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Biomedical subjects

D Cholewa

Publications and source records attributed to D Cholewa.

12 recordsLinked to original sources
PubMed2006

[A young child with acute abdomen and iron deficiency anemia].

The case of a 20 month-old girl that was admitted to the emergency ward because of worsening of her general condition in the setting of acute non-bloody gastroenteritis is reported. The clinical examination revealed signs of severe dehydration and a prominent tender abdomen. Laboratory evaluation showed leucocytosis, elevated C-reactive protein and severe hypochromic microcytic anemia. Abdominal X-ray revealed diffuse meteorism. The child underwent laparascopic evaluation. A perforated Meckel's diverticulum was found. Perforation and anemia due to occult bleeding are unusual presentations of Meckel's diverticulum. The differential diagnosis of children presenting with an acute abdomen with special focus on Meckel's diverticulum is discussed.

Abdomen, Acute↗
PubMed1999

Hirschsprung's disease and intestinal neuronal dysplasia--a frequent association with implications for the postoperative course.

Between 1991 and 1993, 106 newly diagnosed cases of Hirschsprung's disease (HD) were prospectively analyzed for the association of HD and intestinal neuronal dysplasia (IND) at ten pediatric surgical departments in central Europe. Hirschsprung-associated IND (HaIND) was found in 40% of cases. IND was disseminated in one-third and localized in two-thirds of the patients. Initial clinical symptoms were related to the length of the aganglionic segment, but not to the presence of HaIND. An enterostomy performed in 72 cases (67.9%) was located in a segment of pathologically innervated bowel in 50% of all cases, but in 72% of cases of HaIND. The proximal margin of the resected bowel showed pathological innervation in 44% of cases. Supplemental biopsies from the intestine (apart from diagnostic suction biopsies and biopsies at the enterostomy site) led to the first identification or definition of length of associated IND in 17.9% of cases. Postoperatively, the presence of long-segment aganglionosis or associated IND implied a delay in the restoration or normal defecation. Persistent constipation was found in 40% of patients with associated disseminated IND at follow-up at 6 months, compared to 20.6% in patients with isolated HD. These children needed secondary interventions more often than patients with associated localized IND or isolated HD. HaIND thus has clinical implications for the postoperative course if IND is disseminated.

Child↗
PubMed1999

[Percutaneous removal of a brachiocephalic vein anchored venous catheter with wire loop and mini-laparoscopy scissors].

PURPOSE: The use of mini-laparoscopy scissors to remove a central venous catheter inadvertently fixed to the wall of the brachiocephalic vein is described. PATIENT AND METHODS: During a rethoracotomy in a 15-year-old female patient, a central venous catheter preoperatively introduced in the left subclavian vein was inadvertently trapped by a suture and fixed to the wall of the left brachiocephalic vein. The foreign body was removed by use of a transjugularly introduced venous sheath, a catheter wire snare, and mini-laparoscopy scissors. RESULTS: The fixed catheter was freed from the wall of the vein under fluoroscopic control with the help of a mini-laparoscopy scissors. Since the intravasal end of the catheter had already been grasped during mobilization with the wire snare it could be completely removed subsequently without any problem. CONCLUSIONS: The percutaneous, intravascular use of mini-laparoscopy instruments may be considered for foreign body removal in special cases.

Adolescent↗
PubMed1998

Laser treatment of hemangiomas of the larynx and trachea.

BACKGROUND AND OBJECTIVE: Hemangiomas have a typical clinical course and may lead to life-threatening obstruction if the central respiratory tract is involved. STUDY DESIGN/PATIENTS AND METHODS: This was observed in 32 children over a period of 20 years. The radiation parameters and application procedure of Neodymium:Yttrium-Aluminum-Garnet-laser (Nd:YAG-laser) therapy were adjusted for the degree of obstruction and the type of disease. RESULTS: The success rate was 93.8%, of which a maximum of one application was sufficient in 24 children (75.0%). Subglottic cicatricial stenosis was considered a laser-related complication. CONCLUSION: Nd:YAG-laser treatment is a safe and effective therapeutic measure for eliminating respiratory tract obstruction caused by hemangiomas.

Bronchoscopy↗
PubMed1998

Magnetic resonance imaging: controlled interstitial laser therapy in children with vascular malformations.

