PubMed Health⌕ Search

Biomedical subjects

Daniel F Saad

Publications and source records attributed to Daniel F Saad.

10 recordsLinked to original sources
PubMed2006

Left-sided gastroschisis.

Gastroschisis is a periumbilical, abdominal wall defect arising to the right of the umbilicus. We describe the clinical course of a left-sided gastroschisis in a term female born at 39 weeks' gestation. To our knowledge, there have been only 14 left-sided abdominal wall defects reported in the literature. We discuss our case and review the literature to try to determine if there is any clinic difference between right- versus left-sided lesions to make recommendations as to management.

Colon↗
PubMed2005

Renal artery pseudoaneurysm secondary to blunt trauma treated with microcoil embolization.

BACKGROUND: Renal artery pseudoaneurysms are rarely described sequelae of blunt abdominal trauma. Interventional radiological advances have allowed such lesions to be managed nonoperatively. METHODS: The authors review the presentation, diagnostic evaluation, and hospital course of an 11-year-old girl who developed a right renal artery pseudoaneurysm 14 days after blunt abdominal trauma. RESULTS: An 11-year-old girl fell off a horse onto her right flank. She sustained multiple right hepatic lobe lacerations and a complex fracture of the upper pole of the right kidney. Her initial hospital course was uncomplicated, and she was discharged after an uneventful 6-day course. The child did well for 2 weeks, until she developed right back pain and gross hematuria. A computed tomography scan revealed a right renal artery pseudoaneurysm. Angiography confirmed the presence of a pseudoaneurysm, which was fed by a single segmental branch originating from the renal artery. The artery was successfully occluded with a single platinum microcoil, which was demonstrated by the absence of contrast flow into the pseudoaneurysm. The patient recovered and was discharged shortly after the procedure. She initially had intermittent pain and hematuria, which resolved. Follow-up computed tomography scans have shown resolution of both the renal and hepatic lesions. CONCLUSIONS: Renal artery pseudoaneurysms that arise after blunt abdominal trauma in the pediatric population may be safely and effectively managed with arterial embolization, thereby avoiding extensive surgical interventions.

Accidental Falls↗
PubMed2005

Laparoscopic cystogastrostomy for the treatment of pancreatic pseudocysts in children.

Pancreatic pseudocysts (PPSs) are common sequelae of pancreatitis and pancreatic trauma. The management is based upon the pseudocyst size and presence of symptoms. Those requiring intervention are often drained using several available options. The use of laparoscopic cystogastrostomy for large and recurrent PPSs has been described in adult patients as a less morbid alternative to open drainage procedures. This technique is considered a novel approach in children. We describe 2 children who had PPSs amenable to laparoscopic cystogastrostomy. The first was an 11-year-old girl who had blunt abdominal trauma from a bicycle handlebar. The second patient was a 7-year-old girl who developed idiopathic pancreatitis. Briefly, 2 ports were placed through the anterior abdominal and gastric walls, and into the lumen of the stomach. This intraluminal placement provided access to the posterior gastric wall. Using electrocautery diathermy, an incision was made through the posterior gastric wall and into the adjacent pseudocyst to obtain complete and unobstructed drainage. Both children tolerated the procedures well with resolution of their PPSs. The patients were each discharged on the fourth postoperative day and have been asymptomatic on 2 years follow-up. Laparoscopic cystogastrostomy is a safe and effective alternative to open cystogastrostomy for the minimally invasive management of PPSs in the pediatric population.

Child↗
PubMed2005

Laparoscopic adrenalectomy for neuroblastoma in children: a report of 6 cases.

Neuroblastoma, a neoplasm of the sympathetic nervous system, is the most common solid extracranial tumor of childhood. Complete tumor resection has been shown to improve outcomes in both low- and high-risk neuroblastoma. The efficacy of laparoscopic adrenalectomy (LA) for metastatic lesions, benign tumors, and small neuroblastomas (<20 mm in diameter) is well established. However, the role of LA for large neuroblastomas is unclear. The authors describe the technical aspects of LA in 6 children with adrenal neuroblastomas greater than 2 cm and summarize their outcomes. All 6 patients underwent successful LA with removal of their tumors and surrounding lymph nodes. The specimens were placed in a laparoscopic specimen retrieval bag and morsulated in situ. The pathologic specimens were adequate for biologic factor analysis and histology. Mean operative time for all cases was 146 minutes. The average size of the adrenal tumors resected was 3.3 x 3.7 x 3.3 cm, and there were no intraoperative or perioperative deaths. All children, except the fifth patient who stayed for chemotherapy, were discharged home within 48 hours after surgery and are well. Our preliminary data suggest LA is a safe treatment option for neuroblastoma tumors greater than 2 cm in the select children.

Adrenal Gland Neoplasms↗
PubMed2005

Protection from lethal endotoxic shock after testosterone depletion is linked to chromosome X.

Men are considered more susceptible to sepsis after severe injury than are women, which has been attributed to a suppressing effect of male sex steroids on the inflammatory response. Moreover, the effect of sex steroids on the inflammatory process depends on the genetic background. The present study examined the genetic contribution to survival after endotoxic shock in mice depleted of testosterone by surgical castration. Six-week-old male mice, from strains A/J, AKR/J, C57BL/6J (B6), BALBc/J, DBA/2J, and C3H/HeN, were castrated (CX) or nonoperated (NoOp). Two weeks after surgery, mice were injected intraperitoneally with Escherichia coli lipopolysaccharide (15 mg/kg) and the frequency of mortality was monitored. CX A/J mice showed a significantly higher survival rate than NoOp mice, but this protective effect was not observed in the other strains. Administration of 5-alpha-dihydrotestosterone to CX A/J mice reverted the protection by CX. The protective effect of CX was also observed in crosses of female A/J and male B6 (AXB), but not female B6 and male A/J (BXA), suggesting that protection is linked to the A/J X chromosome. This possibility was corroborated by using consomic mice containing A/J chromosome X and the remaining chromosomes from B6. These results suggest that testosterone is a negative factor in the recovery from endotoxic shock, depending on the genetic background.

Animals↗