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Biomedical subjects

G Pelizzo

Publications and source records attributed to G Pelizzo.

At least 19 recordsLinked to original sources
PubMed2005

Giant omphaloceles with a small abdominal defect: prenatal diagnosis and neonatal management.

A giant omphalocele is a liver-containing protrusion through an abdominal defect wider than 5 cm in diameter. The giant form with a small abdominal wall defect is a rare condition which, to our knowledge, has not been described previously. We describe three cases with the typical features of elongated vascular liver pedicle and angiomatosis of the hepatic portal system. The abnormal liver organogenesis, due to extra-abdominal development, represented a significant risk factor for hepatic thrombosis after visceral reduction and liver rotation. All the neonates underwent surgery on the first day of postnatal life. One died because of a postoperative liver infarction, and the survivors needed prolonged respiratory support. Prenatal sonographic features, timing, delivery, type of surgical repair, and postnatal outcome are reviewed. A prenatal sonographic diagnosis could be useful to evaluate the abdominal ring and serial ultrasound examinations are recommended to detect promptly ominous signs of hepatic and bowel damage. Color Doppler may be useful to assess the anatomy of the abdominal vessels and their relationships with the herniated organs, although it was not used in any of the cases reported here. This congenital malformation might be considered as a pathological entity separate from giant omphalocele with large abdominal defect, with a severe prognosis due possibly to its different embryological development.

Abdominal Wall↗
PubMed2004

Acute airway obstruction in an infant with Pierre Robin syndrome after palatoplasty.

This report describes a complication of post-operative oedema of the palate, tongue and pharynx after a Perko-revised cleft palate repair, which resulted in a life-threatening airway obstruction in an infant with Pierre Robin syndrome. Although infants experiencing airway problems after Wardill-Kilner, von Langenbeck and Furlow palatoplasty have been described, airway complications in a group of Perko-revised repair children have not been previously reported. We speculate that this complication, which occurred in the absence of a history of previous airway problems, is due to prolonged operating time and excessive pressure exerted on the base of the tongue by the Kilner-Doughty retractor. Acknowledgments of this risk permits to identify those patients prior to surgery so that they can be managed appropriately.

Acute Disease↗
PubMed2001

A new technique of bladder enlargement and continent urinary diversion using the ceco-appendicular unit.

The authors developed a new technique using the cecum with in-situ appendix to simultaneously achieve bladder enlargement and continent urinary diversion (CUD) in five cases of neuropathic bladder or serious complications of abdominopelvic trauma. The cecoplasty provides a large-capacity, low-pressure reservoir; the submucosally-embedded appendix gives complete continence with 3 to 5 intermittent catheterizations daily. It is an alternative to the Mitrofanoff principle when bladder augmentation and CUD are necessary, and easier to achieve when faced with a neuropathic bladder where the thickness of the detrusor makes appendicular implantation difficult.

Adolescent↗
PubMed2001

Carcinoid tumors of the appendix in children.

We report ten cases of carcinoid tumor of the appendix observed in children from 1988 to 1996. The patients included six females and four males with an average age of 13 years at presentation. They were admitted after complaining of pain in the lower abdominal quadrant. In eight children who presented with symptoms of acute appendicitis, the tumor was located at the tip of the appendix. Diagnosis was performed after appendicectomy (AE) and pathologic examination, which revealed a tumor slightly under 1 cm in size. Two other children were admitted with clinical signs of peritonitis due to larger tumors measuring more than 2 cm on the base of the appendix. One patient underwent a cecectomy, the other a right hemicolectomy. For all patients follow-up was 3 years, and all recovered fully. According to these findings and a review of the literature, we suggest conservative surgical procedures in children. More than 70% of these tumors are localized at the tip of the appendix and represent an incidental pathologic finding during AE; AE alone is curative. Patients with a bulky tumor of the appendicular base measuring 2 cm and invading the serosa and mesoappendix without metastases may be treated with a cecectomy; ileocecal resection may be indicated in cases where the tumor has infiltrated tissue beyond the cecum with localized metastases and in patients with incomplete gross resection. Right hemicolectomy is questionable in this age group and restricted to rare conditions.

Adolescent↗
PubMed2001

Prenatal management of inherited urogenital malformation: case report.

Documentation of unique kidney renal function early in pregnancy can be helpful in defining prenatal management and therefore in improving prognosis. Antenatal diagnosis of a solitary kidney was performed at 20 weeks' gestation in a foetus with a 1,7 chromosome translocation. Because of the decreasing renal function and the increasing pelvic dilatation, an early in utero stenting was placed at 23 weeks' gestation. Optimal outcome occurred and the baby was delivered at 32 weeks. Complete assessment of the malformation showed a left hydronephrosis due to a megaureter, right renal agenesis with ipsilateral cryprorchidism and agenesis of the right vas deferens. The chromosomic translocation was inherited from the mother who was affected by uterus didelphys, obstructed right hemivagina and right renal agenesis. Renal function of the unique kidney with hydronephrosis can be early diagnosed and promptly treated. This condition should also increase the index of suspicion of underlying genital and chromosomal anomalies.

