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D T Alvear

Publications and source records attributed to D T Alvear.

At least 19 recordsLinked to original sources
PubMed1999

Infantile hypertrophic pyloric stenosis: delays in diagnosis and overutilization of imaging modalities.

Infantile Hypertrophic Pyloric Stenosis (IHPS) can usually be diagnosed by the detection of a pyloric olive on examination performed by an experience examiner. In babies with typical symptoms and a palpable olive, no further confirmation of diagnosis is required. We retrospectively reviewed the diagnostic evaluations of 93 consecutive patients with proven IHPS. Many patients who had the diagnosis confirmed on physical examination underwent one or more unnecessary and redundant studies. The performance of these studies was associated with delayed diagnosis and possibly with adverse clinical health problems. An algorithm for management of patients with suspected IHPS is proposed. Prompt examination by an experienced examiner is key to the evaluation of such patients.

Algorithms↗
PubMed1989

True clinical entity of vascular compression of the duodenum in adolescence.

Thirteen pediatric patients were diagnosed with superior mesenteric artery syndrome (SMAS) at our institution between 1974 and 1986. Four were successfully treated with nasojejunal feedings only, and nine underwent a derotation procedure designed to alleviate the problem of compression of the duodenum by the superior mesenteric artery. Of the nine patients who were operated upon, only one required a gastrojejunostomy to bypass a persistent obstruction. Therapy was aimed specifically toward the problem of duodenal occlusion at the mesenteric root. Because this therapy was successful in all of the patients, we conclude that SMAS exists as a treatable entity and must be considered in any adolescent patient who presents with symptoms of obstruction of the upper part of the gastrointestinal tract and failure to thrive.

Adolescent↗
PubMed1978

Prenatal ultrasonographic diagnosis of fetal gastroschisis.

Two cases of fetal gastroschisis were diagnosed in utero by ultrasound. In one patient, a cluster of sonolucent "cystic" structures was seen in the amniotic fluid which corresponded to fluid-filled bowel loops. The second infant was the firstborn of dichorionic twins and the gastroschisis abnormality appeared as two sonolucencies in relationship to the trunk. An extensive review of the literature is presented.

Abdominal Muscles↗