombre" => "Clara" "apellidos" => "Ferrero García-Loygorri" ] 2 => array:2 [ "nombre" => "Mariano" "apellidos" => "Del Valle Diéguez" ] 3 => array:2 [ "nombre" => "Juan Vicente" "apellidos" => "Darriba Alles" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403320305348" "doi" => "10.1016/j.anpedi.2020.11.030" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403320305348?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287924001169?idApp=UINPBA00005H" "url" => "/23412879/0000010000000004/v1_202404250845/S2341287924001169/v1_202404250845/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Paediatrics</span>" "titulo" => "Perineal mass at birth" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e26" "paginaFinal" => "e27" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ignacio Arroyo Carrera, Carlos Manuel Ojeda Espino, Rafael Ayuso Velasco, Yoana Franco Rodríguez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Ignacio" "apellidos" => "Arroyo Carrera" "email" => array:1 [ 0 => "iarroy@telefonica.net" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Carlos Manuel" "apellidos" => "Ojeda Espino" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Rafael" "apellidos" => "Ayuso Velasco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Yoana" "apellidos" => "Franco Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Unidad de Neonatología, Hospital San Pedro de Alcántara, Cáceres, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Pediatría, Hospital Ciudad de Coria, Coria, Cáceres, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Cirugía Pediátrica, Hospital San Pedro de Alcántara, Cáceres, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Anatomía patológica, Hospital Universitario de Cáceres, Cáceres, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Masa en el periné al nacimiento" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1531 "Ancho" => 2094 "Tamanyo" => 333719 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Perineal mass that had undergone exstrophy between the right outer fold of the vulva, which was hypertrophic, and the anus: (A) appearance on initial examination; (B) improved visualization of its relationship with adjacent perineal anatomic structures; (<span class="elsevierStyleSmallCaps">C</span>) surgical specimen.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Perineal masses are rare in childhood. We present the case of a female neonate with a mass protruding from the perineum.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The pregnancy was normal, with provision of prenatal care, normal antenatal ultrasounds and blood tests. The patient was born to term, with an Apgar score of 9. Her anthropometric measurements were within the 50th to 75th percentile. No family history of interest. At birth, a bilobulated mass was detected that had an external portion measuring 4 × 2.5 cm, was lined with mucosa and had a distal orifice, set in the perineal region between a hypertrophic outer fold and the anus. There were no associated anomalies, the urethral meatus was patent, with passage of urine with normal appearance and normal labia minora and vaginal introitus, the anus in the right location slightly compressed by the mass that allowed passage of meconium without abdominal distension or perineal fistulas (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Imaging with ultrasound and magnetic resonance did not detect anomalies in any other organs (genitals, gastrointestinal tract/anal canal, urinary system, perineal muscle) or any fistulas. The base of the mass was located in the right ischioanal fossa, lateral to the anal canal and vagina, without communication between these two structures, and ending in a pouch that continued externally with an inner cavity of mucosal contents and an external orifice directed toward the skin. The mass was resected with an anterior sagittal approach without postoperative complications, save for wound dehiscence that ended up healing without sequelae. Biopsy: anorectal duplication (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Gastrointestinal tract duplications are infrequent congenital anomalies, and only 5% of them involve the rectum; they are usually cystic, as opposed to tubular, and can be found within, posterior to or anterior to the rectum.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Duplications that protrude as a perineal mass and have undergone exstrophy are extremely rare and may be associated with other malformations, including anorectal, genitourinary or vertebral anomalies<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> (none of which were present in this patient), so they should be ruled out.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1531 "Ancho" => 2094 "Tamanyo" => 333719 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Perineal mass that had undergone exstrophy between the right outer fold of the vulva, which was hypertrophic, and the anus: (A) appearance on initial examination; (B) improved visualization of its relationship with adjacent perineal anatomic structures; (<span class="elsevierStyleSmallCaps">C</span>) surgical specimen.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 981 "Ancho" => 1305 "Tamanyo" => 368969 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histological appearance of the inside-out mass with anal squamous epithelium (green arrow), transitional zone (black arrow) and rectal mucosa with two layers of muscle (yellow arrow) (×4), findings consistent with the diagnosis of anorectal duplication.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perineal mass protrusion with rectal mucosa: a rectal duplication that underwent exstrophy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Sun" 1 => "S. Vongphet" 2 => "Z. Zhang" 3 => "J. Mo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpedsurg.2011.07.006" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Surg" "fecha" => "2011" "volumen" => "46" "paginaInicial" => "E5" "paginaFinal" => "E8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22075370" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anorectal malformation associated with a perineal protrusion of the rectal mucosa: case presentation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Shinkai" 1 => "K. Mochizuki" 2 => "Y. Hirata" 3 => "S. Honda" 4 => "N. Kitagawa" 5 => "H. Take" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00383-009-2415-x" "Revista" => array:6 [ "tituloSerie" => "Pediatr Surg Int" "fecha" => "2009" "volumen" => "25" "paginaInicial" => "815" "paginaFinal" => "817" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19629502" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Duplicación rectal extrofiada asociada a malformación anorrectal y transposición pene-escrotal con hipospadias perineal. Reporte de un caso clínico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Fernández" 1 => "L. Parodi" 2 => "J. Carrasco" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Invest Clin" "fecha" => "2014" "volumen" => "55" "paginaInicial" => "168" "paginaFinal" => "172" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24974632" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000010000000004/v1_202404250845/S2341287924000851/v1_202404250845/en/main.assets" "Apartado" => array:4 [ "identificador" => "77701" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Paediatrics" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000010000000004/v1_202404250845/S2341287924000851/v1_202404250845/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287924000851?idApp=UINPBA00005H" ]
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