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Intestinal atresia

Yoshiaki Takahashi, Toshiharu Matsuura, Yusuke Yanagi, Koichiro Yoshimaru, Tomoaki Taguchi
BACKGROUND/PURPOSE: There is currently no unified view regarding whether liver transplantation or splenectomy should be performed for hypersplenism before liver transplantation in biliary atresia (BA) patients. We herein describe the efficacy of splenectomy before liver transplantation. METHODS: Splenectomy was performed in ten patients with hypersplenism associated with BA. We retrospectively reviewed their perioperative and postoperative courses, the number of leukocytes and thrombocytes, and the MELD score...
September 26, 2016: Journal of Pediatric Surgery
Ying Zhang, Yisong Chen, Keqin Hua
STUDY OBJECTIVE: To describe our technique of robotic assisted reconstruction of cervix and vagina by SIS (small intestinal sub-mucosa, SIS) graft and fusion of hemi-uterus. DESIGN: Step-by-step explanation of the procedure using video. SETTING: Congenital complete vaginal and cervical atresia is rare. Some patient has urinary system abnormality. No standardized surgical treatment guideline was available and the performance is varying for each patient...
October 1, 2016: Journal of Minimally Invasive Gynecology
Masahito Sato, Yoshinori Hamada, Miyuki Kohno, Kazuya Ise, Keiichi Uchida, Hiromi Ogata, Hiroaki Masuyama, Yoshiki Morotomi, Masao Yasufuku, Motoshi Wada
PURPOSE: The purpose of this study is to identify the current clinical features of neonatal gastrointestinal perforation in Japan. METHODS: A questionnaire about cases of neonatal gastrointestinal perforation treated in recent 5 years was sent to participating institutions of the Japanese Society of Pediatric Surgeons (JSPS). RESULTS: Five hundred and thirty-six neonates with gastrointestinal perforation were treated. They consisted of 42 patients with gastric rupture/perforation (GR), 33 patients with intestinal atresia/stenosis (IA), 3 patients with malrotation (ML), 118 patients with necrotizing enterocolitis (NEC), 160 patients with focal intestinal perforation (FIP), 46 patients with meconium-related ileus (MRI), 77 patients with meconium peritonitis (MP), and 57 patients with other conditions...
September 30, 2016: Pediatric Surgery International
Seyed Abdollah Mousavi, Hasan Karami, Hossein Saneian
INTRODUCTION: The duodenum is the most common site for congenital intestinal obstruction. The duodenal web with a central hole can present without any overt signs of obstruction at a later age. MATERIAL AND METHODS: Over a 7-year period, children with congenital intestinal obstruction were identified in this study. The complications and operative findings of patients with duodenal web with conditions such as wind sock deformity and delayed diagnosis were evaluated in this study...
October 1, 2016: Archives of Medical Science: AMS
Barkha Maheshwari, Maitrayee Roy, Shipra Agarwal, S Devi, Ashu Singh, Nita Khurana, Sangeeta Gupta
Umbilical cord ulceration is a rare condition presenting with sudden fetal bradycardia due to fetal hemorrhage and in most cases leading to intrauterine death. A strong association with intestinal atresia has been reported. Most cases present after 30 weeks of gestation, with preterm labor or rupture of membranes followed by sudden fetal bradycardia. We report two such cases of umbilical cord ulceration and review the available literature. One of the cases interestingly presented at 26 weeks, much earlier than what is reported in the world literature...
September 2016: Obstetrics & Gynecology Science
Sushma Malik, Mani Singhal, Shruti Sudhir Jadhav, Charusheela Sujit Korday, Chitra Shivanand Nayak
BACKGROUND: Hirschsprung's disease is one of the commonest causes of intestinal obstruction in neonates because of gut motility disorder. It is characterized as a complex genetic heterogenous disorder with variable inheritance. Hirschsprung's disease occurs as an isolated phenotype in majority (70 %) of cases. In other cases it may be associated with syndromes (such as Down's syndrome, Waardenburg syndrome, congenital central hypoventilation, or cartilage-hair hypoplasia) or with a spectrum of congenital anomalies involving neurological, cardiovascular, or urological systems or with sensorineural anomalies...
