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Biomedical subjects

A J Mares

Publications and source records attributed to A J Mares.

At least 19 recordsLinked to original sources
PubMed2002

Preduodenal portal vein causing duodenal obstruction associated with situs inversus, intestinal malrotation, and polysplenia: A case report.

Preduodenal portal vein (PDPV) is a rare anomaly described in only 82 patients in the literature. In a few patients, the PDPV was the direct cause of duodenal obstruction. The authors have treated a newborn with PDPV associated with total situs inversus, intestinal malrotation and polysplenia who presented clinically with duodenal obstruction.

Abnormalities, Multiple↗
PubMed2001

Unusual presentation of psoas abscess in a child.

Primary abscess of the psoas muscle is relatively rare in infants and young children. The clinical presentation of the disease, with limping, fever, and abdominal pain, may be confused with conditions such as septic arthritis of the hip, osteomyelitis, or appendicitis. The authors present an unusual case of a ruptured left psoas abscess presenting as generalized peritonitis in a child. J Pediatr Surg 36:1859-1860.

Diagnosis, Differential↗
PubMed2000

Unusual presentation of omphalomesenteric duct remnant: a variant of mesodiverticular band causing intestinal obstruction.

Two unusual cases of small bowel obstruction associated with an omphalomesenteric duct remnant are described in 2 girls aged 14 years. The causative factor was a stenotic area in the terminal ileum caused by a ringlike lipovascular mesenteric band encroaching externally on the lumen. A phytobezoar was lodged proximally. This is as yet an undescribed variant of a mesodiverticular band.

Adolescent↗
PubMed2000

Traumatic avulsion of kidney into the chest through a ruptured diaphragm in a boy.

This report presents a case of a teenage patient who survived following severe blunt trauma with complete avulsion of the right kidney into the chest through a ruptured diaphragm. The combination of kidney avulsion into the chest is extremely rare. Only three similar cases have been reported in the English literature to date (1-3).

Abdominal Injuries↗
PubMed1999

[Laparoscopic spermatic vein ligation: first experience in the treatment for varicocele in adolescents].

We report our initial experience with laparoscopic ligation of spermatic veins in the treatment of varicocele in adolescence. 19 boys, 13 to 18 years old, underwent this treatment between I 1997 and III 98. The varicocele was always on the left side. 12 complained of scrotal discomfort and pain, but in 7 it was found incidentally during routine medical examination by the family or school physician. The diagnosis was based only on physical examination. There has been no morbidity related to the laparoscopic procedure and all returned to normal activity within a few days. Follow-up 2-12 months after surgery showed no varicocele in any. We conclude that laparoscopy is useful in the treatment of varicocele in adolescents.

Adolescent↗
PubMed1999

[Diagnostic and therapeutic laparoscopy for non-palpable testis--3.5 years of experience at Soroko Medical Center].

From January 1994 to July 1997, 20 boys 1.5-13 years of age underwent laparoscopic examination and treatment for non-palpable testis. In 1 there was bilateral nonpalpable testis. Only 3 had intra-abdominal testes viable for orchiopexy. In 8 atrophic testicles were removed and in 9 laparoscopic examination revealed intra-abdominal blind ending of the spermatic cord and no testicular tissue. We conclude that laparoscopy is a useful and safe technique for accurate diagnosis and may avoid additional intervention in treating non-palpable testes. Furthermore, intra-abdominal testes may be managed laparoscopically under the same anesthetic.

Adolescent↗
PubMed1999

Comparative experimental study of esophageal wall regeneration after prosthetic replacement.

This study compares three prosthetic materials for potential use in patching and bridging congenital and acquired esophageal defects. The study was divided into two parts. In the first part, full-thickness, 6-cm2 cervical esophageal defects were induced in three groups of young mongrel dogs and were replaced with patches of lyophilized dura mater (Lyodura), polyethylene terephthalate (Dacron), or expanded polytetrafluoroethylene (PTFE). The dogs in the Lyodura subgroup were scheduled to be sacrificed after 1, 2, 4, 8, and 12 weeks and the dogs in the PTFE and Dacron subgroups were sacrificed after 1, 2, 3, 4, 6, and 7 months. The patched esophagus was removed for gross and microscopic examination. In the second part of the study a segment of the esophagus was excised in another three groups of dogs and replaced with 3 x 2 cm tubes of Lyodura, Dacron, or PTFE. Here the follow-up was prolonged and included radiological, endoscopic, and histological assessment. The dogs of each subgroup were scheduled to be sacrificed after 6, 8, and 12 months. Results indicated that lyophilized dura mater covered and neoepithelialized the patched area within the shortest period of time without foreign body reaction and with only slight collagen deposit, resulting in a ductile repaired esophageal wall. Therefore, its use may be considered for replacement of partial esophageal defects. For complete circumferential defects, the present study and our review of the literature showed that there is as yet no ideal prosthetic material that promotes good incorporation but is not prone to stenosis. Further studies in this area are required.

