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T Ben-Ami

Publications and source records attributed to T Ben-Ami.

At least 19 recordsLinked to original sources
PubMed2001

Retroperitoneal abscess and mycotic aortic aneurysm: unusual septic complications of central vascular line placement in premature infants.

OBJECTIVE: To describe the sonographic appearance of unusual septic complications after central vascular line placement in premature infants. METHODS: Two case reports are presented. RESULTS: The first patient had a retroperitoneal abscess after percutaneous central venous catheter placement. The second patient had a ruptured mycotic aneurysm of the abdominal aorta after umbilical arterial catheter placement. CONCLUSIONS: Retroperitoneal abscess and aortic aneurysm should be considered in patients with histories of long-standing catheters or line sepsis. Both of these complications are readily diagnosed on the basis of sonography.

Aneurysm, Infected↗
PubMed1999

Manual epigastric compression during upper gastrointestinal examination of neonates: value in diagnosis of intestinal malrotation and volvulus.

OBJECTIVE: This paper describes the value of manual epigastric compression during upper gastrointestinal examination in establishing the diagnosis of intestinal malrotation and volvulus in five neonates. CONCLUSION: In two patients, the location of the duodenojejunal junction was near normal. Manual compression revealed abnormal mobility of the duodenojejunal junction, indicating malrotation. In three other patients, the duodenum was completely obstructed. Manual compression unequivocally displayed the anatomy of midgut volvulus by allowing contrast material to pass beyond the point of obstruction.

Congenital Abnormalities↗
PubMed1998

Implications of early sonographic evaluation of parapneumonic effusions in children with pneumonia.

OBJECTIVE: To devise a clinically relevant grading system for the sonographic evaluation of parapneumonic effusions, and to evaluate length of hospital stay as a function of treatment approach and sonographic grades. METHODS: Chest sonograms of 46 pediatric patients diagnosed with empyemas and admitted to two medical centers in the last 8 years were retrospectively evaluated using a grading system based on the degree of fibrinous organization within the parapneumonic effusions. Hospital charts were reviewed to determine the method of treatment and length of hospital stay. Patients were divided into two treatment groups: nonoperative (n = 26) (antibiotics alone, or combined with thoracentesis, or tube thoracostomy) and operative (n = 20) (open decortication, or video thoracoscopy and pleural debridement). Patients in the nonoperative group were further subdivided into two groups: those who received antibiotics alone (n = 11) and those who received antibiotics plus nonoperative drainage thoracentesis and/or tube thoracostomy (n = 15). Within each treatment group, patients were subdivided into two ultrasound grades: low (no evidence of organization) and high (evidence of organization such as fronds, septations, or loculations). Student's t test was performed to compare the lengths of hospital stay for each of the treatment groups and ultrasound grades. RESULTS: The length of hospitalization was no different for patients with low-grade ultrasounds in the nonoperative (9.8 days) and operative groups (8.0 days). In contrast, length of hospitalization was significantly shorter for patients with high-grade sonograms in the operative group (8.6 days), when compared with the nonoperative group (16.4 days). Length of hospitalization for patients in the nonoperative group with high-grade sonograms was significantly longer (16.4 days) than for those with low-grade ultrasounds (9.8 days). Furthermore, when the nonoperative patients were divided into an antibiotics alone group and a nonoperative drainage group, the patients with low-grade sonograms had no difference in the length of hospitalization (9.0 days vs. 10.4 days), whereas those patients with high-grade sonograms in the nonoperative drainage group had a significantly longer hospitalization (19.9 days) than the antibiotics alone (high-grade) group (11.4 days). CONCLUSIONS: Patients with a low-grade sonogram had similar length of hospitalization if treated with either nonoperative or operative measures. Patients with high-grade sonograms had significantly shorter length of hospitalization when treated with decortication. Our retrospective study suggests that patients with high-grade ultrasound studies treated nonoperatively do not benefit from pleural drainage procedures or chest tube placement. This study demonstrates the usefulness of early sonographic evaluation of parapneumonic effusions. A prospective study evaluating the usefulness of sonographic assessment of severity of disease in the treatment of children with parapneumonic effusions is warranted on the basis of our retrospective data.

