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Biomedical subjects

S Ekkelkamp

Publications and source records attributed to S Ekkelkamp.

17 recordsLinked to original sources
PubMed1992

[Experiences in the treatment of intestinal invagination in children].

Intussusception is one of the more common causes of an acute abdomen in infancy. There is discussion about the appropriate method of treatment, and especially about the criteria for hydrostatic reduction. To evaluate the effectiveness of treatment of patients with intussusception presenting at the Paediatric Surgical Centre in Amsterdam, a retrospective study was carried out. 84 Cases were seen between 1980-1990. Three quarters of the children were operated, one-third without prior barium enema. In half the cases an attempt at hydrostatic reduction was made, and this succeeded in only 43%. Ultrasound was only rarely used diagnostically. The literature shows that the use of air to attempt reduction is more likely to be effective and less likely to cause complications than barium.

Barium Sulfate↗
PubMed1992

Hypertension associated with skeletal traction in children.

Since traction-associated hypertension seems to be a relatively unknown phenomenon, a survey was done of its incidence in children treated with skeletal traction for fractures and orthopaedic diseases. The correlation with hypercalcaemia, a possible aetiological factor, was also explored. Blood pressure was recorded three times a day with an automatic oscillometric unit during the stay in the hospital. Serum calcium, creatinine and total protein concentrations were measured once a week. Patients with pre-existing diseases or renal trauma were excluded. Arterial hypertension (systolic and/or diastolic) was found in 31/50 children (62%). In almost half of these the rise in systolic blood pressure was 10 mmHg or more above the 95th percentile. Hypertension occurred in most cases within the first 3 weeks of treatment; in 7 children it developed after 3 or more weeks of traction. All children became normotensive within 1 week after discontinuation of traction. Clinical symptoms were rare: two children complained of headache. In no instance had traction to be discontinued before the planned date because of hypertension. In the hypertensive group were more preschool children and more humeral fractures as compared to the normotensive group (n = 19). Hypercalcaemia occurred in 11 children and was equally distributed in hypertensive and in normotensive children. It is concluded that arterial hypertension is a frequent finding in children in traction, but its clinical relevance is uncertain. Hypercalcaemia is not a rare finding in immobilized children, but probably plays no causative role in traction-related hypertension.

Adolescent↗
PubMed1992

True hermaphroditism in 45,X/46,XY mosaicism.

This report discusses the clinical findings on two patients with 45,X/46,XY mosaicism, two boys presented with penile hypospadias and cryptorchidism. A dysgenetic ovary and a testis were found in one boy, and a dysgenetic ovary in the other. Both patients can be considered to be true hermaphrodites on the basis of histology and clinical and hormonal observations. 45,X/46,XY mosaics have a wide range of phenotypic appearances and their gonadal morphology can also show great differences. However, the incidence of true hermaphroditism in individuals with 45,X/46,XY mosaicism is low and the reports in the literature rare. It is likely that males with 45,X/46,XY who suffer only mild maldevelopment of the external genitalia will not be recognized. In all patients with penoscrotal hypospadias and cryptorchidism with 45,X/46,XY mosaicism, the possibility of true hermaphroditism should be considered.

Child↗
PubMed1991

[Results of a standardized approach for various forms of hypospadias].

Hypospadias is a congenital malformation of the penis, in which the external meatus is ventrally situated. Proximal localisation and chordee result not only in cosmetic-psychologic but also in functional disturbances. Complete operative correction (a straight penis with the meatus on top) is performed around the second year. Various procedures are used depending on the localisation of the meatus. Glandular and coronal forms are managed in our series by the MAGPI operation. In the more proximal forms a preputial island flap operation, either as an onlay or as tube, is performed. The results of the MAGPI were good: only 3 of 27 children needed a second procedure. After island onlay operations a second operation was necessary in 5 of 8 children. Six of 7 patients with an island tube operation developed a fistula which was closed subsequently. The final result was good in all children, both from cosmetic and functional point of view.

Child↗
PubMed1990

[Congenital laryngeal stenosis; a rare cause of dyspnea in the newborn infant].

