Crohn's disease mimicking enterocolitis in a patient with an endorectal pull-through for Hirschsprung's disease.
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Anti-Inflammatory Agents, Non-Steroidal↗
Biomedical subjects
H B So
Publications and source records attributed to H B So.
Eighteen years' experience with neonatal Hirschsprung's disease treated by endorectal pull-through without colostomy.
METHODS: In the past 18 years, the authors have treated 84 patients with Hirschsprung's disease. Of these, 43 patients were under 1 month of age and underwent endorectal pull-through without colostomy. Some have undergone follow-up for as long as 18 years. RESULTS: Thirty-four of these 43 (79%) newborn patients were available for follow-up. Twenty-two were totally continent. The remaining 12 have normal sphincter tone. Of the 41 patients above 1 month of age, 34 (83%) were available for follow-up. Some have undergone follow-up for as long as 18 years. CONCLUSION: Twenty-two of this latter group (79%) have normal bowel control.
Adolescent↗
A case of life-threatening gastrointestinal hemorrhage in an infant with AIDS.
This is the first reported case of an infant with acquired immune deficiency syndrome (AIDS) and cytomegalovirus (CMV) infection that presented with massive life-threatening lower intestinal hemorrhage. Arteriography was useful in localizing a bleeding source prior to operation.
Acquired Immunodeficiency Syndrome↗
Idiopathic infant pyoceles.
Three infants presented with acute scrotal swelling, erythema, and a tender irreducible firm mass within the scrotum. All patients were operated upon with the preoperative diagnosis of testicular torsion. At operation, grossly purulent fluid was found in a hydrocele sac. In all the cases, the testes were normal and no source of the scrotal infection was identified. A variety of bacterial organisms were cultured and responded readily to antibiotics. Follow-up has documented survival of the testes without apparent atrophy. "Idiopathic" infant pyocele is rarely described and consequently, not included in the differential diagnosis of patients with acute surgical conditions of the inguinoscrotal region.
Diagnosis, Differential↗
Recurrent chylous ascites associated with intestinal malrotation and lymphatic rupture.
An 11-yr-old female with abdominal distension since birth, underwent four operations because of intractable and debilitating chylous ascites. The curative procedure consisted of preoperative ingestion of the lipophilic dye, a secondary Ladd's procedure, lysis of extensive adhesions, and ligation of an easily identifiable ruptured lymphatic.
Abdomen↗
Segmental colonic duplication presenting as a sigmoid volvulus.
This is a case report of a four-year-old girl who presented with severe intermittent abdominal pain. She had an infra-levator imperforate anus repaired as a newborn. Operation demonstrated duplications of the right and left colons, separated by a normal transverse colon. The left colon duplication was closed at both ends, and it contained 500 cc of intestinal secretions. The sigmoid colon and its duplication volvulized. The terminal ileum was also duplicated; one ileum joining a normal ascending colon duplication, which was patent proximally, but closed distally.
Child, Preschool↗
Total lung sequestration in association with oesophageal atresia and multiple tracheo-oesophageal fistulae.
This is a case presentation of a full-term newborn female who vomited her feedings and had a chest x-ray demonstrating opacification of the right hemithorax, coiling of the nasogastric tube in the proximal oesophagus, and air in the gastrointestinal tract. The infant underwent three procedures which included: 1. gastrostomy: 2. a left thoracotomy with division of a double tracheo-oesophageal atresia: 3. division of an oesophagobronchial fistula and right pneumonectomy.
Bronchopulmonary Sequestration↗
Tubular duplication with autonomous blood supply: resection with preservation of adjacent bowel.
This 10-mo-old patient represents an unusual small bowel duplication in that: (1) the duplication involved almost the entire small intestine; (2) the technetium scan was diagnostic; and (3) the duplication was resected, leaving the majority of normal bowel intact. Bremer, in his original discussion of the embryology of intestinal duplications, hypothesized the situation that was found in this patient, i.e., separate blood supplies, which, at first glance, appear to be contained within a single mesentery. This anatomical arrangement permitted the duplication to be resected, leaving the adherent normal small intestine.
Humans↗
Endorectal "pull-through" without preliminary colostomy in neonates with Hirschsprung's disease.
The diagnosis of Hirschsprung's disease in the newborn does not mandate the performance of a preliminary colostomy. Enterocolitis can be adequately and safely treated by a precise regimen of colonic irrigations. The endo-rectal "pull-through" procedure is safe and effective when performed in the neo-natal period. Long-term follow-up is necessary to evaluate possible late complications.
Colon↗
An ectopic gastric duplication arising from the pancreas and presenting with a pneumoperitoneum.
This case report describes a large gastric duplication, which had no attachment to the stomach, and it was found in the pancreas. The second unusual feature of this duplication was that it had eroded into the splenic flexure of the colon, resulting in a large pneumoperitoneum.
Colonic Diseases↗
Segmental colonic gangrene: a surgical emergency in the hemolytic-uremic syndrome.
A 2 1/2-year-old girl had rectal bleeding, an abdominal mass, and diffuse peritonitis. A segment of gangrenous colon was removed. Following surgery she developed the hemolytic-uremic syndrome (HUS), which is characterized by renal failure, hemolytic anemia, and the thrombocytopenia. The intestinal manifestations associated with the HUS are stressed. This case demonstrates that gangrenous bowel can occur in these patients, and that their survival may depend on resectional surgery.
Child, Preschool↗
Chronic insertion of foreign bodies into the mature breast.
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Adult↗
Arteriohepatic dysplasia. I. Pitfalls in diagnosis and management.
Differentiating intrahepatic cholestasis from extrahepatic biliary tract obstruction may be difficult. Four patients with intraoperative cholangiographic evidence of extrahepatic ductal atresia who underwent hepatoportoenterostomy are described. All were ultimately shown to have arteriohepatic dysplasia with hypoplastic but patent extrahepatic ductal systems. The difficulty in establishing an accurate diagnosis, hazards associated with hepatoportoenterostomy, and suggestions for evaluation and management are discussed.
Bile Ducts↗
Arteriohepatic dysplasia. II. Hepatobiliary morphology.
Five children were noted to have arteriohepatic dysplasia (Alagille's syndrome) between 3 and 7 months of age. Prior to diagnosis, four underwent Kasai procedures after intraoperative cholangiograms failed to demonstrate patency of the extrahepatic bile ducts. In three patients, a focal proximal hypoplasia of the common hepatic duct was demonstrated with fibrosis and increased vascularity. Hypoplasia of the gallbladder occurred in two patients. Changes were observed in the porta hepatis. Eighty of 208 micrometers bile ducts were associated with peripherally located gland-like structures. These changes are indistinguishable from those in fibrous remnants of extrahepatic biliary atresia. Hepatic features of sequential liver biopsies obtained in the five patients were divided into early and late changes. From birth to 3 months of age, the pathology consisted of cholestasis and bile duct destruction. After 3 months of age, there was persistent cholestasis, paucity of interlobular bile ducts, and portal fibrosis. Ductular proliferation was not an intrinsic change. When present, it was related to a recent episode of cholangitis.
Bile Ducts↗