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Biomedical subjects

V Raveenthiran

Publications and source records attributed to V Raveenthiran.

18 recordsLinked to original sources
PubMed2006

Spontaneous knotting of urinary catheters: clinical and experimental observations.

Urinary catheters are known to spontaneously knot inside the bladder. Approximately 40 cases of this complication have been recorded in the world literature. Clinical observation in 4 children and simulation experiments done using a balloon model are described herein. Risk factors identified in this study includes catheter size less than 10 Fr, overdistended bladder and insertion of more than 10 cm length of catheter inside the bladder. Water-current generated by the flow of urine appears to play an important role in the pathogenesis of catheter knotting.

Child↗
PubMed2005

Congenital Spigelian hernia with cryptorchidism: probably a new syndrome.

Nearly 28% of pediatric Spigelian hernias reported in the literature are associated with ipsilateral cryptorchidism. However, the pathogenetic relationship between the two has not been satisfactorily explained in the past. This paper describes a male neonate born with cryptorchidism and imperforate anus. Anal stenosis following the treatment of imperforate anus had let to the development of multiple hernias including Spigelian hernia on the right side. Surgical exploration revealed the right testis being located within the Spigelian hernia. Based on the sequence of events, it is hypothesized that Spigelian hernia in this case is a sequela of maldescended testis and raised intraabdominal pressure. As this explanation is also applicable to all of the previously reported cases, the author suggests that the combination of Spigelian hernia and ipsilateral cryptorchidism could probably form a hitherto unrecognized new syndrome.

Cryptorchidism↗
PubMed2005

Choice of drainage procedure in paediatric pyopericardium: a 30-year experience.

Although there is general agreement on the necessity of draining pyopericardium, debate continues as to the safe and effective method of drainage. Studies describing head-to-head comparison of various drainage procedures are very few and are disadvantaged by small numbers of cases. In this observational study, we review our 30-years experience with different techniques of pericardial drainage. Between 1972 and 2003, the authors have personally treated 39 children who suffered from pyopericardium. Among the 22 children who underwent early partial pericardiectomy, 20 were alive. In contrast to this, 12 out of 15 children treated with repeated pericardiocentesis or sub-xiphoid tube drainage were dead. The median hospital stay for pericardiectomy group was 18 days (range 11-32) and that for the non-thoracotomy group was 34 days (range 18-55 days). With regard to immediate survival and early convalescence in the pyopericardium, partial pericardiectomy is superior to pericardiocentesis and sub-xiphoid tube drainage. Pericardiocentesis can be used for diagnostic or temporizing purposes, but not as the definitive drainage procedure. Partial pericardiectomy can be done even in small hospitals where heart-lung machines are not available.

Bacterial Infections↗
PubMed2003

Restorative resection of unprepared left-colon in gangrenous vs. viable sigmoid volvulus.

BACKGROUND AND AIMS: Emergency resection and primary anastomosis of unprepared left-colon is a controversial subject. Although this approach has been reported in several series, there is paucity of data on the relative safety of it in viable vs. gangrenous colon especially when the gut is unprepared. PATIENTS AND METHODS: Case records of 57 consecutive patients with acute sigmoid volvulus were reviewed; there were 27 with gangrenous colon (group G) and 30 with viable colon (group V). All of them had undergone emergency resection and primary anastomosis without on-table lavage or caecostomy. RESULTS: Group G had a lower mean haemoglobin value (8.4 vs. 9.7 g/dl) and higher incidence of circulatory shock on admission (26% vs. 7%) and required more blood transfusion (85% vs. 53%) than group V. Mean hospital stay (16 vs. 12 days), overall anastomotic leak (15% vs. 27%) and mortality (3.5% vs. 3%) did not differ significantly between the groups. However, the rate of wound infection in Group G was four times greater than that of group V. CONCLUSION: One-stage restorative resection without on-table lavage or caecostomy appears to be a promising alternative in the emergency management of acute sigmoid volvulus. Comparison of primary anastomosis in gangrenous vs. viable colon did not reveal any significant difference in hospital stay, rate of anastomotic leak or mortality. However, the risk of wound infection was more in patients with gangrenous sigmoid volvulus.

Acute Disease↗
PubMed2003

Rosai-Dorfman disease: report of a 3-year-old girl with critical review of treatment options.

Rosai-Dorfman disease (sinus histiocytosis with massive lymphadenopathy) is a newer pathological entity described in 1969. It is a self-limiting disorder of unknown aetiology. It is likely to be mistaken for lymphoma. It predominantly affects children and adolescents. However there are no publications on this disorder in the paediatric surgical literature. In this report we describe a 3-year-old girl who presented with this disease and we critically review the therapeutic options available for children. Prednisolone therapy with long-term follow-up appears to be sufficient. Surgery should be limited to biopsy and relief of compression symptoms.

Child, Preschool↗
PubMed2002

Solar eclipse sign of intussusception on barium enema.

The colographic appearance of intussusception is variously described as a claw sign, pincer defect, shouldering effect, and coiled-spring pattern. This report adds a new radiographic sign to the list. An end-on view of an intussusception on barium enema shows a ring of contrast resembling a solar eclipse. Familiarity with this bizarre appearance is desirable, lest it may be mistaken for spillage of barium due to a colonic perforation.

Barium Sulfate↗
PubMed2001

The ileosigmoid knot: new observations and changing trends.

