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Biomedical subjects

S Watanatittan

Publications and source records attributed to S Watanatittan.

12 recordsLinked to original sources
PubMed1999

Meconium peritonitis.

Meconium peritonitis is an unusual and often fatal form of neonatal peritonitis characterized by intraperitoneal calcification, numerous fibrosis with or without pseudocyst formation due to antenatal extravasation of meconium. This report is a retrospective study of 32 pediatric patients who were treated at the Surgical Department of the Children's Hospital from 1987 to 1996. The purposes of this study emphasize clinical manifestations, radiological findings, operative procedures and results of treatment. Twenty seven were neonates and five were older infants. The most common clinical presentation was abdominal distension at birth. The abdominal X-rays showed abnormal calcification and mass lesion in the peritoneal cavity in 71.9 and 46.9 per cent respectively. Only one patient was not treated surgically because he had no evidence of gut obstruction and inflammation. Thirty-one patients were operated on. At laparotomy, all of them had numerous inflammatory adhesion bands and matted bowel loops. Giant pseudocysts and intestinal perforations were noted in 64.5 and 54.8 per cent respectively. The obvious causes of meconium peritonitis were ileal atresia in 4, jejunal atresia in 3 and appendiceal perforation in 1. In the other 23 patients, no apparent cause of perforation was noted. Only lysis of the adhesion with or without drainage was done in 9 patients and one of these died. Partial resection of pseudocysts and exteriorization of the perforated bowel were done in 10 patients and 2 of these babies died. Primary anastomosis after resection of the perforated bowel was done in 12 patients and 5 of these cases died. The overall survival rate was 75 per cent. Our data from this study suggested that partial resection of the pseudocyst and temporary enterostomy should be done in cases with bowel perforation and severe meconium contamination. Early diagnosis, proper operative procedure and meticulous postoperative care offer the best opportunity for survival of patients with meconium peritonitis.

Female↗
PubMed1998

Choledochal cyst: review of 74 pediatric cases.

Seventy-four cases of CDC were treated at the Children's Hospital from 1977 to 1995. Female to male ratio was 5:1. Forty per cent of the patients developed symptoms within one year after birth and 75 per cent within 5 years of age. About one third of the cases were treated surgically within one year of age. Only 5 patients or 6.8 per cent had all the clinical triads of jaundice, abdominal pain and mass. Jaundice was the most common symptom in infants below one year of age but abdominal pain was the most common symptom in older children. Three newborn infants had associated biliary atresia. Established liver cirrhosis was noted during surgery in 9 patients who were operated upon within one year of age but none of the older children. All but one had either type I or type IV CDC, while the remaining one had Caroli's disease or type V CDC. Excision was the preferred treatment. Overall operative mortality rate after excision was 6.5 per cent. None of the patients who had internal drainage procedures succumbed. Infants below one year of age appeared to have high morbidity and mortality rates after surgery. Internal drainage procedure may be considered in high risk patients with advanced cirrhosis. Available information suggests that the occurrence of this disease in Thailand is probably more common than in Western countries and etiology of CDC in infants may be different from that in older children or adults.

Adult↗
PubMed1991

Association of Hirschsprung's disease and anorectal malformation.

Nine patients with the association of Hirschsprung's disease (HD) and anorectal malformation (ARM) were treated at the Children's Hospital, Bangkok, Thailand during the 10-year period between 1977 and 1986. Four cases had the low type of ARM, four had the intermediate type, and one had the high type. Aganglionosis involved the rectum only in four cases, extended up to the rectosigmoid in three, up to the sigmoid in one, and involved the whole colon and the last 15 cm of the ileum in the other. A transitional zone was noted in the loopogram films after the initial colostomy for ARM in two cases. Barium enema was performed in six cases. Evidence of ultrashort segment aganglionosis was noted in one case. A transitional zone was noted in one case, but was not present in the remaining four cases. Delay of diagnosis of the associated HD in some cases was due to the atypical symptomatology and radiological findings. The association of these two conditions may probably be more common than generally recognized.

Anal Canal↗
PubMed1981

Cervical teratoma in children.

Two cases of cervical teratoma in newborn infants are reported. One had neural tissue in cervical lymph nodes, posing the question of malignancy. Only two similar cases have been previously reported. One hundred forty-nine cases of cervical teratoma and two patients of our own have been reviewed with regard to age, sex, clinical manifestation, pathology, management, and prognosis. Early excision is emphasized. The available evidence indicates that cervical teratomas, at least in the newborn period, are virtually always benign. Further studies, including long-term observation of children and a complete consideration of the histology of the neoplasms, are needed to clarify the problem of whether malignancy ever occur in cervical teratomas of children. A conservative surgical management of these neoplasms is recommended.

Diagnosis, Differential↗
PubMed1978

Giant hemangiomatosis of the liver in infancy.

Two case reports of hepatic hemangiomatosis in infancy are presented to clarify the definition of this condition and to review its therapy by administration of corticosteroids and by ligation of the hepatic artery.

Adrenal Cortex Hormones↗
PubMed1976

Biliary excretion and concentration of cefazolin.

The excretion of cefazolin into the human biliary tract in health and disease was investigated in 34 patients undergoing surgical procedures. The patients included: I. Four controls. IIA. Eleven patients with cholelithiasis and/or cholecystitis and a radiological visualized gallbladder. IIB. Nine patients with cholethiasis and cholecystitis and a radiologically nonvisualized gallbladder. III. Five patients with obstructive jaundice. IV. Five patients with a T-tube in the common bile duct. Two dose regimes: 1. A single dose of 500 mg and 2. four doses each of 500 mg. given every six hours, were used. Samples of serum, gallbladder bile, common duct bile and gallbladder tissue were assayed for antibiotic activity by the cylinder plate method with Bacillus subtilis. Following administration of four doses of the antibiotic, the mean level of the drug in the gallbladder bile, in controls was 127.0 mug/ml. In the group with cholelithiasis and cholecystitis and a gallbladder that is visualized, a similar high level was noted (mean = 132.2 mug/ml.). In the presence of a nonvisualized gallbladder or obstructive jaundice, the levels in bile were lower. Two hours following a single injection of the drug, the level in the common duct bile reaches a peak of 10 mug/ml and at eight hours falls to less than one mug/ml. In the absence of obstruction cefazolin reaches a significantly high level in bile and could be valuable in treatment of biliary infections.

Bile↗