Dilatation, Pathologic↗
PubMed2001

[Post-traumatic complication of trans-appendiceal cystostomy: urinary peritonitis].

Two children who had undergone a transappendicular urinary diversion (type Mitrofanoff) developed bladder rupture, one following abdominal trauma, 4 months after the operation and the other following traumatic self-catheterization at 4 years. The clinical history and standard radiological examinations (ultrasonography, cystography) confirmed the diagnosis of urinary peritonitis. Emergency surgical repair was possible in both cases with an uneventful postoperative course. This serious and rare complication requires emergency surgery and justifies rigorous selection of children suitable for this type of diversion giving preference to increased bladder neck resistance over bladder neck closure.

Adolescent↗
PubMed2000

Abdominal expansion using a polytetrafluoroethylene prosthesis in the treatment of Pepper syndrome.

The authors report three cases of stage IV-S neuroblastoma in infants aged 4, 6, and 8 weeks, who despite chemo- and radiotherapy required surgical intervention to urgently relieve major thoracoabdominal compression secondary to massive hepatomegaly. The results were successful, with abdominal expansion being achieved by the introduction of a polytetrafluoroethylene prosthesis, which was removed during the 2nd, 3rd and 7th postoperative month, respectively, after tumor regression. Two children were in complete remission 32 and 38 months later, the 3rd died after 16 months of tumor progression.

Adrenal Gland Neoplasms↗
PubMed2000

Surgical treatment of diaphragmatic agenesis by transposition of a muscle flap: report on 15 cases.

Between 1987 and 1996 the transposition of a muscle flap using the anterolateral abdominal wall (the internal oblique and transversus abdominus muscle) has been used for the surgical treatment of fifteen cases of diaphragmatic agenesis. There are several advantages of this technique: a more accurate reconstruction of the diaphragmatic dome, a better adapted muscle flap, good tolerance and evolution as a result of the use of autologous material with thus less risk of recurrence and/or infection. The disadvantages are represented by the nine cases of abdominal herniation at the site of the muscle flap, three of which necessitated secondary surgical treatment. Nine children survived this treatment, six died following severe cardio-pulmonary complications associated with this malformation.

Chylothorax↗
PubMed1999

[Cystic dysplasia of the rete testis and ipsilateral kidney agenesis in children].

BACKGROUND: Cystic dysplasia of rete testis, a rare abnormality, is often associated with renal agenesis. CASE REPORT: A 5-year-old boy was examined because he presented large scrotum. This was initially considered as hydrocele. Surgery showed a cystic dysplasia of the testis that in this patient was associated with ipsilateral renal agenesis. CONCLUSION: This congenital abnormality, explained on the basis of embryological development, has been reported in 15 children. The testis appears cystic at surgical exploration; echography can affirm diagnosis and MRI can give specific features. A conservative attitude is proposed as this lesion is benign. Long-term follow-up is recommended for possible painful effects or growth of the lesion.

Child, Preschool↗
PubMed1999

[Modified Dyplay technique in the treatment of anterior hypospadias. Immediate and long term results in 321 cases and review of the literature].

OBJECTIVES: Description of a surgical technique in the treatment of anterior hypospadias, a frequent malformation for which the treatment is not devoid of complications. Evaluation of the short-term as well as the long-term results. MATERIAL AND METHODS: Retrospective study of 321 patients treated according to this method. 58 patients were reviewed with a mean follow-up of 71 months. RESULTS: The immediate results were marked by the development of 16 fistulas (5%), 4 of which closed spontaneously. Five cases (1.6%) of meatal retraction and 6 meatal stenoses (1.9%) were observed. The overall complication rate requiring specific treatment was 5.6%. The long-term results showed meatal retraction in 20.7% of cases, meatal stenosis in 1.7% of cases and fistula in 3.5% of cases. This is the series with the longest mean follow-up. Comparison with the currently proposed technique suggests that this technique is indicated in the treatment of anterior hypospadias. Long-term analysis of the results strongly encourages regular and prolonged follow-up of children treated for hypospadias in the first 2 years. CONCLUSION: The modified Duplay technique is reliable, can be easily performed, and gives perfectly satisfactory results, even in the long-term, for the treatment of anterior hypospadias.

Adolescent↗
PubMed1998

Gastric necrosis in newborns: a report of 11 cases.

