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Biomedical subjects

E Arnbjörnsson

Publications and source records attributed to E Arnbjörnsson.

At least 19 recordsLinked to original sources
PubMed2002

Transanastomotic feeding tube after an operation for duodenal atresia.

UNLABELLED: The aim of this study was to answer the question whether or not, after an operation for duodenal atresia, a transanastomotic feeding tube reduces the time to full preanastomotic feeding. The method used was a retrospective study and a prospective observation. 18 consecutive newborns with duodenal atresia, nine from each of two different centres of paediatric surgery, were studied retrospectively. The patients in one centre received a nasogastric tube and a transanastomotic feeding tube during the operation, while in the other centre only a nasogastric tube was used. Seven control patients with duodenal atresia treated postoperatively with a nasogastric tube and a transanastomotic feeding tube were prospectively observed. The main outcome measure used to compare these two groups was the time required to achieve full preanastomotic feeding. RESULTS: The patients who were treated postoperatively with the transanastomotic feeding tube needed significantly less time to achieve full preanastomotic feeding than those with a nasogastric tube only (P < 0.001, Mann-Whitney U test). CONCLUSION: The use of a transanastomotic feeding tube, after an operation for duodenal atresia, leads to earlier full preanastomotic feeding.

Anastomosis, Surgical↗
PubMed2002

Stenting of the biliary tract in children.

We report on the technique and results of percutaneous transhepatic biliary drainage (PTBD) in children with obstructive jaundice. Three patients aged 8 - 15 years were treated, two of them for a benign and one for a malignant stricture. Endoscopic treatment was not possible and all the PTBD procedures were done under general anaesthesia. One of the children was treated with external-internal drainage, and the two others by insertion of a plastic endoprosthesis. There were no immediate complications. The PTBD had a good palliative effect in two cases, and in one case surgical treatment was necessary. We conclude that PTBD is a safe modality and that it can be used in children for the relief of obstructive jaundice.

Adolescent↗
PubMed2000

Newborn infants' cry after heel-prick: analysis with sound spectrogram.

The aim of the study was to test the hypothesis that a newborn infant's cry can be used in conjunction with an instrument to measure pain. Crying due to pain was analysed after a heel-prick stimulus. In a prospective, descriptive study, 50 healthy newborn infants were subjected to a heel-prick for phenylketonuria screening. Their cries of pain were recorded and analysed. Duration of the crying sound was analysed and, using a sound spectrogram, the fundamental frequency and the cry melody of the first five cry sounds were analysed. The analysis showed that the crying sound after the painful stimulus of the heel-prick had a significantly higher fundamental frequency and lasted longer at the first than at the fifth cry. The first cry had a more varied crying melody than the fifth. There were large differences between individual cries from a single infant, as well as in the duration of each cry, total crying time, and fundamental frequencies between infants. While the first cry was more like a cry of pain, the fifth cry more resembled crying for reasons other than pain. The results suggest that newborn infants react to pain in a recognizable way. However, other stimuli may cause a similar reaction. Crying can therefore be used to measure pain in newborn infants only when the cause of crying is known.

Blood Specimen Collection↗
PubMed1999

Ulceration in an ileocolic anastomosis treated with ranitidin.

The authors report the case of a child born with a gastroschisis and an ileal atresia. After surgery, only 100 cm small bowel and the distal one third of his colon remained. Perianastomotic ulcers developed 6 years later. These were treated successfully with ranitidin, a treatment not previously reported in the literature. The authors conclude that treatment with ranitidin was successful in a patient with an ulcer in an ileocolic anastomosis.

Anastomosis, Surgical↗
PubMed1999

Complications of laparoscopy-aided gastrostomies in pediatric practice.

PURPOSE: The aim of this report is to establish the frequency and type of complications of laparoscopy-aided gastrostomy in pediatric practice and to identify patients at risk for postoperative complications. METHOD: This is a follow-up study of 98 children with nutritional problems including inability to swallow, inadequate calorie intake in neurologically impaired children, patients with cystic fibrosis, malignancies, neurometabolic diseases, and cardiac malformations. Laparoscopy-aided gastrostomy was attempted in all patients. These patients have undergone follow-up at our outpatient clinic. Postoperative complications and problems with the gastrostomy device were registered. The postoperative complications were divided into minor problems and major or life-threatening complications. RESULTS: There was no perioperative mortality. No life-threatening complication developed, whereas minor problems were common, necessitating medical attention postoperatively. Patients with congenital heart disease, chronic respiratory failure, and metabolic diseases experienced the highest frequency of postoperative complications. CONCLUSIONS: The surgical placement of an enteral access device in children should be considered a major surgical procedure, demanding medical attention for 1 to 2 months postoperatively. The rate and severity of complications with the method described are tolerable considering the severity of the underlying diseases.

Child↗
PubMed1999

Routine laparoscopy for nonpalpable testes?

There are still no accepted criteria for the selection of patients with nonpalpable testes for laparoscopy versus a primary surgical exploration. We here report our experience using routine laparoscopy in such patients. The aim was to determine whether laparoscopy should be the first operative intervention or follow an inguinal exploration. Included in the study were 61 boys with 69 nonpalpable testes. Thirty-three testes were found in the abdomen, and 36 testes were extra-abdominal or nonexistent. If an exploration of the inguinal region had been the initial surgical intervention, six testes would have been found, making laparoscopy unnecessary. On the other hand, in the search for 63 missing testes, laparoscopy saved the patients from laparotomy or an extensive inguinal exploration. We conclude that an accurate knowledge of testis, vas, and vessel location gained by laparoscopy facilitates the selection of an appropriate surgical strategy, saving at least 51% of patients from laparotomy or an extensive inguinal exploration.