PURPOSE: Ileosigmoid knot is a rare surgical emergency. Most previous publications are either retrospective reviews of hospital records or sporadic case reports. Personal experience with this condition is often limited to one or two cases. This article describes the personal experience with this rare condition of a single author. This seems to be the largest reported prospective study of ileosigmoid knot. METHODS: Seven patients with ileosigmoid knot were treated during a period of three years. RESULTS: Ileosigmoid knot was common in males in their fourth decade. Mean duration of symptom was 22 hours. Correct preoperative diagnosis was possible in 71 percent of cases. The knot was successfully unraveled in 71 percent of cases. Sigmoid colon was gangrenous in all the patients (100 percent), whereas the ileum was gangrenous in only 43 percent of cases. There was no correlation between duration of symptoms and incidence of gangrene. After resection of gangrenous intestine, primary anastomosis was done in all patients. There were no deaths. The mean hospital stay was 14 days. CONCLUSIONS: Correct preoperative diagnosis of ileosigmoid knot is possible when clinical, radiologic, and sigmoidoscopic features are considered together. Unraveling of the knot seems to be beneficial in ileosigmoid knot except when both components of the knot are frankly gangrenous. Primary anastomosis (ileoileal and/or colocolic) of resected gut seems to be a safe and better alternative in the management of ileosigmoid knot.

Adult↗
PubMed2000

Emptiness of the left iliac fossa: a new clinical sign of sigmoid volvulus.

BACKGROUND: Diagnostic difficulties are common in sigmoid volvulus. This diagnostic delay contributes to high morbidity and mortality. AIM: This paper recognises visible or palpable emptiness of the left iliac fossa as a new clinical sign of sigmoid volvulus. Predictive accuracy of the sign was assessed in this study. METHODS: 519 patients with acute abdomen of non-traumatic origin were prospectively studied. RESULTS: The new sign was present in 24 out of 86 patients (28%) with sigmoid volvulus. It was absent in all those who did not have sigmoid volvulus. The positive predictive value of the sign was 100%. CONCLUSION: Emptiness of the left iliac fossa is a valuable diagnostic adjunct. Positive sign is pathognomonic of sigmoid volvulus. Nevertheless, a negative sign warrants further investigations.

Abdomen, Acute↗
PubMed1995

Post-typhoid anhidrosis: a clinical curiosity.

A 19-year-old girl developed generalised anhidrosis following typhoid fever. Elaborate investigations disclosed nothing abnormal. A skin biopsy revealed the presence of atrophic as well as normal eccrine glands. This appears to be the third case of its kind in the English literature. It is postulated that typhoid fever might have damaged the efferent pathway of sweating.

Adult↗
PubMedDate not supplied

Richter's hernia in Spigelian hernia.

A 75-year-old woman presented with a painful abdominal lump. Clinically and sonographically it was diagnosed as an abscess. Surgical exploration revealed a Spigelian hernia with Richter's type of strangulation. The strangulated portion of the ileum had perforated, leading to abscess formation.

Abdominal Abscess↗
PubMedDate not supplied

Gastric and intestinal lactobezoars.

Two male full-term infants presented with unusual features of lactobezoar. One had gastric disease while the other had small bowel bezoar. The gastric lactobezoar was managed medically while the intestinal one required surgical intervention.

Bezoars↗
PubMedDate not supplied

Observations on the pattern of vomiting and morbidity in patients with acute sigmoid volvulus.

BACKGROUND: Vomiting is usually a late and an infrequent symptom of colonic obstructions. Contrary to this general rule, it occurs early and more frequently in some cases of sigmoid volvulus. AIM: To study the clinical significance of vomiting in patients with sigmoid volvulus. SETTING: Teaching hospital in Western Orissa, India STUDY DESIGN: Prospective observational study MATERIAL AND METHODS: Prospectively enrolled subjects with sigmoid volvulus diagnosed on the basis of clinical, radiological and laparotomy evidence were included in the study carried out in a tertiary care centre in India. Detailed history was obtained from them, especially to elicit information about the occurrence of various symptoms. Information regarding type of vomiting was also obtained. Efforts were made to exclude other causes of vomiting. Statistical tests such as Chi-Square test, Fisher's exact test or Student's t test were used. RESULTS: Ninety-three consecutive subjects with sigmoid volvulus were enrolled. Five patients with possible other aetiologies for vomiting and seven patients with compound sigmoid volvulus were eliminated from further analysis. Two patterns of vomiting were noted in 81 evaluable patients with sigmoid volvulus. In 33 patients (Group A), vomiting preceded or coincided with the onset of other abdominal symptoms (Type 1 vomiting). In 48 patients (Group B) vomiting occurred after the onset of other abdominal symptoms (Type 2 vomiting). The period between the onset of these symptoms and that of vomiting varied from a few hours to several days. Group A patients sought medical help much earlier than those of Group B. Incidences of circulatory shock (24% vs. 8%), haemorrhagic ascites (21% vs. 6%) and colonic gangrene (64% vs. 35%) were significantly higher in Group A than in Group B. The mortality rate (15% vs. 4%) was higher in Group A as well. About 25% (n = 7) of Group A patients in contrast to 4% (n=2) of Group B required hospitalization exceeding 3 weeks. Vomitus was predominantly non-bilious (21 out of 33 patients) in Group A (64%) and bilious (10 out of 11 patients) in Group B (91%). CONCLUSION: Type 1 vomiting appears to be an indicator of more severe presentation and is associated with an increased morbidity and mortality. This study suggests that the pattern of vomiting could be a simple and useful predictor of prognosis in sigmoid volvulus.

Aged↗