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Natalia Simanovsky

Publications and source records attributed to Natalia Simanovsky.

10 recordsLinked to original sources
PubMed2006

Is non-operative intussusception reduction effective in older children? Ten-year experience in a university affiliated medical center.

Ileo-colic intussusception in older children is frequently caused by a pathological lead point. Therefore, in many cases, no attempts at hydrostatic or air reduction are performed in non-pediatric hospitals. This study summarizes our experience in management of intussusception in children aged 3 years or older, in order to determine its efficacy and safety in this age group. We retrospectively reviewed medical records and radiological images of 26 cases of intussusception in 24 children older than 3 years admitted to our hospital over a 10-year period. In one child no attempt of reduction was made. Three children underwent unsuccessful imaging-guided reduction and an underlying tumor was identified at surgery and resected. In 18 cases air reduction was successful and no pathological lead point was discovered. In four children hydrostatic or air reductions failed. Manual reduction was performed, with no predisposing cause found. No complications were observed in any of our patients. Older age is not a contraindication for imaging-guided intussusception reduction attempt. Most of these patients can benefit from such an attempt, thereby avoiding surgery.

Child↗
PubMed2006

Close reduction and intramedullary flexible titanium nails fixation of femoral shaft fractures in children under 5 years of age.

We retrospectively reviewed 13 cases of diaphyseal femoral fractures treated with close reduction and intramedullary flexible titanium nails, in children aged 3-5 years. The mean follow-up time was 11.5 months (range 3-29). No cases of nonunion or malunion were noted. Minor complications were observed in two children. Loss of initially restored femoral lengthening had occurred in one child, with nail protrusion and related focal cellulites. Mild postoperative leg-length discrepancy occurred in another child. The healed fractures usually exhibited abundant callus, which allowed an early ambulation. Although the operative approach to simple diaphyseal fractures of the femur at such a young age is not routinely recommended, it can be a valuable option as an initial treatment, or when a conventional treatment with a spica cast has failed. In our group of patients, the parents chose this type of treatment as an alternative to the conventional spica cast.

Bone Nails↗
PubMed2005

Partial duplication of the scapula.

We report an extremely rare case of partial scapular duplication. Mild shoulder area deformity in a newborn prompted further evaluation that included radiography, ultrasonography and spiral CT. These revealed an additional bone in the area of the left shoulder, above the humerus and lateral to the scapula. The accessory bone articulated with the upper part of the glenoid and caused caudal displacement of the humeral head. However, it did not restrict the normal range of motion in the shoulder joint.

Diagnosis, Differential↗
PubMed2005

Sonographic detection of radiographically occult fractures in paediatric ankle injuries.

BACKGROUND: In some paediatric ankle injuries, the clinical picture is suggestive of a fracture despite negative three-view radiographs. OBJECTIVE: To determine the effectiveness of high-resolution US to differentiate radiographically occult fractures from sprains. MATERIALS AND METHODS: During a 12-month period, children aged 5-13 years who had sustained an acute ankle injury suspicious of a fracture on clinical examination, but with negative radiography, were referred for high-resolution US. Follow-up radiographs were obtained after 2-3 weeks. RESULTS: A total of 20 children were examined. In 13, US did not reveal a fracture; small fractures were detected in 7. All patients with negative US studies had negative follow-up radiographs. In six patients with positive US the follow-up radiographs demonstrated a periosteal reaction. In one child in whom a fracture line identified by US was in the depth of the lateral malleolus, the follow-up radiograph demonstrated an area of increased bone density. CONCLUSIONS: US is effective for the detection of radiographically silent fractures of the paediatric ankle. It may be used as an adjunct to radiography in clinically suspicious, but radiographically negative ankle injuries.

Adolescent↗
PubMed2004

The use of ultrasound for the diagnosis of spinal hemorrhage in a newborn.

We present a case of an unusually large spinal epidural hematoma in an infant after a total breech extraction, which was diagnosed by high-resolution ultrasonography. The lesion appeared unusually large, homogeneous, and isoechoic to the spinal cord. This case demonstrates the ability of ultrasound to diagnose the nature of the lesion, its exact location and full extent. Magnetic resonance imaging was used in this case only as a secondary modality to demonstrate the hemorrhagic nature of the lesion.

Extraction, Obstetrical↗
PubMed2002

The infant with chronic vomiting: the value of the upper GI series.

BACKGROUND: Vomiting is very common in infants. It is usually attributed to gastroesophageal reflux and no radiological evaluation is performed. Pediatric radiologists, however, still perform many upper GI series in these infants to exclude an underlying anatomic abnormality as a cause for vomiting. OBJECTIVE: To evaluate the yield of upper GI series in the evaluation of otherwise healthy infants 1 month to 1 year of age with vomiting for more than 30 consecutive days. MATERIALS AND METHODS: Clinical records and upper GI reports of 344 otherwise healthy infants that were referred for UGI by pediatric gastroenterologists because of chronic vomiting were analyzed. Patients with hematemesis, bilious vomiting, dysphagia, respiratory symptoms and patients that required hospitalization were excluded. RESULTS: Findings other than gastroesophageal reflux were seen in only 2 patients out of 344 (0.6%). In one patient duodenal stenosis was diagnosed. In another patient a small hiatal hernia was seen. CONCLUSIONS: The yield of upper GI in otherwise healthy infants 1 month to 1 year of age with chronic vomiting is extremely low, and the performance of the UGI in this specific group of patients may not be justified.

Chronic Disease↗
PubMedDate not supplied

Portal venous gas following trauma in a preterm infant.

During the neonatal period, pneumatosis intestinalis (PI) and portal venous gas (PVG) are pathognomonic of necrotizing enterocolitis (NEC). Rare cases of such findings evolving after abdominal trauma have been reported in adults and children, but none in premature infants. We report a case of a 3-week-old premature infant where both PI and PVG were found following a fall from a scale. The presence of these findings prior to the evolvement of clinical symptoms suggestive of NEC strongly supports a traumatic etiology.

Accidental Falls↗
PubMedDate not supplied

Removal of flexible titanium nails in children.

Removal of hardware in children after orthopaedic procedures is controversial. The authors retrospectively reviewed hospital charts and radiographs of 143 children who underwent removal of flexible titanium nails from the femur and the forearm. In 16 children the nails were removed because of protrusion, skin irritation, and some discomfort. Most of the patients were asymptomatic and underwent nail removal electively, according to the authors' policy for routine hardware removal in children. Complications included unsuccessful nail removal in three children and refractures after nail removal in two. Although the authors are still inclined to remove flexible titanium nails in most of the patients, the need for routine elective execution of this procedure may be questionable.

Adolescent↗