Biomedical subjects

George M Wadie

Publications and source records attributed to George M Wadie.

4 recordsLinked to original sources

PubMed2005

Cervical spondylodiscitis from an ingested pin: a case report.

In the pediatric literature, only 1 case of cervical spondylodiscitis from an ingested foreign body is reported and this was caused by a blunt radiolucent foreign body. The authors now describe a unique case of a 13-year-old teenaged boy who presented with neck pain 6 days after accidental ingestion of a sewing pin. Uncomplicated removal of this pin was followed in 36 days by the development of cervical spondylodiscitis that failed conservative management and required surgical debridement and arthrodesis. Physicians should be aware of the possibility of this complication in any patient that presents with neck pain after foreign body ingestion.

Accidents↗

PubMed2005

Ductal carcinoma in situ in a 16-year-old adolescent boy with gynecomastia: a case report.

Ductal carcinoma in situ (DCIS) of the male breast is rare. Even more rare is the finding of DCIS in association with gynecomastia. After an extensive literature search, only two cases have been reported in the literature, both in adults. Here we present the case of a 16-year-old adolescent boy who presented with pubertal gynecomastia that was treated with bilateral subcutaneous mastectomies. A DCIS focus was found in the right breast specimen, and the patient underwent bilateral completion total mastectomies uneventfully. Despite its rarity, surgeons should be aware of the possibility of the breast of adolescents with gynecomastia harboring a neoplastic focus.

Adolescent↗

PubMed2003

Early experience with needleoscopic inguinal herniorrhaphy in children.

BACKGROUND/PURPOSE: To validate its safety and efficacy, the authors evaluated their early experience with needleoscopic inguinal herniorrhaphy in children. METHODS: Twelve consecutive children, older than 6 months, with unilateral (n = 8) or bilateral (n = 4) inguinal hernias underwent a needleoscopic herniorrhaphy. A 1.7-mm needle laparoscope was introduced through the umbilicus, and a grasper placed laterally was used for traction. A curved stainless steel awl introduced percutaneously anterolateral to the internal ring was used to pass a ligature circumferentially to complete an extraperitoneal high ligation of the sac (without handling the vas deferens and spermatic vessels in males). Four of 12 patients underwent their repair combined with other procedures. Children who underwent herniorrhaphy only were allowed immediate return to unrestricted activity. Data recorded with IRB approval included operating time, postoperative discomfort, recurrence, and complications. RESULTS: For herniorrhaphy only the mean operating time was 23 minutes (unilateral, n = 5) or 46 minutes (bilateral, n = 3). All were able to return to immediate unrestricted activity. None required any analgesics other than acetaminophen. There were no recurrences or complications. CONCLUSIONS: Needleoscopic inguinal herniorrhaphy in children is safe and effective. This technique potentially offers less risk of injury to cord structures with a superior cosmetic result.

Child↗

PubMed2002

Gastroesophageal reflux disease in neurologically impaired children: the role of the gastrostomy tube.

We review our experience with gastrostomy techniques in neurologically impaired (NI) children, with or without a Nissen fundoplication. The records of 130 NI children who had a gastrostomy tube (GT) placed between January 1999 and October 2001 were reviewed. Data collected included: demographics, neurological status, operative time, time to first feed, postoperative stay, analgesic requirements, follow-up, mortality and complication rates. Open GTs were placed using the standard Stamm gastrostomy technique through a midline incision and were combined with a standard open Nissen fundoplication when indicated. Laparoscopic GTs were placed after institution of carbon dioxide pneumoperitoneum using a 2-port technique, a Mic-key G device of appropriate size and anchored to the anterior abdominal wall with 2 "U" stitches. The laparoscopic Nissen fundoplication (LNF) procedures were performed using a 5-port technique. Patients were divided into 4 groups: group I (n = 12) laparoscopic GT alone, group II (n = 44) open GT alone, Group III (n = 44) laparoscopic GT with LNF and Group IV (n = 30) open GT with Nissen fundoplication. Based on their similar characteristics, Groups I and II and Groups III and IV were compared together. Data were analysed using Student's t test, and internal review board approval was obtained. Patients ranged in age between 10 days and 17.7 years (mean 3.64 years). Their weight was between 1.2 and 63.4 kg (mean 12.8 kg). The compared groups showed similar characteristics with regard to age, weight, cause of mental impairment, and the reason for placement of the GT. The operative time for group III was significantly longer than that of group IV (P < 0.05). Time to first feed was significantly shorter for group I when compared to group II. The postoperative analgesic requirements were not statistically different. The overall short- and long-term complication rates were not statistically different when the related groups were compared, however, site-related complications and feeding problems were significantly less in group I compared to group II. Only 1 operative mortality occurred in group III. Follow-up showed less long-term morbidity and fewer complications with the laparoscopic GT compared to the open one as regard to admissions, surgery, and emergency department visits related to GT problems as well as frequency of GT change. Based on our experience, laparoscopic placement of a low-profile GT in NI children appears to be associated with less morbidity, permits earlier enteral nutrition, and has a cosmetic advantage. We believe that the laparoscopic technique should be the procedure of choice for GT placement in these children even when a Nissen fundoplication is deemed necessary.

Adolescent↗