Adolescent↗
PubMed1996

Extrahepatic portal vein stenosis in recipients of living-donor allografts: Doppler sonography.

OBJECTIVE: The aim of this study was to describe the appearances obtained and the pitfalls involved with the use of Doppler sonography for detecting portal vein stenoses after surgery in 198 recipients of pediatric reduced-size transplants. SUBJECTS AND METHODS: We analyzed sonographic and Doppler studies after surgery for 167 children (average, 2.5 years old) who were recipients of 198 left lobe or left lateral segment liver segments (79 living-donor allografts and 119 cadaveric grafts). Sonographic and Doppler studies were performed either on the basis of clinical evidence of portal hypertension or as part of a screening protocol. Demographic and surgical data were compared with the incidence of portal vein structure. We calculated pressure gradients from Doppler jet velocities and compared them with gradients measured manometrically from direct portography in 12 patients. Imaging criteria that indicated portal vein stenoses were (1) a visualized portal vein diameter of 2.5 mm or less, (2) an acceleration of flow at the stricture or a poststenotic jet of portal vein flow revealed by Doppler imaging, or (3) both. Stenoses meeting these criteria were verified by surgical or angiographic identification. RESULTS: Seventeen (22%) portal vein stenoses were detected in recipients of the 79 living-donor liver transplants, whereas three (3%) were detected in recipients of the 119 cadaveric grafts (p < .005). The use of cryopreserved venous extension grafts was the most significant parameter of correlation (p < .025). Doppler sonography predicted the stenoses in all cases, although it overestimated the pressure gradients in all but one of the verified cases. Intrahepatic portal vein flow was frequently normal in the presence of significant extrahepatic portal vein stenosis. CONCLUSION: Diagnosis of portal vein stenosis in recipients of living-donor allografts requires real-time visualization of the entire length of the portal vein, combined with spectral and color Doppler investigations of the portal and splenic veins and a search for collateral vessels. Visualization of each component alone may be insufficient. In our study, when care was taken to follow this procedure, sonography accurately showed all angiographically verified portal vein stenoses, although pressure gradients frequently were inaccurate. A protocol for periodic follow-up with real-time and Doppler sonography is crucial for pediatric patients to permit early identification of portal vein stenoses.

Adolescent↗
PubMed1995

Sonographic demonstration of a normal thyroid gland excludes ectopic thyroid in patients with thyroglossal duct cyst.

OBJECTIVE: Preoperative thyroid scintigraphy has been performed in patients with presumed thyroglossal duct cyst to document a normal thyroid and to exclude the possibility of an ectopic thyroid mimicking a thyroglossal duct cyst. Often, an ectopic thyroid is the patient's only functioning thyroid tissue, and its removal will result in hypothyroidism. The purpose of this study was to determine whether demonstration of a normal thyroid gland by sonography in children with thyroglossal duct cyst can exclude ectopic thyroid and thereby obviate routine preoperative thyroid scintigraphy. MATERIALS AND METHODS: We studied 30 patients with pathologically proved thyroglossal duct cysts who had neck sonograms. The sonograms were evaluated for the presence or absence of a normal thyroid gland. The medical records of these children were also reviewed. Three children had normal preoperative radionuclide thyroid scans. All the children were clinically euthyroid preoperatively. Follow-up was available in 15 of the 30 patients, and all of these patients were clinically euthyroid postoperatively. RESULTS: A sonographically normal thyroid gland was detected in all patients. CONCLUSION: Preoperative sonographic identification of a normal thyroid gland in patients with thyroglossal duct cyst confirms a source of thyroid hormone separate from the thyroglossal duct cyst and thus excludes ectopic thyroid. Routine thyroid scintigraphy is not necessary.

