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Biomedical subjects

P Daher

Publications and source records attributed to P Daher.

9 recordsLinked to original sources

The Kalicinski ureteral folding technique for megaureter in children. Experience in 23 cases.

We report our series of 16 children with 23 megaureters: 7 were refluxing, 11 were obstructive (7 primary and 4 secondary), 3 both refluxing and obstructive and 2 nonrefluxing nonobstructive. These patients had a Kalicinski folding-under remodeling of their megaureter and Cohen or Lead-better reimplantation. Success rate was 96% with only 2 failures: 1 recurrent low-grade reflux treated with subureteric Teflon injection and 1 stenosis that necessitated reoperation. Kalicinski's technique with Cohen type reimplantation is one of the best alternatives for megaureters, mainly because it does not present the disadvantages of the excisional procedure.

Child, Preschool

Congenital esophageal stenosis.

We report 6 new cases of congenital esophageal stenosis (CES) that presented to us with special diagnostic and management problems and review the literature on this subject. Gastroesophageal reflux and achalasia are important differential diagnoses of esophageal stenosis, they may be associated with CES making appropriate management even more difficult. Treatment is also controversial, ranging from simple dilatation to segmental resection. CES should be present in every pediatric surgeon's mind should dysphagia occur on the introduction of semisolid food or esophageal food impaction, with a segmental stenosis demonstrated at esophagogram even when more obvious diagnoses are evoked.

Child

Congenital cyst of the pancreas. Antenatal diagnosis.

We hereby report the third case of antenatal diagnosis of congenital cyst of the pancreas. It is a very rare lesion and could present as a differential diagnosis of any intra-abdominal cystic mass. Early treatment is easy and prevents complications such as ascites and pancreatitis in case of intra-pancreatic enteric duplication.

Diagnosis, Differential

Neurenteric cyst: antenatal diagnosis and therapeutic approach.

We hereby report the second case of antenatally diagnosed "neurenteric cyst" in the literature. The patient we describe presented as a neonatal respiratory distress syndrome (NRDS) which did not respond to a vigorous resuscitation. Anomaly of the antenatal ultrasonography and of the initial chest x-ray added to the non-response to therapy, led us to an urgent thoracic scan and to a lifesaving thoracotomy. We think that every posterior mediastinal cystic mass, with or without vertebral malformations, diagnosed antenatally, should raise the possibility of neurenteric cyst. The perinatal management of the newborn to be, will thus be simplified. This will lead to a better outcome.

Humans

[Treatment of severe and recurrent hypospadias. Personal experience in thirteen cases].

The treatment of severe and recurrent hypospadias includes different techniques. We present thirteen cases (7 recurrent and 1 circumcised). In four recurrent cases of midshaft hypospadias, we chose Mathieu's technique, and in nine severe cases, three of them were recurrent cases, Duckett's technique (3 cases), free bladder mucosal graft (4 cases), and free prepucial mucosal graft (2 cases). Our results were good in 9/13 cases (70%) with three fistulas, two of them were cured as out care patient. We try to precise each technique indications and details which would lessen the postoperative complications rate.

Child

Congenital prepubic sinus.

We report the fifth case of congenital prepubic sinus that goes from the anterior wall of the bladder through the public symphysis to the skin. The various embryological theories that could be responsible for this pathology are discussed, and according to us, it seems to be a variant of dorsal urethral duplication.

Cutaneous Fistula

Pheochromocytoma in children: 15 cases.

Pheochromocytoma is an uncommon tumor in childhood; nevertheless, 20% of all pheochromocytomas are found in the pediatric population. Fifteen children have been treated in our institution from 1962 to 1990. One percent of patients referred over the same period for investigation of high blood pressure were found to have a pheochromocytoma. The majority of patients have hypertension. It varies in intensity and is paroxysmal in about half the patients. Many pediatric cases of unilateral, bilateral, extra-adrenal, familial, and recurrent pheochromocytomas have been reported. We reviewed our 28 years experience with this tumor and concentrated on the diagnosis, the preoperative and operative management, and the occurrence of the multiple endocrine neoplasia syndromes.

Adolescent

[Surgical treatment of vesico-ureteral reflux: comparison between sub-ureteric injection of Polytef and the Cohen technique].

40 patients who need surgical treatment for their vesico-ureteral reflux have been operated between 1989 and 1992; 26 of them have got the subureteric injection of Polytef (S.U.I.P.) and 14 the neo-uretero-cystostomy (N.U.C.) of Cohen. Even the N.U.C. of Cohen keeps the best results in our experience with only one stenosis on 28 operated ureters (3%), the S.U.I.P. is still an excellent technic because of its simplicity, low morbidity with 90% rate of success. This rate seems stable after a recoil of 19 +/- 13 months. Research must focus on finding a new substance to replace the Polytef and stop the fear of its particles migration found experimentally in animals.

Adolescent