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G Pistor

Publications and source records attributed to G Pistor.

At least 19 recordsLinked to original sources
PubMed2003

[Sonographic visualization of the axial level of the anal sphincters. Preliminary results in children].

BACKGROUND: The sonographic visualization of anal sphincter structures in children through perineal sections in the sagittal and the coronary plane is unsatisfactory for the assessment of morphologic pathologies. Only the scan direction vertically to the longitudinal axis of the rectum facilitates the showing of the sphincter structures and their circumferential course. Up to now, this could only be achieved by a rectal introduction of the probe. This method has not found any acceptance with the diagnosis of children due to the necessary penetration as well as problems with orientation, resolution and time consuming preparations. METHOD: The anal sphincter structures of 10 children in the age of 2-6 years were examined. As a control group 5 children had no previous operations and a normal bowel movement. The others had previous operations due to anal atresia as well as pathological defecation. The Combison 530D (Kretz) was used. We started with the prototype of a 3D transducer that was derived from those designed for intravaginal use in gynecology. Modifications were made concerning the transducer design, the direction of the ultrasound was changed to 145 degrees forward angulation and a probe with short focus and 7.5 MHz. RESULTS: Our first investigations showed that axial levels calculated from the digitally registered volume scan permit so far not yet achieved visualization of the anal sphincter structures in children. Relevant pathomorphological findings can exactly be located. The examinations are non invasive and well accepted by children.

Anal Canal↗
PubMed2003

[Sonographic diagnosis of supracondylar fractures of the humerus].

AIM: The aim of this study is to evaluate whether sonography as a primary diagnostic tool can be used for the diagnosis of supracondylar fractures of the humerus within a screening regimen. METHOD: With standardized sonography, a total of 75 children with suspected fractures of the distal humerus were investigated. The initially retrospective study (learning phase) was followed by a prospective study. All examinations were counter-checked by radiography. Supplementary to the standard sections two new sectional planes had to be added and evaluated. RESULTS: Of 65 children with fractures of the elbow, 43 had supracondylar fractures. All fractures could be visualized sonographically in the retrospective study and were diagnosed in the prospective examination. No supracondylar fracture was overlooked. Five results were falsely positive and would have been classified as undislocated supracondylar fractures type Baumann I. With the introduction of the two new sectional planes (dorsal radial and dorsal ulnar longitudinal section), rotatory deformity could be assessed. CONCLUSION: The longitudinal sections of the first compartment (standard sections) together with the two newly added dorsal radial and ulnar sections improved the diagnosis of supracondylar fractures of the humerus. The primarily unsatisfactory results could be improved by introduction of these additional sections, which are now recommended as standard sections of ultrasound application. Having acquired sufficient experience, the method can be used as a screening method for primary diagnosis and documentation of supracondylar fractures.

Child↗
PubMed1996

The Currarino syndrome--hereditary transmitted syndrome of anorectal, sacral and presacral anomalies. Case report and review of the literature.

The Currarino triad is a hereditary transmitted syndrome, originally defined by Currarino as ASP-association, consisting of an anorectal malformation, a sacral bony defect and a presacral mass. In most cases autosomal dominant transmission is suggested. In family members one or two features of the syndrome may be missing, indicating an incomplete form of this complex. We describe two unrelated girls at the age of 8 and 9 months respectively with ASP-association. Family screening in both patients showed 8 additional cases with a complete or incomplete Currarino triad, four of them being asymptomatic. A review of the literature up to 1991 revealed 48 patients with ASP-association. In more than 80% of cases, this complex is diagnosed in the first decade, whereas incomplete Currarino syndrome is diagnosed predominantly in adults. Most frequently the presacral mass in ASP-association was reported to be an anterior meningocele (47%) and a benign teratoma (40%). The number of patients with Currarino syndrome has been underestimated so far. We recommend anorectal examination, pelvic ultrasound and pelvic x-rays in all patients with a history of chronic constipation since early childhood. Positive findings should lead to further investigations such as barium enema, MRI, myelography and family screening. Close cooperation between pediatric surgeons and neurosurgeons is required to ensure adequate surgical treatment, considering both the risk of malignant degeneration as well as the risk of intraoperative nerve damage. Thus, radical excisional surgery is not obligatory in every case of Currarino syndrome.