Animals↗
PubMed1999

Near total intestinal aganglionosis with extreme short-bowel syndrome--a difficult surgical dilemma.

Forty cases of total or near-total intestinal agangliosis (NTIA) were described to date in the English literature. Most cases had a lethal outcome. We describe the 41st case--a Beduin male neonate--who had only 30 cm of proximal hypoganglionic jejunum. He is presently almost one-year-old and thriving on home TPN, receiving one quarter of his caloric requirements orally using pregestamil, an MCT formula. The initial intricate course, diagnosis and several operative procedures, are elaborated. A review of the scant literature is discussed. The elusiveness of the correct diagnosis is pointed out and means to overcome these errors are described. Various surgical procedures have been suggested, none of which offer the perfect solution to the severe basic problem of short bowel. Long-term parenteral hyperalimentation is still the main modality of treatment. Based on our modest experience, we suggest saving every possible length of jejunum, even if hypoganglionic, since this bowel, following a few weeks of adaptation, starts to function fairly well, suggesting perhaps some neuro-muscular maturation. The best surgical approach is still pending. We present a report of a child with this disease and discuss the therapeutic dilemma.

Hirschsprung Disease↗
PubMed1999

Nissen fundoplication and Boix-Ochoa antireflux procedure: comparison between two surgical techniques in the treatment of gastroesophageal reflux in children.

Over a period of 19 years an antireflux procedure was performed for gastroesophageal reflux in 59 children. Thirty-two patients underwent Nissen fundoplication and 27 children underwent the Boix-Ochoa antireflux procedure. Six patients died between two and 15 months post surgery of unrelated causes. Follow-up period from six months to 18 years was available in 45 (85%) of the surviving patients. This report summarizes the complications and long-term results with the two surgical procedures and their comparisons. The follow-up evaluation included parental interview and physical examination. Upper GI series and pH monitoring were performed only in children with signs and symptoms of recurrent GER or other post-operative complications. At follow-up with a mean period of 8.7 years following Nissen fundoplication, 87.5% showed good results without any residual symptoms. However, the overall complication rate was as high as 50%. Following the Boix-Ochoa antireflux procedure, 17 (81%) children showed excellent results while four children had recurrent GER. This occurred in two neurologically impaired children and two patients following esophageal atresia repair. No other post-operative complications were encountered with the Boix-Ochoa antireflux procedure. In our experience, the Boix-Ochoa antireflux procedure should be the procedure of choice in the surgical treatment of GER in otherwise normal children while the Nissen fundoplication is preferable in neurologically impaired children and in patients with GER following esophageal atresia repair.

Female↗
PubMed1998

Ganglioneuroma: an 'incidentaloma' of childhood.

In adults clinically silent adrenal masses can be discovered incidentally in imaging studies. Most of these 'incidentalomas' are benign, non-functioning adenomas. In contradistinction, in infancy and childhood the most common adrenal mass is the neuroblastoma, a malignant neural crest tumour. Four children are described, each with a benign neural crest tumour - ganglioneuroma - incidentally discovered by conventional radiography or sonographic examination. Complete surgical excision resulted in total recovery of all the children.

Adrenal Gland Neoplasms↗
PubMed1998

The use of collagen-coated vicryl mesh for reconstruction of the canine cervical esophagus.

Collagen-coated vicryl mesh (CCVM) was used experimentally to patch partial and total segmental defects in the canine cervical esophagus. The esophageal healing process over a 6-month period with successful incorporation of the CCVM and esophageal wall regeneration are described. Twenty-two (91.7%) of 24 dogs survived the procedure without any evidence of esophageal stricture or dysphagia. CCVM has proved to be a suitable material for substitution of esophageal tissue in the canine model. Its clinical use in congenital and acquired esophageal lesions should be considered only pending further experimental laboratory work.

Animals↗