Biomedical subjects

L S Kasat

Publications and source records attributed to L S Kasat.

10 recordsLinked to original sources

PubMed2005

Epidural emphysema associated with subcutaneous emphysema following foreign body in the airway.

Epidural emphysema is a rare condition and usually accompanies pneumothorax, subcutaneous emphysema (SCE), or pneumomediastinum. We report a child who presented with epidural emphysema (pneumorachis) and SCE. The child was subsequently found to have a foreign body obstructing the airway, which was the likely cause of the pneumorachis. Thus, foreign body aspiration should be considered in an infant with SCE, and early intervention in the form of bronchoscopy should to be done to arrest the condition's progressive nature.

Bronchi↗

PubMed2002

Duodenal intubation and test for bile - a reliable method to rule out biliary atresia.

Between January 1997 and December 1998, 30 consecutive children with suspected biliary atresia (BA) were selected to assess whether duodenal intubation (DI) and testing of aspirate for bile would help to rule out BA. Duodenal fluid was aspirated every 2 h for 24 h and tested for bile. A HIDA scan was also done in all cases. Every patient underwent a peroperative cholangiogram (POC) and liver biopsy; a Kasai portoenterostomy was done in indicated cases. In 22 cases all three investigations (DI, HIDA scan, POC) suggested BA. In 3 the HIDA scan ruled out BA, but DI and POC suggested BA. In 2 other cases, both the HIDA scan and DI suggested BA, but POC ruled it out and suggested biliary hypoplasia; in 3 others the HIDA scan suggested BA, but DI and POC both, ruled it out. There was no case where DI ruled out BA (i.e., showed bile in aspirate) and POC suggested BA. A liver biopsy confirmed BA in all proven cases. DI and testing the aspirate for bile is a very reliable means to rule out BA if the aspirate tests positive. It is an inexpensive, noninvasive, and quick bedside test that may be especially useful in developing countries where biliary scintigraphy is not available.

Bile↗

PubMed2001

Complete spontaneous regression of a functioning adrenocortical carcinoma in an infant.

A 9-month-old female presented with Cushing's syndrome. Investigations suggested the diagnosis and revealed a functioning left adrenal carcinoma without metastasis. However, when the abdomen was explored 30 days later after controlling the hypertension only normal adrenals were encountered, suggesting complete spontaneous regression. This is the fourth case of its kind. The case along with a review of this rare phenomenon is presented.

Adrenal Cortex Neoplasms↗

PubMed2001

Pseudoexstrophy of the bladder: a rare variant.

A 15-day-old female presented with a healed omphalocele and a triangular musculoskeletal defect in the hypogastric area similar to the defect seen in classic bladder exstrophy. The bladder was normal on exploration. The defect was successfully closed using a bilateral anterior pubic ramotomy. Only ten cases of pseudoexstrophy have been reported in the world literature.

Abdominal Muscles↗

PubMed2001

Spontaneous perforation of the extrahepatic bile duct in an infant.

A 1.2-year-old male presented with gradual-onset biliary ascites, mild icterus, and failure to thrive due to spontaneous bile-duct perforation (SPBD) confirmed by technetium 99Tc HIDA scan and abdominal paracentesis. Peritoneal tube drainage for 2 weeks helped the perforation to seal spontaneously, as there was no distal obstruction. No surgery was needed. Only less than 100 cases of SPBD have been reported in the English literature. The pathogenesis and treatment options are reviewed and discussed.

Ascites↗

PubMed2000

Factors responsible for successful primary closure in bladder exstrophy.

To assess the important factors for successful primary closure in staged reconstruction of bladder exstrophy, 25 patients (18 males, 7 females) underwent primary bladder closure during the years 1993-1997. Twenty-one were more than 72 h old; all of these underwent bilateral posterior iliac osteotomies followed by primary bladder closure during the same anesthetic. Bladder closure was done in a double layer. The ureteric catheters were removed after 2 weeks and the bladder catheter after 3.5-4 weeks. Only 1 patient had a bladder dehiscence on the 10th postoperative day due to infection; 3 had partial wound dehiscences but no bladder dehiscence. One had a partial bladder prolapse. The osteotomies needed no drainage, and no complications occurred. One patient needed a urinary diversion 3 years after surgery as the bladder capacity did not increase. Eleven important factors play a pivotal role for successful primary bladder closure: (1) Proper patient selection; (2) A staged approach; (3) Anterior approximation of the pubic bones with placement of the bladder and urethra in the true pelvis; (4) Posterior bilateral iliac osteotomies in all indicated cases; (5) Double-layered closure of the bladder; (6) Two weeks' proper ureteric catheter drainage; (7) Prevention of infection; (8) Prolonged and proper postoperative immobilization; (9) Prompt treatment of bladder prolapse; (10) Prevention of abdominal distension postoperatively; and (11) Ruling out bladder-outlet obstruction before removing the bladder catheter.

Bladder Exstrophy↗

PubMed2000

Spontaneous scrotal faecal fistula in an infant.

A 2-month-old, full-term male presented with a left scrotal faecal fistula due to spontaneous bursting of an incarcerated inguinal hernia for 8 days, with complete decompression of the small bowel through it. Resection and end-to-end anastomosis of the engaged ileal loop was successfully done after incising the ring via the inguinal approach. Only two such cases have been reported in the world literature to date.

Cutaneous Fistula↗

PubMed1999

Bladder agenesis with urometrocolpos.

A 20-day-old female presented in acute renal failure with an absent bladder and vaginal atresia. The right ureter opened into the uterus, resulting in a urometrocolpos, and the left ureter opened through a stenotic opening into the introitus. The literature is reviewed for reported cases and the embryo-pathology of bladder agenesis is discussed.

Abnormalities, Multiple↗

PubMed1998

Roundworm obstruction of the hepatic limb of a Roux-en-Y anastomosis.

A 7-year-old female with a type I choledochal cyst underwent an exploratory laparotomy. A Roux-en-Y choledochojejunostomy was done following cyst excision. The patient was re-explored 8 days later for an anastomotic bile leak and high fever. A round-worm was found obstructing the jejunal lumen at the porta hepatis, resulting in a biliary leak. Various aspects of biliary ascariasis are discussed along with the case report.

Anastomosis, Roux-en-Y↗

PubMed1998

Covered exstrophy: a rare variant.

A case of covered exstrophy without sequestration of a bowel segment is reported. A 4-year-old female presented with dribbling of urine. Treatment to date has been simple excision of the covered membrane with functional closure of the bladder and bilateral posterior iliac osteotomies, with reconstruction of the bladder neck and genitalia to be performed at a later date. The embryogenesis of this rare variant, a review of the reported cases, and management options are discussed. Keyword Covered exstrophy. Exstrophy. Bladder variants

Bladder Exstrophy↗