Abnormalities, Multiple↗
PubMed1990

[Surgical strategies in thyroid gland diseases in childhood and adolescence].

In the Department of Paediatric Surgery of the University Hospital of Mainz and the Department of Paediatric Surgery of the University Hospital of Frankfurt/M 90 children with thyroid gland lesions were operated on between 1970 and 1988. 78 patients had benign findings and 12 had malignant tumours. The most frequent operative indication for benign lesions was the euthyroid goitre (57 patients). We found nodular goitre in 45 patients, cystic goitre in 11 patients, and diffuse goitre in only 1 patient. 20 children were suffering from hyperthyroidism (11 with Basedow's disease, 9 with autonomy) and 1 from Hashimoto's thyroiditis. Among the malignant tumours, papillary carcinomas were the most frequent (5 patients), followed by follicular carcinomas (2 patients) and C-cell carcinomas (2 patients), and 1 case each of C-cell hyperplasia, retothelial sarcoma and malignant lymphoma. The following operative interventions were necessary: Among the patients with the benign findings, 28 unilateral subtotal resections were done (17 right side and 11 left side). 24 lesions were enucleated, 24 goitres were subjected to subtotal bilateral resection; in 1 case subtotal resection on the right side and hemithyroidectomy on the left side was performed, and in one patient polresection was necessary. All the 12 patients with malignant tumours underwent thyroidectomy: In 4 cases one-step operations were done and in other 8 cases multistep operations were performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Functional colonic ultrasonography: normal findings of colonic motility and follow-up in neuronal intestinal dysplasia.

Three types of neuronal intestinal dysplasia (type A, type B, and combination with Hirschsprung's disease) can be distinguished. Functional assessment of the affected bowel segments can be achieved by functional colonic ultrasonography, thus providing exact parameters for further therapeutical procedure. The technique is described. Ten children with neuronal intestinal dysplasia in whom functional colonic ultrasonography was employed and results of their follow-up examinations are reported.

Child↗
PubMed1987

[Diagnosis and therapy of non-parasitic splenic cysts in children].

Splenic cysts of various types are rare surgical abnormalities. The diagnostic and therapeutic procedures are discussed with special reference to the author's clinical material consisting of six children with non-parasitic cysts. Sonography and, in special cases, CT are the most important methods of examination. The desirability of conserving the spleen, while removing the cyst, is stressed.

Adolescent↗
PubMed1987

[Functional echo morphology of Bauhin's valve].

Following rectal irrigation, it is possible to demonstrate the ileo-caecal valve sonographically, using a right para-inguinal approach. The shape, position and motility of the valve can be evaluated. The normal valve is two to three mm. thick, similar to the colonic wall, but its lips are thickened. Two distinct mechanisms are responsible for opening the valve, the ileocolic pressure gradient and relaxation of the circular muscle round the valve. The resulting intraluminal flow can be quantified by duplex sonography. The information may be of diagnostic and therapeutic significance, particularly during childhood.

Adolescent↗
PubMed1986

[Relaparotomy in childhood].

From 1.1.1976 to 31.12.1983 1,793 laparotomies were performed on children up to the age of 15 years at the Hospital of Pediatric Surgery, Mainz University. The incidence of acute unplanned relaparotomies was 4.6%. The most frequent indication of acute relaparotomy was postoperative obstruction due to adhesions (in 53% of all cases); burst abdomen, peritonitis, intestinal perforation, anastomotic insufficiency and secondary hemorrhage were less frequent causes of repeated abdominal procedures. 15% of all relaparotomised children underwent more than one repeat laparotomy. More than 40% of acute relaparotomies were performed on children within their first year of life. 56% of all relaparotomies had to be performed within the first four postoperative weeks, 87% within the first year. The lethality rate of acute relaparotomy was 15%. Lethality was especially high in children suffering from anastomotic insufficiency or burst abdomen; it increased with the number of relaparotomies. The significance of preoperative sonography for the diagnosis leading to acute unplanned relaparotomies is discussed and commented with examples.