Adolescent↗
PubMed1998

Two children with xeroderma pigmentosum developing two different types of malignancies simultaneously.

Patients with xeroderma pigmentosum (XP) are highly sensitive to ultraviolet radiation and prone to develop multiple skin malignancies. We report two children under 6 years of age with XP who each developed two histologically different types of malignancies simultaneously. We conclude that it is of importance to be aware of the possibility of multiple malignancies of different types, even in young children.

Carcinoma, Basosquamous↗
PubMed1998

Single-puncture laparoscopic gastrostomy in children.

An original one-puncture technique of performing laparoscopic gastrostomy is described. The implications are analysed. The results of five operations are presented and the advantages and limitations are discussed in the light of current available methods.

Adolescent↗
PubMed1998

Gastrostomy button causing perforation of the posterior gastric wall.

A gastrostomy button complication, not previously reported, is described. The button, with an inflatable balloon, was used for nutrition. The patient had had a gastrostomy for 4.5 y, with the same type of gastrostomy button for the previous 2 y and the same device for 1 y. The tip of the button caused a perforation of the posterior stomach wall, leading to death.

Child↗
PubMed1997

Membranous duodenal stenosis.

The experience of our 16 patients treated for membranous duodenal stenosis is reported. Their treatment and course was analysed in a retrospective study. Eight patients were operated on within the first 16 days of life and in the remaining group surgery was performed at 1 month to 4 y of age. The presenting symptom leading to diagnosis was, in all but one case, non-bile-stained vomiting. Associated malformations were found in all but four patients, mostly morbus Down. The operative procedure performed was a partial excision of the duodenal membrane and a duodenoplasty in 10 patients, a duodenojejunostomy in 5 patients, and a duodenoplasty only in 1 patient. The postoperative course was without lethal complications. One late stricture in an anastomosis occurred. We conclude that in its presentation, duodenal stenosis differs from duodenal atresia, and can often be misinterpreted, resulting in a late diagnosis, and should be reported as a separate entity.

Child, Preschool↗
PubMed1997

Laparoscopy aided gastrostomy in children.

BACKGROUND AND AIMS: The aim of this report is to describe a method for laparoscopy aided button gastrostomy in children. MATERIAL AND METHODS: The method includes the use of two ports, one umbilical and one subcostal on the left side. The stomach is exteriorized using a grasping forceps in the subcostal port. Under direct vision the gastrostomy button, MIC-KEY, is inserted into the stomach at the lesser curvature and secured by purse string sutures. The stomach is attached to the anterior abdominal wall. RESULTS: The results show that this method has been successfully used in 33 children without operative complications. CONCLUSIONS: We conclude that by inserting the gastrostomy button under direct vision, damage to other abdominal organs is avoided and a correct placement at the lesser curvature obtained. The combination of laparoscopic and open procedures makes the method easy and safe.

Adolescent↗
PubMed1996

Laparoscopy for nonpalpable testis in childhood: is inguinal exploration necessary when vas and vessels are not seen?

A case of bilateral nonpalpable testes is described. Ultrasonography showed no testis. Laparoscopy revealed no intraabdominal testis, vas or vessels. Human chorionic gonadotrophine test suggested the presence of testicular tissue. Computed tomography showed a testis present in each inguinal canal. Inguinal exploration confirmed the finding. This case stresses the importance of careful interpretation of the laparoscopic findings together with other diagnostic methods in localizing testicular tissue in patients with nonpalpable testes.

Child↗
PubMed1996

Nonsuture end-to-end microvascular anastomosis using intravascular stents.

The objective of this report is to describe a new method of nonsuture end-to-end microvascular anastomosis. The vessels to be anastomosed are prepared separately before division by inserting a cylinder-shaped intravascular stent into each vessel. The anastomosis is completed after dividing the vessels. The vessels containing the stents are approximated. The anastomosis is then performed by sliding the stents into each other and is kept together by the force of friction. The method was used for anastomosing the aorta, end to end, in seven rats. The rats survived for one to 25 days with a radiological patient aorta and a fibrous healing of the vessels. This method has a potential use for microvascular anastomosis.

Anastomosis, Surgical↗
PubMed1992

Elective testicular biopsy at the end of maintenance treatment for acute lymphoblastic leukemia. A prospective study.

Open testicular wedge biopsy has electively been performed prior to completion of maintenance therapy for acute lymphoblastic leukemia. 25 boys during 6 years were included in this prospective study. Three boys developed testicular enlargement while on maintenance therapy and biopsies confirmed testicular leukemia. The remaining 22 boys were biopsied at termination of maintenance therapy. Occult testicular relapse was revealed on histologic examination in only one boy with normal testicular size. During the follow-up period, one boy developed overt testicular relapse two months after negative biopsy. These results will not justify electively performed routine biopsy prior to termination of chemotherapy. Instead, careful and minute clinical examination of the testicles, estimating their size and consistence, should be performed regularly at short intervals.

Adolescent↗