Biomedical subjects
Publications and source records attributed to T Mihailovic.
A 6-month-old male infant with difficulty swallowing, recurrent aspiration pneumonia and failure to thrive was diagnosed with cricopharyngeal achalasia. Normal oral feeding and no further aspirations followed a single catheter balloon dilatation.
Pancreatic drainage patterns have been studied by endoscopic retrograde cholangiopancreatography (ERCP) in four children with choledochal cyst (CC). The first two had mild or chemical pancreatitis; the third had a history of recurrent cholangitis and was diagnosed as chronic pancreatitis. The fourth manifested with severe, acute pancreatitis. All children were found to have an impaired flow through the papilla of Vater. In the first three cases, the duct of Santorini (DS) seemed to play an important role in the pancreatic drainage. In the fourth case, however, the duct was found to be absent. ERCP findings in additional eleven children without CC also were reviewed, and in this group the DS did not seem to play any significant role in pancreatic drainage. These results indicate that in children with common bile duct (CBD) anomalies, the DS may relieve the obstruction and ameliorate the pancreatitis.
A 4-year-old boy with a short history of jaundice and hepatomegaly was studied by endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC). A large obstructing choledochal tumour was found at the level of cystic duct insertion and at surgery, a botryoid sarcoma was removed. Subsequent cytotoxic therapy was complicated by persistent dilatation of the extrahepatic bile ducts which necessitated eventual excision. There was no evidence of persistent tumour.
A 14-month-old severely retarded girl with a history of regurgitation, aspiration, and recurrent pneumonia was found to suffer from diffuse oesophageal spasm. This diagnosis was made by oesophageal cineradiography. This case suggests that diffuse oesophageal spasm is an oesophageal motility disorder that causes respiratory disease in the retarded child.
A 4 month old girl with oesophageal achalasia was successfully treated with a single pneumatic dilatation. A subsequent barium swallow showed almost normal oesophageal caliber. During the following eighteen months, vomiting and feeding problems did not recur.
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