Abdomen, Acute↗
PubMed1986

[Modern diagnosis and therapy of traumatic hemobilia in childhood].

The authors report on the first case of haematobilia diagnosed in childhood by means of sonography. Massive haematemesis occurred in a six-year-old boy on the 57th postoperative day after an oversewn rupture of the liver. Sonography revealed an atonic gallbladder with stratification phenomena and free floating highly reflecting coagulates, as well as pulsations and flow phenomena in an area of the size of a bean at the floor of a necrotic cavity of the liver (aneurysm). Relaparotomy was done by locating the aneurysm via sonography and performing a purse-string ligature. The high mortality rate of 10 to 20% can be reduced if the gradually evolving condition is identified at an early stage, which means that regular sonographic examinations should be conducted in the postoperative control of liver rupture. Intraoperative sonography with sterilisable sound heads enables accurate location of the source of bleeding.

Aneurysm↗
PubMed1986

[Post-traumatic radio-ulnar synostoses in childhood].

This article reports on five children treated surgically during 1973-1975 for posttraumatic radioulnar synostosis. The synostoses had developed as a complication after a proximal radial fracture. Lesion of the proximal ulna plays an important part in creating such an osseous union. Another factor of equal importance is the traumatization of the tissues during surgical treatment of the fracture, especially if debris of the periosteum and fine bone fragments additionally enter into the space between radius and ulna. Formation of excess callus, and hence synostosis, is also promoted if repositioning or re-repositioning of a proximal radial fracture is effected too late. The article presents the technique of surgical treatment of proximal radioulnar synostosis with Lyodura sheathing. Follow-up examination of the five children during an observation period of five years showed good results in two children, a moderate result in one, and poor results of surgery in two cases. Improved results may be expected from further improvement of the surgical method, such as resection of the bicipital tuberosity (tuberositas radii) or from additional partial sheathing of the ulna at the side facing the radius.

Adolescent↗
PubMed1985

[Consequences from prenatal sonography of urinary tract abnormalities].

At the Gynaecologic Clinic of the University of Milan/Italy from 1979-1983, pathological changes of the urinary tract were diagnosed in 55 foeti on the occasion of routine sonography of pregnants. In 23 children prenatal diagnosis was confirmed. 5 neonates had another disease than the disease of the urinary tract assumed during the prenatal period. In 19 neonates the first diagnosis had to be rescinded because of a second examination showing normal findings. 8 neonates could not be examined a second time. Advantages of an intrauterine diversion of urine could not be verified. Therefore, the following diagnostic and therapeutic consequences from the prenatal examination by sonography are recommended: Immediate check and analysis of prenatal findings in the neonatal period by further examinations. Short-term checks to clarify indication for operation. Avoidance of early complications and other kidney changes by early therapy.

Diagnosis, Differential↗
PubMed1985

[Mesenteric cysts in childhood].

5 children with mesenteric cysts, 3 boys and 2 girls, aged 2 to 10 years, were admitted with acute abdominal pain. In adults the most common symptom is chronic abdominal pain whereas in children the onset of symptoms is acute due to intestinal obstruction. Sonography, performed in two patients, is the diagnostic method of choice. Excision of the cyst required resection of the small intestine in 2 patients, while simple enucleation was possible in 3. All 5 patients survived, and there have been neither complications nor recurrences. Early recognition and appropriate resection of these occasionally life-threatening malformations are associated with a good prognosis.