Eleven neonates ranging in gestational age from 34 to 40 weeks presented with gastric necrosis. The 4 full-term neonates showed sudden-onset hemorrage and "coffee-ground" vomiting; in the 7 premature babies the initial clinical finding was abdominal distention. The criteria for diagnosis were: perinatal distress in prematures and transient neonatal respiratory distress in full-term babies. Radiographic evidence of gastric distention was typical and preceded clinical signs of hematemesis and gastric perforation. Surgery was performed in 8 patients; 3 received medical treatment. At surgery 1 total and 3 subtotal gastrectomies and 4 segmental gastric resections were performed. Three of these patients died post-operatively as a consequence of multiorgan failure; a second look was necessary in one patient 1 week after surgery because of prepyloric perforation due to ulcers. Biopsy specimens taken from the site of perforation demonstrated extensive necrosis; ulceration was disseminated in the surrounding gastric mucosa; no signs of phlogosis were detected. The diagnosis, treatment, and physiopathologic considerations are reviewed.

Biopsy↗
PubMed1998

[Continent urinary diversion using a tubulized sigmoid segment. An alternative to trans-appendicular diversion].

OBJECTIVE: The authors propose the use of a sigmoid tube reimplanted submucosally in the bladder and brought out onto the skin in the midline or in the umbilicus as a method of continent urinary diversion allowing urinary catheterization several times a day when the appendix cannot be used. MATERIALS AND METHODS: Three adolescents with neurogenic bladder were treated according to this procedure; the summit of the sigmoid colon loop was selected to form a continent tube from a segment 4 cm wide, opened along its antimesenteric border and sutured longitudinally. RESULTS: The postoperative course was uneventful in all 3 cases. The cystostomy was continent. Catheterizations were easily performed. CONCLUSION: Creation of a sigmoid tube is an alternative to the use of the appendix for continent urinary diversion according to Mitrofanoff's procedure. This technique can always be performed due to the proximity of the sigmoid colon and bladder, which is not always the case with the appendix. This tube is richly vascularized and presents the advantage of a very narrow mesocolon which does not interfere with creation of the intravesical submucosal tunnel.

Abdomen↗
PubMed1998

[Endoscopic treatment of vesicorenal reflux in children. Five-year assessment of the use of Macroplastique].

OBJECTIVE: To compare the results of endoscopic treatment of vesicorenal reflux by Macroplastique implantation versus Teflon implantation. MATERIAL AND METHODS: 297 children with 454 refluxing vesicorenal units were treated by endoscopic implantation of Macroplastique (Rplasty)-A.B.S.: 385 cases of primary reflux and 69 cases of secondary or associated reflux. All children were reviewed by ultrasound and cystography 6 weeks and 1 year after implantation. RESULTS: Regardless of the aetiology and the grade, reflux resolved in 91.2% of children (93.3% of ureters). Complications such as ureteric stasis were rare (3 cases). 161 children (253 ureters) were reviewed 1 year after treatment: reflux had recurred in 8.7% of patients. CONCLUSION: Although the mean quantity implanted was lower with Macroplastique, the results appeared to be better than those obtained with Teflon (bases on a previous series of 402 children: cure for 87.1% of ureters and 85.7% of children). The advantages of Macroplastique compared to Teflon include the less liquid consistency, the absence of retraction of the product and the presence of larger microparticles without any local or distant inflammatory reaction.

Child↗
PubMed1998

[Urethral fistulas after surgical treatment of hypospadias. Apropos of a series of 74 cases].

OBJECTIVE: To analyse the causes of fistulas following urethroplasty procedures and the principles of their surgical treatment. MATERIAL AND METHODS: 74 fistulas were treated: 6 were on the glans, 17 coronal, 33 on the distal shaft, 6 midshaft, 8 proximal shaft and 4 penoscrotal. More than 75% underwent a simple closure or invagination of the fistula into the urethra, often without urinary diversion. A second-stage urethroplasty was necessary in 15 cases. RESULTS: The initial success rate was 72.5%. Results obtained with simple closure or invagination were better than extensive surgery (50% failure rate). Seventy two percent of these fistulas without urinary diversion were treated successfully as compared to 53.8% of those which had required a catheter. CONCLUSION: Of all the complications of hypospadias surgery, fistulas are in most cases the easiest to resolve, provided that some fundamental rules are respected: a minimum of 6 month between both procedures, previous treatment of any concomitant urethral stenosis, use of a tourniquet and loops magnification, and an additional layer of interrupted subcutaneous sutures. A haemostatic dressing reduces the tension of the sutures. An urinary diversion is only necessary for larger fistulas which require a second-stage urethroplasty.

Adolescent↗
PubMed1992

[Transplantation of the left lung in a 2-month-old piglet. The Study Group for Lung Transplantation].

Experimental surgery in animals remains an irreplaceable model for the clinical application of a new technique. We performed a single lung allotransplantation in young pigs. The pigs were organized into groups: 1) 6 to assess the surgical anatomy; 2) 10 to receive left transplantation; 3) 3 to study the pathophysiology of the transplanted lung. The preliminary results demonstrated that the surgical model is useful.

Animals↗