Biomedical subjects

R M Schisgall

Publications and source records attributed to R M Schisgall.

6 recordsLinked to original sources

PubMed1986

Radiographic features of appendiceal colic in children.

The concept of appendiceal colic was introduced in 1980 to explain the common problem of recurrent crampy abdominal pain (RAP) in children. Children with appendiceal colic often have inspissated casts of stool as foreign bodies of the appendix. The radiographic findings of 115 children operated upon for appendiceal colic have been reviewed. The radiographic features of this syndrome have included: filling defects of the appendix (83% incidence of inspissated casts of stool within the appendix); partial filling of the appendix (44% incidence of fecal casts); retained barium behind 72 h (92% incidence of fecal casts blocking egress of barium); non-visualization of the appendix (42% incidence of fecal casts); and distention of the appendix (100% incidence of fecal casts). The correlation of radiographic and operative findings will be presented. A rational approach to the radiographic workup of a child with RAP will be presented.

Abdomen↗

PubMed1986

Ischemic enterocolitis as a complication of Hirschsprung's disease.

Enterocolitis is a recognized complication of Hirschsprung's disease. However, little distinction has been made in the literature between inflammatory enterocolitis and ischemic (necrotizing) enterocolitis when seen with Hirschsprung's disease. We report on four cases of ischemic enterocolitis complicating Hirschsprung's disease. The characteristics of ischemic enterocolitis are compared to those of inflammatory enterocolitis.

Enterocolitis, Pseudomembranous↗

PubMed1983

Use of the barium swallow in the diagnosis of acute appendicitis.

A simplified radiographic procedure was utilized in children with suspected acute appendicitis in an effort to improve diagnostic accuracy. Children with suspected appendicitis were given 6 oz of barium by mouth, and follow-up posteroanterior, and oblique radiographs of the abdomen were obtained 6 to 12 hours after barium ingestion. Appendicitis was not seen in 63 children with complete appendiceal filling. An 8 percent incidence of appendicitis was seen with partial appendiceal filling. A 42 percent incidence of appendicitis was noted in 110 children with nonvisualization of the appendix, and an 86 percent incidence of appendicitis was noted where there was a mass effect on the cecum. The advantages and disadvantages of the barium swallow have been discussed. By utilizing the barium swallow as a diagnostic adjunct, an overall 95 percent accuracy rate in the diagnosis of acute appendicitis was achieved over a 4 1/2 year period.

Acute Disease↗

PubMed1982

Solitary thyroid nodules in children and adolescents.

Thirty-nine children and adolescents with a solitary nodule of the thyroid gland were seen over a 16-yr period and 35 had their nodules removed surgically. All of the patients had preoperative thyroid scintiscans, of which 27 showed a cold nodule. The most common cause of solitary thyroid nodules was follicular adenoma. Five of the 27 cold nodules were malignant (18.5%) while no malignancies were present in the warm or hot nodules. Available diagnostic methods of attempting differentiation of benign from malignant solitary nodules are reviewed and an approach to the clinical management of such nodules as derived from our experience is presented.

Adenoma↗

PubMed1980

Appendiceal colic in childhood: the role of inspissated casts of stool within the appendix.

Seventy pediatric patients with histories of recurrent crampy abdominal pain, right lower quadrant tenderness, and proven filling defects or distention of the appendix on radiographs, have been subjected to appendectomy. Inspissated fecal material was found within the appendix in 72.8% of such children. Fecal material was found in only 12.9% of 155 normal appendices and in 33.8% of 530 acutely inflamed appendices. It is postulated that inspissated fecal material acts as a foreign body of the appendix, leading to intermittent obstruction and distention of the appendix--appendiceal colic. An 86% correlation between the appendiceal filling defects seen on radiographs and the inspissated fecal material found within the appendix at operation has been noted. Ninety-six per cent of these 70 children had been relieved of their recurrent abdominal pain by appendectomy. Appendiceal colic characterized by crampy abdominal pain, right lower quadrant tenderness, and appendiceal filling defects appears to be a veritable and verifiable diagnosis.

Abdomen, Acute↗

PubMed1978

Overwhelming postoperative streptococcal infection.

Fulminant postoperative group A beta-hemolytic streptococcal infections present a serious and potentially lethal threat to children. Three children with severe postoperative streptococcal wound infections are presented. Each child developed high fever within the first 24 hr after surgery, followed shortly by signs of septic shock. In all patients, the clinical appreciation of wound infection became apparent late in the course of the illness. All three children had white blood cell counts below 6000/cu mm. One child developed crepitus in the incision; another showed radiographic evidence of free air in the soft tissues. The only survivor received antibiotics immediately following the initial fever along with re-exploration and drainage of the operative wound.

Anti-Bacterial Agents↗