Biomedical subjects
Publications and source records attributed to B R Girdany.
We report two young girls with gastric trichobezoars in whom ultrasound, computed tomography and upper gastrointestinal contrast studies were done. Since sonography and, less frequently, computed tomography are usually the first studies obtained in a child with an abdominal mass it is important to recognize the rather distinctive appearance of a trichobezoar on these images.
Explore the source record for details and available documents.
Five hundred consecutive radiographic examinations of acutely limping infants and toddlers were analyzed retrospectively. One hundred of the 500 (20%) had a fracture as the underlying etiology. Although the most common sites of involvement were the tibia/fibula (56 cases) and femur (30 cases), fractures in the pelvis and feet, notably the metatarsals (11 cases), also were seen. We therefore recommend obtaining radiographs of the pelvis and both lower extremities including the feet, when occult trauma is suspected and the exact area of injury cannot be pinpointed clinically.
Blunt and penetrating chest trauma in children results from many causes but the major cause is motor vehicle accidents. The trauma induces a variety of injuries to the bony thorax, the pulmonary parenchyma, and mediastinal structures. In recent years, a disturbing increase in iatrogenic chest trauma has occurred in patients, particularly small infants, receiving intensive hospital care. Radiologic evaluation plays an important role in documenting and diagnosing these traumatic and iatrogenic injuries. The various radiologic manifestations of these injuries are described and discussed.
Clinical and radiographic observations in 34 infants and children with congenital stenosis of the oesophagus are reported. (1) Congenital stenosis of the oesophagus occurs more frequently than the previous literature suggests. (2) A congenital stenosis most commonly affects the lower oesophagus at the junction of its middle and distal thirds. (3) High oesophageal stenosis is less common, usually producing respiratory distress. Low oesophageal stenosis is more frequent, usually producing vomiting and oesophageal obstruction at the time the patients begin eating solid foods. (4) Oesophageal stenosis persists into adult life although its clinical course is benign. (5) An infant who vomits undigested food should have an oesophagram for evaluation of possible congenital oesophageal stenosis. (6) A child who impacts a foreign body in the oesophagus, particularly in the distal half of the oesophagus, should have a follow-up oesophagram after removal of the foreign body to assess the possibility of congenital oesophageal stenosis.
This is a report of a family with major focus on the daughter who was of short stature. The mother had hypochondroplasia and the father had multiple exostoses. The daughter's skeletal roentgenograms show features of both hypochondroplasia and multiple exostoses. The roentgenographic, clinical and genetic aspects of these skeletal dysplasias are reviewed and hypochondroplasia is contrasted with achondroplasia. The genetic and counseling implications of the association of hypochondroplasia and multiple exostoses are discussed.
Two children presented with ischemic enterocolitis, a prodrome that occurs in 80% or more of patients with the hemolytic-uremic syndrome. When the prodrome precedes the development of characteristic laboratory findings or oliguria, the diagnosis of the hemolytic-uremic syndrome often is delayed. The severity of the enterocolitis itself may overshadow renal impairment. Findings of thumbprinting on plain radiographs or on barium enema examinations allow the radiologist to suggest the hemolytic-uremic syndrome as a possible cause before renal or hematologic abnormalities become manifest.
Hydrops of the gallbladder was diagnosed by ultrasonography in five out of ten consecutive patients with mucocutaneous lymph node syndrome (MLNS). Certain signs and symptoms were correlated with the development of hydrops. Follow-up ultrasonography revealed the return of the gallbladder to normal size in four out of four patients. One patient was lost to follow-up. Hydrops of the gallbladder in patients with MLNS appears to be a self-limiting condition with a benign course.
Initial clinical results are described for a new method of digital radiography based on high-detail self-scanning linear diode arrays which overcome many of the limitations of present film or other digital methods. The technique uses a fan-shaped x-ray beam to produce a nearly scatter-free image on a phosphor strip that is fiber-optically coupled to six self-scanning arrays of light-sensitive diodes spaced 0.025 mm, thus providing 6,144 discrete sensors across the field of view. Because these diodes have a greatly expanded dynamic range and operate at very low noise, it becomes possible to visualize small density differences or contrast below 1% both in the light and dark areas of the image. Because of the efficiency of detection and display, radiation doses can be reduced for a given information content. Our preliminary clinical studies have shown to broad application of our method in examining the chest and abdomen and in performing intravenous digital arteriography.
Trigonocephaly is a relatively rare deformity of the skull characterized by triangular prominence of the bones of the forehead and orbital hypotelorism. Long-term results in a group of patients with clinical and radiographic follow-up are analyzed, the radiographic findings reviewed, and possible etiologies discussed. The etiologic relationship between premature synostosis of the metopic suture and trigonocephaly is questioned. Uncomplicated trigonocephaly is a self-limited, self-correcting deformity, and a normal cosmetic appearance develops without surgical treatment. Surgical craniectomy as treatment for uncomplicated trigonocephaly is not indicated on the basis of the authors' experience.
Four newborn infants with megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) were identified at Children's Hospital of Pittsburgh. These cases provide additional insight into the syndrome and broaden its spectrum. This report includes MMIHS in an infant boy, one long-term survivor, an apparently related complication of neonatal obstructive volvulus, evidence of small intestinal hypoperistalsis, and histopathologic findings as follows: (1) apparently increased numbers of ganglion cells in early biopsies and normal or even decreased numbers of ganglion cells in later biopsies probably due to bowel dilatation; and (2) in two of three infants at autopsy, there were many nerve trunks (a neuromalike layer in one), and there was elastosis of the urinary bladder.
Explore the source record for details and available documents.
Radiographic examinations of the paranasal sinuses and chests of 187 patients with C.F. from five months to 27 years of age were reviewed. One hundred eight-five patients consistently had opaque maxillary and ethmoidal sinuses. Forty-five patients had normal chest radiographs. These observations show that the paranasal sinuses are almost always affected in children with C.F. Although opaque paranasal sinuses do not indicate the diagnosis of C.F., clear paranasal sinuses exclude this disease with reasonable certainty.
Leiomyoma is a benign, smooth-muscle tumor which rarely affects children. Calcification in this tumor is unusual. Two boys, aged three and six years, had large axillary leiomyomas with "mulberry" calcifications similar to those seen in calcified uterine leiomyoma. The lesions did not recur after total surgical excision.
The radiological findings in 14 children with polyarteritis nodosa (PN) were evaluated in relation to clinical, laboratory, and histological findings. In this series, there were two major groups of radiological findings, one associated with renal insufficiency and the other with intestinal vascular insufficiency. No radiographic finding was pathognomonic. Two patients were suspected of having small bowel intussusception (SBI), and SBI was documented at laparotomy in a third patient. The diagnosis and management of PN in children is dependent upon the correlation of clinical and laboratory findings. Associated pertinent radiological features which may be useful in the management of children with PN are reviewed.
Explore the source record for details and available documents.
Adenoidal-nasopharyngeal ratios (AN ratios) obtained by simple linear measurements from lateral skull radiographs are described. The AN ratio reliably expresses adenoidal size and patency of the nasopharyngeal airway. The validity of the ratio as an indicator of adenoidal size was determined by evaluation of measurements of radiographs of 1,398 infants and children and comparison with a subjective visual assessment made by experienced observers in 92 patients. An AN ratio greater than 0.80 was present in 34 of 36 patients (94%) subjectively judged to have enlarged adenoids.
The authors describe abnormal intestinal motility with a very slow transit time in eight children with gastroschisis. Other abnormal findings include malrotation, dilatation, and fixation of the loops of the bowel.