Child↗
PubMed1994

Sclerosis of the mastoid air cells as an indicator of undiagnosed otitis media in children with Down's syndrome.

We hypothesized that many children with Down's syndrome have undiagnosed otitis media. In a 1989 study of lateral neck radiographs of 22 children with Down's syndrome, we found that 64% had sclerosis of the mastoid air cells, indicating untreated or inadequately treated otitis media. We reviewed the lateral neck radiographs of 53 children with Down's syndrome and interviewed their parents regarding the diagnosis of otitis media. Mastoid air cells were found to be sclerotic in 22 (42%) of study subjects; 32% of these had no known history of otitis media. For the 68% of children diagnosed as having had otitis media, the most common symptoms were fever (61%) and cough or coryza (58%). Sclerosis of the mastoid processes was not associated with a high frequency of otitis media (> 20 episodes) or a higher frequency of hearing loss, but was associated with subsequent myringotomy and insertion of a ventilatory tube (P = .038). Our finding of sclerotic mastoids in 42% of children with Down's syndrome raises the possibility that children with Down's syndrome have unidentified or inadequately treated episodes of otitis media.

Adolescent↗
PubMed1992

Menetrier's disease associated with formula protein allergy and small intestinal injury in an infant.

Menetrier's disease in infancy is extremely rare, and its natural course has not been studied in detail. The present case report describes an infant whose initial diagnosis was formula protein allergy and who developed gastric outlet obstruction by 3 months of age. The diagnosis of Menetrier's disease was suggested by characteristic radiological, pathological, and functional abnormalities of the stomach. Small intestinal partial villous atrophy, malabsorption, and protein loss from both the stomach and the intestine were documented. Cytomegalovirus infection was excluded. There was no evidence for an immune deficiency. The described features and an unrelenting course suggest that infantile Menetrier's disease may be an entity distinct from the childhood and adult forms.

Biopsy↗
PubMed1992

Hypoplastic posterior arch of C-1 in children with Down syndrome: a double jeopardy.

Radiographs of 38 children with Down syndrome (aged 2-3 years) were retrospectively evaluated for hypoplasia of the posterior arch of the C-1 vertebra. The anteroposterior dimensions of the posterior arch of C-1 were measured and compared with those of an age- and sex-matched control group. The posterior arches of C-2 to C-5 were similarly evaluated. Radiographs demonstrated hypoplasia of the posterior arch of C-1 in 26%. This anomaly of C-1 was an isolated event; sagittal diameters of C-2 to C-5 were within normal limits compared with those of the control group and published standards. Because of the known, potentially devastating atlantoaxial dislocation in Down syndrome, the increased prevalence of a second C-1 anomaly causing preexistent narrowing of the vertebral canal is of clinical concern. A hypoplastic posterior arch of C-1 may amplify the risk of spinal cord damage following atlantoaxial subluxation, as the subsequently smaller vertebral canal has less room for dorsal movement of the odontoid process. This potential "double jeopardy" of C-1 vertebral abnormalities should be recognized and assessed on cervical spine screening radiographs in children with Down syndrome.

Cervical Vertebrae↗
PubMed1990

Possible heterogeneity in spondyloenchondrodysplasia: quadriparesis, basal ganglia calcifications, and chondrocyte inclusions.

We report on 6 patients with short stature and progressive enchondromatous-like changes of the vertebral bodies and the metaphyses of the long bones. Parental consanguinity was observed in 5 of 6 cases, supporting autosomal recessive inheritance. In spite of the similarity in radiographic changes and body proportions, genetic heterogeneity is suggested by the presence of CNS calcifications in 3 patients. Two of the latter had progressive quadriparesis. We tentatively classified these patients into 2 provisional types. An iliac crest biopsy in one of the patients with "type I" disease did not demonstrate enchondromatosis. Light and transmission electron microscopic studies demonstrated large cisterns and small inclusion bodies containing a flocculent material within the rough endoplasmic reticulum of the chondrocytes. Based on the histological and radiographic findings, we propose to classify these conditions among the spondylometaphyseal skeletal dysplasias.

