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Biomedical subjects

J Plaz

Publications and source records attributed to J Plaz.

7 recordsLinked to original sources
PubMedDate not supplied

ERCP in the diagnosis of extrahepatic biliary atresia.

This study assessed the usefulness of ERCP in the diagnosis of biliary atresia. We evaluated 57 infants with prolonged cholestasis with abdominal ultrasound, liver biopsy, and ERCP. Using clinical observations alone, 22 infants were thought to have biliary atresia; whereas 35 children were thought to have neonatal hepatitis. The ERCP was performed with a prototype duodenoscope and was successful in all infants except two with biliary atresia. In 20 infants three types of radiological findings consistent with biliary atresia were seen: type 1, no visualization of biliary tree (35%); type 2, opacification of the distal common duct and gallbladder without visualization of the main hepatic duct (35%); and type 3, opacification of the distal common duct, the gallbladder, and a segment of the main hepatic duct with biliary lakes at the porta hepatis (30%). Twenty-five of 35 infants with suspected neonatal hepatitis were excluded because of a liver biopsy that was diagnostic. In the remaining 10 infants the liver biopsy had some features of extrahepatic biliary atresia and ERCP was performed prior to surgery. A normal extrahepatic biliary tree was obtained in all of them. In conclusion, ERCP permits the visualization of the biliary tree in young infants and is useful in selecting those infants who should be considered for exploratory laparotomy.

Biliary Atresia↗
PubMedDate not supplied

ERCP and endoscopic sphincterotomy in infants and children with jaundice due to common bile duct stones.

ERCP was performed in two infants (29 and 62 days old) and eight children (5 to 12 years old) with jaundice due to common bile duct stones. Seven patients had hemolytic anemia and three patients had a family history of gallstone disease. Successful cannulation of the common bile duct demonstrating stones was accomplished in all patients. Four patients had coexisting gallstones and were treated surgically. Six children who had previously undergone cholecystectomy were treated by endoscopic sphincterotomy and stone extraction without complication. We believe that ERCP should be utilized by expert endoscopists in children with evidence of extra-hepatic cholestasis, and endoscopic sphincterotomy should be the treatment of choice in children who have previously undergone cholecystectomy, and who are jaundiced secondary to common bile duct stones.

Child↗
PubMedDate not supplied

The role of ERCP in the diagnosis and treatment of idiopathic recurrent pancreatitis in children and adolescents.

ERCP was performed in 51 patients, aged 1 to 18 years, as part of diagnostic evaluation for recurrent pancreatitis without obvious cause or as therapeutic intervention. ERCP was successful in 50 patients (98%). Thirty-four patients (68%) had anatomic findings indicating a possible cause of recurrent pancreatitis. Three patients (6%) had findings suggestive of sphincter of Oddi dysfunction. Eighteen of the 37 patients (49%) with ductal abnormalities underwent endoscopic therapy, with a favorable outcome in 15 (83%). Eleven patients were treated surgically, and 8 of these patients (73%) improved symptomatically. Eight patients received no treatment, and 6 of them (67%) had recurrent bouts of clinical pancreatitis. One mild case of pancreatitis (1.9%) occurred after ERCP, and 3 mild cases followed endoscopic therapy. In conclusion, ERCP is a relatively safe technique that produces opacification of the desired ductal system with a high degree of accuracy and provides useful information in the evaluation of children with idiopathic recurrent pancreatitis. These data suggest that endoscopic pancreatic therapy may result in symptomatic improvement, eliminating the need for surgery in selected children. Furthermore, the study demonstrates that manipulation of the pancreatic duct is comparatively safe and less hazardous than formerly believed.

Adolescent↗
PubMedDate not supplied

[Double sphincterostomy of pancreatic and choledochal sphincters in the treatment of chronic recurrent pancreatitis].

The treatment of recurrent chronic pancreatitis is controversial. Some patients may have sphincter of Oddi motor abnormalities. Although widely used in the biliary tree, little data is available on endoscopic sphincterotomy of the pancreatic sphincter. This report describes 5 patients with recurrent chronic pancreatitis, who had pancreatic sphincterotomy for hypertensive sphincter of Oddi. Four patients continue long-term follow-up with marked reduction of chronic pain of attacks of recurrent pancreatitis. It is concluded that endoscopic sphincterotomy of the pancreatic sphincter may improve pain in chronic pancreatitis and may obviate the need for surgery.

Adolescent↗
PubMedDate not supplied

[Usefulness of the PCR technique (polymerase chain reaction) in the follow-up of patients infected with hepatitis C virus. Preliminary communication].

UNLABELLED: In the study we show the usefulness of PCR (polymerase chain reaction) to follow patients with chronic hepatitis, infected with hepatitis C virus (HCV) of Centro Médico de Caracas. The study included 14 patients: 12 anti-HCV positive, 1 with chronic autoimmune hepatitis and 1 classified as non B-non C hepatitis. The patients were divided in 3 groups: Group 1 (5 pretreatment patients, anti-HCV+), 4 with increase in ALT and PCR positive, 1 with normal ALT and PCR negative. Group 2 (7 treated with recombinant interferon alpha 2b), 4 without normalization of ALT and PCR positive, 3 with normalization of ALT and PCR negative. Group 3 (control) 2 patients anti-HCV negative and PCR negative. Two posttreatment patients could be genotyped: one patient was infected with 1a and showed an early relapse with treatment and the other was infected with genotype 1b, which is reported to be more refractory to antiviral treatment. CONCLUSIONS: the results show a 100% correlation between biochemical markers of HCV infected patients and the presence of viral RNA detected by PCR. the usefulness of determination of genotype to assess any prognostic value of this parameter in Venezuela is discussed.

Follow-Up Studies↗