BACKGROUND AND OBJECTIVE: Interstitial laser therapy (ILT) is a minimally invasive treatment method for congenital vascular malformations (CVM). This study was intended to show whether or not open magnetic resonance imaging (MRI) offers a means of on-line thermometry and procedure control. STUDY DESIGN/PATIENTS AND METHODS: ILT using a bare fiber and an Nd:YAG laser was applied in 20 children with CVM under open MR control. RESULTS: With the open MR systems, needle placement and advancement was excellent in all cases. On-line thermometry was possible in 90% of the therapy spots. The 6 week MR follow-up revealed a 76% reduction in tumor size in 14 patients. Clinical symptoms improved in 85% of the patients. CONCLUSION: MR-guided ILT could become a safe method to treat selected types or selected regions of CVM.

Adolescent↗
PubMed1998

Vascular lesions in children: percutaneous MR imaging-guided interstitial Nd:YAG laser therapy--preliminary experience.

PURPOSE: To investigate the use of magnetic resonance (MR) imaging to guide interstitial laser therapy of deep hemangiomas and vascular malformations in children. MATERIALS AND METHODS: Sixteen children aged 3 months to 16 years with symptomatic vascular lesions underwent percutaneous laser treatment. MR imaging guidance of the laser applicator and online thermomonitoring with MR imaging were performed with a 0.2-T open MR system. Follow-up studies were performed 2 days and 6 weeks after thermotherapy. RESULTS: Interactive positioning of the laser applicator was possible in all patients. Online thermomonitoring was possible in 122 of 137 therapy spots (89%). There was a good correlation between volumes of coagulated tissue on intraprocedural T1-weighted images and volumes of coagulated tissue on follow-up T2-weighted images. At 6-week follow-up, MR imaging demonstrated a reduction in lesion size in 10 patients (mean reduction, 72%) and an increase in lesion size in two patients (mean increase, 134%). Clinical symptoms improved in 14 of 16 patients (88%). CONCLUSION: MR imaging-guided laser therapy appears to be a safe and potentially effective minimally invasive treatment for selected children with vascular lesions.

Adolescent↗
PubMed1998

[Transcutaneous and laparoscopic laser treatment in extensive retroperitoneal lymphangiomas in childhood].

Retroperitoneal lymphangiomas are rare congenital vascular malformations. They cannot always be completely excised and are associated with high recurrence, complication and morbidity rates. We therefore utilize an alternative treatment concept in some cases. We excise the cystic types laparoscopically with a Nd: YAG laser (wavelength 1064 nm). Residual tissues are percutaneously managed by interstitial laser therapy under MRI monitoring. The high soft-tissue contrast of the MRI enables exact positioning of the laser fiber. The examination is thermosensitive and provides online and noninvasive demonstration of the interstitial tissue coagulation. We have treated four infants laparoscopically and three other children percutaneously.

Adolescent↗
PubMed1997

A 7-year-old child with primary tumour localisation in the distal duodenum--new imaging procedures for an improved diagnosis.

UNLABELLED: Duodenal gastrinomas in childhood are extremely rare and often missed at first medical consultation. We report on a 7-year-old child with sporadic gastrinoma of primary localisation in the distal duodenum. Small metastases in the liver and regional nodes were detected pre-operatively by somatostatin receptor scintigraphy (SRS) but not by other conventional imaging procedures. Diagnostic procedures include pre-operative SRS, endoscopic ultrasound and intra-operative endoscopic transillumination. CONCLUSION: Gastrinomas are rare abdominal tumours in childhood. Pre-operative tumour-specific diagnosis is possible by 111indium pentreotide SRS.

Biomarkers, Tumor↗
PubMed1996

[Interstitial laser hyperthermia of gastrinoma liver metastases in a child].

Ultrasound-guided, laser-induced thermocoagulation with Nd:YAG laser (1064 nm) was performed in a child with metastatic gastrinoma disease. The emitted laser energy to coagulate a radius of 15-20 mm of metastatic liver tissue was 4 W with a duration time of 300 s. Marked reduction of gastrin was observed after interstitial laser hyperthermia.

Biomarkers, Tumor↗
PubMed1996

[Problems in technical development of laparoscopy and thoracoscopy in infancy].

In neonates a new fixation of the trocars must be found since the umbilical ring is large and distensible and the abdominal wall is very thin. The pressure-controlled pneumoperitoneum is maintained by using a special "surgiflator" system which prevents high pressure peaks in the small abdominal cavity of neonates. By using a Nd:YAG laser for transection during coagulation an additional trocar can be dispensed with.

Endoscopes↗
PubMed1995

Spheric duodenal duplication in a 13-year-old child.

Duodenal duplications are rare. Modern imaging procedures demonstrate the relation of the duplication to the duodenum and the adjacent organs. Thus the surgical procedure can be selected preoperatively. Endoscopic ultrasound is an excellent technique for visualizing a duodenal duplication. A cystic duodenal duplication measuring 6 cm in diameter was resected in a 13-year-old boy.

Adolescent↗