Abdomen, Acute↗
PubMed1985

[Methodologic studies of manometry of the rectum].

For the purpose of an experimental study in which the three different types of pressure catheters most commonly used in anorectal manometry were compared, a Starling-resistance could be established. Under equal conditions the pressures could be changed in this resistance and the data obtained by using a membrane-catheter, an open-tip and an open-side-catheter were compared among one another and to the known ideal straight line. The open tip catheter measures the opening pressure and the recorded pressure does not necessarily reflect the pressure at the site of the tip hole. Because of its elastic and plastic characteristics, the membrane-catheter yielded the best results with prestretch of the membrane and with calibration before and after each study.

Anal Canal↗
PubMed1985

[Appendicitis in childhood].

Appendectomy was performed on 1,059 children at the University Clinic of Paediatric Surgery in Mainz from 1. 1. 1975 to 31. 6. 1983. For the retrospective examination of the indication for appendectomy histopathological and intraoperative findings were analysed and evaluated. Histologically five types of appendicitis were differentiated: 1. acute appendicitis (two forms: acute ulcero-phlegmonous appendicitis with or without perforation and acute superficial appendicitis), 2. chronic appendicitis, 3. lymphatic hyperplasia, 4. submucosal fibrosis, 5. rare diseases. In 618 cases (= 58.3%) acute appendicitis was diagnosed histologically. In another 203 cases (= 19.2%) intraoperative findings (e.g. Lymphadenitis mesenterialis, Meckel's diverticulum) were retrospectively collected; they caused symptoms similar to those of appendicitis. However, there remain retrospectively 22% of all appendectomised children with no indication for laparotomy. The statistical analysis of postoperative complications showed a significant dependance from the histopathological findings. The highest rate of complications was seen in cases with perforated (34%) or non-perforated (10%) ulcero-phlegmonous appendicitis. Children with acute superficial appendicitis had a complication-rate of 5%; those with lymphatic hyperplasia and submucosal fibrosis of 6% each. Relaparotomies were almost exclusively necessary in cases with acute appendicitis; septic and pulmonary complications were mostly seen either in infants with malformations or other perinatal risks, or in children with additional severe diseases. Therefore non-acute appendicitis justifies a wide indication for appendectomy because of a low complication-rate; this, however, is not valid for high-risk children (e.g. malformations). In these cases sonography might be useful for preoperative diagnosis.

Adolescent↗
PubMed1984

[Functional colon sonography in neuronal intestinal dysplasia. Report of 3 cases].

For the first time morphology and function of the colon were analysed by sonography in three children with M. Hirschsprung and neuronal-intestinal dysplasia. After one year two children attained almost normalisation of colon-peristalsis in the nonaganglionic segments. A resection of the neuronal-dysplastic segments was not necessary. In one child there was seen no change of the distal colon motility. The limit of resection at operation was determined by sonographic diagnosis following observation of stimulated motility. Sonographic long-time examination in connection with medicamental stimulation of the colon allows determination on timing and kind of therapy in neuronal-intestinal dysplasia.

Age Factors↗
PubMed1984

[Femoral neck fractures in childhood].

Twenty-eight fractures of the neck of the femur occurred in children between 1963 and 1982 were treated and followed up at the Pediatric Surgical Hospital of the University of Mainz. Three children had transepiphyseal fractures (type I), eight children transcervical fractures (typ II), six children cervicobasal fractures (typ III), and eleven children pertrochanteric fractures (typ IV). Surgical intervention was performed in fifteen children, and thirteen children were submitted to conservative treatment. The results were evaluated according to a new system considering troubles, mobility, and X-ray findings. The evaluation showed good results in twenty children, bad results in two children, and satisfactory results in one child. Five children could not be evaluated. Complications necessitating an osteotomy with change of the bone position were only seen after conservative treatment. The therapeutic procedure applied in order to prevent the most severe complication, i.e. the aseptic necrosis of the femoral head, is pointed out.

Adolescent↗