Biomedical subjects

A T Hadidi

Publications and source records attributed to A T Hadidi.

4 recordsLinked to original sources

PubMed2006

A technique to improve vascularity in colon replacement of the esophagus.

OBJECTIVE: The aim of this study was to present a simple method to improve the results of colon replacement of the esophagus in children with post-corrosive esophageal stricture or long gap esophageal atresia. TECHNIQUE: At the gastrostomy operation, the abdomen and colon are explored and the segment of colon to be used for replacement is chosen. The trunk of the middle colic artery supplying the transverse colon is ligated and divided proximally to the marginal artery or, if another segment of the colon is chosen, the corresponding vessel is ligated. METHODS: Between November 1999 and October 2002, 11 children had their middle colic vessels ligated during a gastrostomy operation. They were six boys and five girls. Five neonates had long gap esophageal atresia with or without fistula. The other 6 had long segment esophageal stricture due to swallowing caustic potash. Their ages ranged from one day to 40 months. The hospital stay ranged from 10 to 14 days. The interval between vascular ligation and the replacement was one to three months, depending on the general condition of the patient. The follow-up period was between 21 and 56 months. RESULTS: After the definitive operation for colon replacement of the esophagus, the children resumed feeding through the gastrostomy on day five. They were fed by mouth from day eight and all had returned home by day 15. COMPLICATIONS: There was no wound infection, no fistula, or chest complications. One patient developed stricture at the colo-esophageal anastomosis two months after surgery. The esophageal anastomosis was excised six months after the colon interposition surgery and re-anastomosis was performed through the same neck incision, after which the patient was sent home seven days later. CONCLUSIONS: Ligation of the middle colic vessels during the gastrostomy operation increases the blood supply to the transverse colon through the left upper colic and marginal vessels. This adds an extra ten minutes to the gastrostomy operation. This technique has increased the success rate in colonic replacement and minimized morbidity in our unit. Although the principle is commonly used in plastic surgery in pedicled flap reconstruction and in pediatric surgery for high abdominal testis (Fowler Stephens procedure), to our knowledge, this has never been applied in intestinal surgery before.

Burns, Chemical↗

PubMed2006

An external device for faecal incontinence.

AIM: The aim of the study was to describe a simple external device that enables the incontinent patient to control the time, frequency and place of defecation. PRINCIPLE: The device is based on the principle of a "ball & socket" valve. The "ball" is an inflatable silastic balloon while the "socket" is the anorectal junction. The device can be used with minor modifications in patients with terminal colostomy to make them continent and avoid the need for colostomy bags. PATIENTS AND METHODS: The inflatable plug has been used successfully in eighteen incontinent children for a period ranging from six months to 8 years. The child decides the amount of air inside the inflatable plug that is comfortable and yet adequate to prevent soiling. This usually ranged between 10 to 25 cm of air. RESULTS AND COMPLICATIONS: To date, the device has been manufactured manually. All the children tolerated the plug without discomfort. Deflation of the balloon occurred after 3 - 5 days of use due to defective manufacturing. None of the patients developed ischaemia of the bowel or skin excoriations. CONCLUSION: This conservative, simple, inflatable plug enhances both qualitative and quantitative faecal continence in children with faecal soiling. An improvement in quality of life was also perceived by the patients and their parents. Better manufacturing may improve the results.

Anal Canal↗

PubMed1999

Childhood intussusception: a comparative study of nonsurgical management.

PURPOSE: A prospective study was conducted comparing air reduction, barium reduction under fluoroscopy, and saline reduction under ultrasound guidance for diagnosis and treatment of intussusception involved in 147 patients. METHODS: Fifty children received air reduction (AR group), 50 received barium enema reduction (BE group) and 47 received saline reduction under ultrasound guidance (US group). Nonoperative management was attempted if there was a history of less than 48 hours; absence of general or abdominal signs of toxicity, peritonism, or peritonitis, and reasonable blood electrolyte levels (K, 3 to 5 mmol/L; Na, 130 to 150 mmol/L). RESULTS: Group AR had successful outcome in 45 of 50 children (90%); BE had successful outcome in 35 of 50 children (70%), and US had successful outcome in 32 of 47 children (67%). This 20% to 23% success rate difference between air reduction and the other two techniques (BE and US) was statistically significant (P = .01). There was no significant difference between BE and US saline (P > or = .05). There were no perforations encountered in AR patients, three perforations in BE patients, and two perforations in US patients. There was no mortality. CONCLUSIONS: Air reduction seems to be associated with fewer complications and the highest success rate. Proper selection of patients is crucial to achieve a high success rate and to minimise complications.

Air↗

PubMed1990

Congenital malformations of the hand. A study of the vascular pattern.

Sixty-five children with 76 hand anomalies had brachial angiography performed to help plan appropriate surgical management. Three different methods of angiography were used. The study showed that the direct exposure method is safe and simple, has few complications and gives the best visualisation of the arterial supply of the hand. It also showed that each type of congenital hand deformity is frequently associated with specific vascular alterations. Angiography is an important and safe investigation in the pre-operative assessment of cases of complex congenital hand deformities.

Angiography↗