Congenital laryngeal obstruction is a rare but serious cause of severe, often fatal, post partum asphyxia. The condition should be recognized and in most cases an artificial airway has to be established immediately because hypoxia allows little time for extensive evaluation. Thereafter a further diagnostic procedure by means of laryngobronchoscopy and contrast laryngography should be performed. The clinical picture of two cases with a congenital laryngeal stenosis is described and the initial therapeutic approach is discussed.

Abnormalities, Multiple↗
PubMed1990

Diagnosis of congenital cystic adenomatoid malformation of the lung in newborn infants and children.

Seventeen patients were diagnosed as having congenital cystic adenomatoid malformation of the lung during 1970-88. One case was associated with congenital diaphragmatic hernia and the child died before operation. The other 16 children underwent successful surgery. The patients presented in one of three ways--with neonatal respiratory impairment (12 cases) requiring urgent diagnosis and treatment, with recurrent respiratory tract infections (3), and with pneumothorax (1). Diagnostic problems arose with the neonatal presentation. In four of the children laparotomy was performed for presumed diaphragmatic hernia; three of these children had right sided lesions. Congenital diaphragmatic hernia was excluded by contrast studies in a further two patients. Histological examination confirmed the diagnosis in all cases. The postoperative course was uneventful in all 16 patients. No long term impairment of pulmonary function was noted.

Child↗
PubMed1990

Tubular colonic duplication: report of two cases.

Colonic duplication is a rare congenital abnormality frequently associated with multisystemic malformations. Colonic duplication presents diagnostic and therapeutic difficulties especially in neonates. We report on two patients, a child and an adult with tubular duplication. Treatment consisted of using the duplicated loop for a pull-through procedure in the first patient and resection of the duplicated loop in the second. The results of the surgical treatment in these two patients have been satisfactory.

Adult↗
PubMed1989

[Lung operations in dyspneic newborn infants].

Thirteen newborns with congenital cystic adenomatoid malformation and six with congenital lobar emphysema were operated on between 1970 en 1988. Eighteen children had more or less severe dyspnoea and (or) tachypnoea, one child presented with respiratory tract infection. The diagnosis could be made on the chest X-ray in most instances. However, diagnostic problems arose in the differentiation between congenital cystic adenomatoid malformation and congenital diaphragmatic hernia. Four times a laparotomy was done for presumed diaphragmatic hernia followed by thoracic surgery in the same session. In two children barium contrast studies of the gastrointestinal tract were done to exclude diaphragmatic hernia. Treatment consisted of lobectomy in 15 cases and segmental resection in four. Histological examination confirmed the clinical diagnosis in all instances. The results of the operations were excellent in all patients. No short- or long-term complications occurred.

Cystic Adenomatoid Malformation of Lung, Congenita↗
PubMed1989

Diagnosis and management of neonatal adrenal haemorrhage.

Three patients with neonatal adrenal haemorrhage (NAH), presenting with various signs and symptoms, are reported. The role of ultrasonography in diagnosis and management of this entity is emphasized. Conservative management is advocated, once the diagnosis is confirmed. Surgery is indicated only for cases of uncontrollable haemorrhage.

Adrenal Gland Diseases↗
PubMed1987

[2 newborn infants with severe arrhythmia caused by hyperkalemia].

Two newborn infants with ventricular arrhythmias secondary to hyperkalaemia are presented. One child also showed a decreased serum calcium concentration. There is scanty literature concerning the often life threatening cardiac arrhythmias due to hyperkalaemia in the newborn infants. Treatment of the cardiac arrhythmias require intravenous calcium gluconat and sodium bicarbonate infusion beside lowering the serum potassium level in the usual way.

Bicarbonates↗
PubMed1987

[Anorectal abnormalities].

An insight in the genesis of anorectal abnormality, combined with a painstaking diagnostic examination leading to a justifiable, well-considered therapeutic procedure, may spell hope and better prospects to approximately 35 children that are born with this abnormality in The Netherlands each year. Subsequently, the function of the anorectoplasty has to be evaluated at regular check-ups. Coupled with a sound understanding of the defaecation mechanism, this should lead to uniformity in the treatment and sustenance of a child with anorectal abnormality, which will reduce the burden of this handicap for both parents and child to a minimum.

Anal Canal↗