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Biomedical subjects

E Somppi

Publications and source records attributed to E Somppi.

9 recordsLinked to original sources

Outcome of patients operated on for esophageal atresia: 30 years' experience.

PURPOSE: The aim of this study was to evaluate the outcome and late sequelae of patients with esophageal atresia or tracheoesophageal fistula. METHODS: Sixty patients with esophageal atresia or tracheoesophageal fistula (EA-TEF) were treated in Tampere University Hospital in the years 1963 through 1993. Long-term outcome was evaluated with a questionnaire, pulmonary and esophageal function test results, 24-hour pH level monitoring, tracheobronchoscopy findings, and esophagogastroscopy with biopsy sections and samples for bacterial cultures. RESULTS: One third of the respondents reported having impaired quality of life because of respiratory infections, dyspnea, and difficulties in swallowing and coughing at night. Eighteen percent had gastroesophageal reflux (GER) symptoms. The rate of symptoms decreased with age. Impaired pulmonary function, GER, abnormal esophageal peristalsis, and transit time were registered. Tracheobronchoscopy showed tracheal narrowing and inflammation in one third; in histopathologic analysis, however, the rate of inflammation was more than doubled. Histologically, esophageal inflammation was found in 51%, Barrett's esophagus in 6%, and a Helicobacter pylori infection in 21% of cases. The severity of GER, esophageal peristaltic abnormality, tracheal inflammation, and impairment of pulmonary function seems to be alleviated with age. CONCLUSIONS: Although the long-term outcome of EA-TEF patients seems to be favorable, respiratory and gastrointestinal symptoms as well as functional abnormalities remain frequent. Gastric metaplasia in the esophagus and the high rate of tracheal, esophageal, and gastric inflammation indicate a need for long-term follow-up.

Adolescent↗

The late appearance of scars after burns in childhood.

The late appearance of scars in children who had been burned, mainly scalded (n = 82, 90%) were analysed retrospectively from patient records and by clinical reassessment. All 91 patients who were re-examined had primarily sustained a burn of at least 5% of their total body surface area (TBSA). Only five patients showed no visible scars. The median interval between primary injury and re-examination was 17.3 years (range 6.4-30 years). Less than half of the patients (n = 36, 40%) had distinct scars without hypertrophy. The remaining 55 (60%) had either hypertrophic or constrictive scars. The scars were mostly located on the trunk (29%) and looked mainly hypertrophic (30.2%). The mean area of scars varied from 0.47% (on the neck) to 3.73% (on the left lower limb). There was no significant association between the appearance of the scar and any given method of treatment. The late cosmetic results were better than anticipated.

Adolescent↗

Early childhood appendicitis is still a difficult diagnosis.

We report on 90 pre-school children operated on for suspected acute appendicitis. The data analysis was retrospective. The outcome of exploration was negative in 54% (49/90) of cases; inflamed nonperforated appendix was removed 28% (25%/90) and a perforated appendix in 18% (16/90) of cases. In infants aged < 3 years (n = 26) the perforation rate was 60%, and in children age 4-5 years (n = 64) it was 27%. Tenderness in the iliac fossa, blood leukocytosis and urinanalysis had little diagnostic value. Preoperative signs of diffuse peritonitis and elevated values of serum C-reactive protein were found more frequently only in the children with a perforated appendix. There was no mortality and the postoperative morbidity varied between 10 and 20%. Thus, although appendectomy is currently a safe procedure in children, more specific non-invasive diagnostic acids are still needed to reduce the number of negative explorations and the rate of perforation.

Acute Disease↗

Paediatric burns in central Finland between the 1960s and the 1980s.

This study comprised 359 paediatric burn-injury cases. The patients were collected from the 1960s, 1970s and 1980s, taking 4 years from each decade. These children were treated exclusively in the Paediatric Surgery Department in the University Hospital of Tampere, Finland. We were interested in the backgrounds and living environments of our patients as well as the children themselves. Special attention was paid to risk factors and methods for prevention. Scalds at home and in the sauna rooms constituted the largest groups of injuries. The number of hospitalized patients has slightly decreased during the past three decades, whereas the proportion of girls has increased. The mortality was very low (0.28 per cent), a single case. This study shows that 80 per cent of born injuries in children occurred under the age of 4 years and over 80 per cent of all burn injuries involved hot liquids; modern kitchen technology has not significantly reduced this factor. The epidemiological profile of paediatric burns changed from the 1960s to the 1980s less than expected.

Adolescent↗