Prolonged total parenteral nutrition using the Broviac catheter.
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Biomedical subjects
Publications and source records attributed to I H Krasna.
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Necrotizing enterocolitis (NEC) that occurs in the high risk neonate is not usually associated with pathogenic organism. In older children the presence of NEC is often due to infection with a specific pathogen. A case of a five month old child with pseudomonas aeruginosa septicemia presented with typical NEC. in the course of two laparotomies, most of the small bowel was resected. Necrotizing skin lesions were also present, and the likely source of both of these lesions were septic embolic.
A simple purse string technique for treatment of colostomy prolapse and intussusception is described. It is suggested as an alternative to more complicated procedures.
Duplications of the alimentary tract may cause extensive bleeding when ectopic gastric mucosa is present. A successful diagnosis can be made preoperatively with the use of conventional barium studies as well as sodium pertechnetate Tc 99m scans.
Administration of low molecular weight dextran and reexploration in 36-48 hr, is recommended in cases of ischemic midgut volvulus. Five cases are presented utilizing this technique and many centimeters of small bowel were saved that would have been resected at time of the original exploration. One patient died as a result of sepsis due to central intravenous nutrition: the others are alive and well.
In three cases of congenital diaphragmatic hernia presenting long after the newborn period, there was striking enlargement of the intraabdominal stomach. In each case there was herniation of the entire small bowel into the thorax and absence of a hernial sac. Despite the enormous capacity of the stomach, which was suggestive of obstruction preoperatively, no site of obstruction could be demonstrated at operation. This enlargement disappeared following surgical repair of the hernia.
Experience with eight cases of malignant hyperpyrexia are presented. The different types are described and illustrated by clinical cases. Early recognition of this condition is the cornerstone in the successful management of the complication. Early diagnosis and methods of treatment are described.
Neonatal adrenal hemorrhage can usually be diagnosed on excretory urography without resorting to surgical exploration or invasive diagnostic procedures. In the typical case an avascular mass is seen between the liver and kidney. A case is presented in which a vascular rim surrounded the avascular mass, giving an appearance similar to that of an obstructed upper pole renal duplication. This early vascular rim, not as well known as the calcified rim which develops days to weeks after the acute hemorrhage, is probably created by compression and displacement of adrenal tissue by the central hemorrhage.
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