Adolescent↗
PubMed1990

Unique anomalies in cephalothoracopagus janiceps conjoined twins with implications for multiple mechanisms in the abnormal embryogenesis.

The anatomic features of female conjoined twins with the Janiceps type of cephalothoracopagus are described. Abnormalities included bilateral clefts of the alveolar arches, shared rudimentary mandible, high, arched clavicles, multiple rib deformities, single shared foregut and small intestine, absent large intestines, omphalocele, multicystic kidneys, hypoplastic lungs, interconnected aortas and neck vessels, single ovary with elongated uterus in each twin, displaced labia, abnormal segmentation of the vertebrae, spinal dysraphism, diastasis of the symphysis pubis, malrotated lower extremity, bilateral posterior dislocation of the hips, and club feet. There were two hearts with internal anomalies. Both spinal cords had a myelocele in the lumbar region. The abnormalities noted in previous reports of conjoined twins of this type are reviewed and compared. We propose that factors associated with conjoining, dysgenetic (developmental) defects, and deformations resulting from crowding in utero all may have been important in the abnormal development in this case.

Digestive System Abnormalities↗
PubMed1990

Lenticulostriate vasculopathy in infants with infections of the central nervous system sonographic and Doppler findings.

Eleven infants had echogenic stripes in the basal ganglia at the location of the lenticulostriate arteries, seen by head ultrasound. Eight patients had proven infection with rubella (2 patients), cytomegalovirus (2 patients), syphilis (1 patient) or bacterial meningitis (3 patients). Two had probable intrauterine infection clinically, but the organism could not be identified; one had trisomy 13. A recent report correlated these echogenic stripes in patients with viral and syphilitic intracranial infection with pathologically proven mineralizing vasculopathy. Our group manifests a wider range of intracerebral infection associated with this finding. Duplex sonography performed in four infants showed these stripes in vivo to be arteries in the basal ganglia. The lenticulostriate arteries are not normally visible by grey scale sonography but their Doppler signal may be elicited in normal children and they are rendered vividly visible by color Doppler. Echogenicity of these vessels is highly suggestive of intracranial infection because it is not encountered normally or in babies with non infectious intracranial disorders except trisomy 13. The prognostic significance of this finding is yet to be determined.

Arteries↗
PubMed1989

The natural history of reflux in the lower pole of duplicated collecting systems: a controlled study.

Thirty two children with reflux into the lower pole of duplicated collecting systems, followed non-operatively for one to five years, were compared to a carefully selected control group of similar children who had reflux into a single collecting system. There were no significant differences between the two groups, either in the outcome of reflux or in the incidence of new renal scars. We conclude that reflux into the lower pole of a duplex kidney does not in itself constitute an indication for early surgical treatment.

Child↗
PubMed1989

Imaging of children with urinary tract infection: a tailored approach.

We reviewed the initial imaging studies of 283 children with urinary tract infection in order to decide on the most effective approach. A voiding cystogram was performed in all, complemented by either urography (147 patients), ultrasonography (65), or both (71 patients). In the latter group there was good correlation between sonographic and urographic findings, except for a more accurate delineation of renal scars and anomalies on urography, all in children with vesicoureteral reflux and/or abnormal sonograms. From these data we derived two imaging sequences tailored to the clinical circumstances: cystography as the initial study in ambulatory patients after infection has subsided, and sonography followed by cystography in children hospitalised with severe infection. The upper tracts are studied by ultrasonography and/or urography in patients with significant vesicoureteral reflex or an abnormal sonogram. Both these sequences reduce radiation by omitting the urogram in roughly half of the patients.

Adolescent↗