Biomedical subjects
Publications and source records attributed to J C Hoeffel.
The sonographic expression of the hemolytic-uremic syndrome in children is a cortical hyper-echogenicity, which has a real prognostic value in comparison to the clinical criteria. In addition, renal ultrasonography with Doppler is useful to predict the evolution of the condition, and may help the clinician to define the therapeutic choices.
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Four pediatric cases of peptic esophagitis in patients with severe dorsolumbar scoliosis including three with a history of neurological disease provide the opportunity to point out that curvature of the spine fairly often causes development of gastroesophageal reflux. By displacing the anchoring points of the stomach and stretching the lower esophageal sphincter, scoliosis can be responsible for malposition of the cardia and fundus and for gastroesophageal reflux. Furthermore, plaster corsets increase intraabdominal pressure and may therefore promote gastroesophageal reflux.
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In a 4-year-old boy, cystitis in a pseudotumoral form with left ureterohydronephrosis wa discovered on the occasion of repeated urinary infections. Several biopsies were required to rule out a malignant tumor, and they showed that this condition was an eosinophilic cystitis. Healing was obtained with an anti-bilharzial treatment, although this child did not suffer form bilharziasis. A few similar cases were found in the literature. We note that the diagnosis is usually not established before biopsy, but the association of repeated urinary infections and of a vesical pseudotumoral syndrome with ureteral obstruction must lead to suggesting it, especially if the first biopsy does not reveal any tumor.
The authors report about the exceptional observation of a left ureterohydronephrosis caused by a cluster of loops trapped inside Douglas'pouch, as was clearly visible on CT. The surgical treatment cured the patient. Regressive renal insufficiency complicated the postoperative period. This case belongs to the category of pelvic hernias through an abnormal opening.
Congenital pulmonary lymphangiectasia is a rare abnormality with dilatation of pulmonary lymphatics and the radiological pattern of a pulmonary interstitial syndrome. It is usually symptomatic at birth and is almost always lethal. We report the case of an infant with congenital pulmonary lymphangiectasis and congenital heart disease who is still alive at 11 years. This case is interesting from the pathogenic, nosologic and prognostic point of view.
A 16-year-old boy suffers from headaches. A bilateral adrenal pheochromocytoma is diagnosed and removed. After surgery, the image of bone sequestrum has disappeared. Osseous microthrombi secondary to hemoconcentration are responsible for the image of button sequestrum.
Persistence of a single pulmonary vein with normal pulmonary venous return is a rape and unusual radiographic finding. We report such a case with the venous opacity partially visible on the right border of the heart on a plain frontal chest film. MRI showed beautifully the pulmonary vein and can now replace angiocardiography.
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Fistulae between an artery arising from the aorta and a pulmonary vein associated with absence of a branch of the pulmonary artery, but without anomalies of the bronchial tree, are exceedingly rare. We report a case in a child who presented with a continuous vascular murmur and developed heart failure due to the left-left shunt. Left lobectomy was performed and showed that the entire left lower lobe was occupied by a huge arteriovenous fistula between an artery stemming from the aorta and the pulmonary veins.
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Metaphyseal sclerotic bone changes associated with benign phaeochromocytoma are very rare in childhood. We report four cases, in each of which the radiographic changes returned to normal after removal of the tumour.
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