2016: Journal of Medical Case Reports
Ahmed Hosni Morsi, Hossam Rashad Omar, Ahmed Osama, Ahmed Refaat Khodary
BACKGROUND: Neonatal pneumoperitoneum is attributed, in most of the reported cases, to necrotising enterocolitis (NEC). There are also other causes leading to free intraperitoneal air. The aim of this study is to describe the clinical spectrum, causes, management and outcome of neonates admitted with pneumoperitoneum in the paediatric surgery unit of a university hospital. SUBJECTS AND METHODS: This retrospective study included neonates having radiographic evidences of pneumoperitoneum from 2012 to the end of 2014...
July 2016: African Journal of Paediatric Surgery: AJPS
Anna Kerola, Hanna Lampela, Jouko Lohi, Päivi Heikkilä, Annika Mutanen, Jaana Hagström, Taina Tervahartiala, Timo Sorsa, Caj Haglund, Hannu Jalanko, Mikko P Pakarinen
The molecular mechanisms underlying progressive liver fibrosis following surgical treatment of biliary atresia (BA) remain unclear. Our aim was to address hepatic gene and protein expression and serum levels of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) after successful portoenterostomy (PE), and relate them to histological signs of liver injury, clinical follow-up data and biochemical markers of hepatic function. LIver biopsies and serum samples were obtained from 25 children after successful PE at median age of 3...
July 2016: Journal of Pathology. Clinical Research
Toshio Sawai, Takeo Yonekura, Katsuji Yamauchi, Takuya Kimura, Keisuke Nose
We present a new, scarless, circular incisional approach around the umbilical cord for neonates with intestinal atresia. This novel approach achieves truly woundless surgery. It is simple, safe, and can be used for an intestinal surgical treatment in neonates.
October 2016: Pediatric Surgery International
K Chakhunashvili, I Pavlenishvili, M Kakabadze, D Kordzaia, D Chakhunashvili, Z Kakabadze
Treatment of biliary atresia is a major challenge in pediatric surgery. Early diagnosis and availability of Kasai procedure with its modern modifications improve outcome of biliary atresia treatment. But Kasai procedure does not fully restore anatomical integrity of biliary tract, because Oddi sphincter is not included in reconstructed system. Constant reflux of intestinal content into the biliary tree is a cause of recurrent cholangitis and change in biliary epithelium that, which is a predisposing factor for cholangiocarcinoma...
June 2016: Georgian Medical News
Maria Hukkinen, Reetta Kivisaari, Laura Merras-Salmio, Antti Koivusalo, Mikko P Pakarinen
OBJECTIVE: To analyze risk factors and prognostic significance of small bowel (SB) dilatation in children with short bowel syndrome (SBS). BACKGROUND: In SBS, the remaining SB may dilate as part of intestinal adaptation. The impact of dilatation on parenteral nutrition (PN) dependence and survival has not been studied systematically. METHODS: SB diameter of SBS children (n = 61) was measured in contrast SB series (n = 169, median age 0.94, range 0...
July 18, 2016: Annals of Surgery
Yosra Kerkeni, Amine Ksia, Hayet Zitouni, Mohsen Belghith, Sahnoun Lassad, Imed Krichene, Mongi Mekki, Abdellatif Nouri
Polysplenia syndrome is a rare malformation characterized by the association of multiple rates and other congenital anomalies dominated by cardiac, vascular, intestinal and bile malformations. We report the observation of a patient operated in the neonatal period (3 days) for an upper intestinal obstruction with situs inversus. Surgical exploration noted the presence of multiple rates, a preduodenal vein, a biliary atresia and a duodenal atresia. The surgical procedures performed were a latero-lateral duodeno-duodenostomy and hepatoportoenterostomy of KASAI with simple immediate and delayed outcomes...
August 2015: La Tunisie Médicale
Jianghua Zhan, Jiexiong Feng, Yajun Chen, Juncheng Liu, Bin Wang
BACKGROUND: Some patients with biliary atresia (BA) have associated anomalies. Our study aimed to investigate the incidence of BA-associated malformations in mainland China, and compare the results with those reported in the Western literature. METHODS: Clinical data were collected retrospectively from five medical centers in mainland China. BA patients were diagnosed and confirmed by laparotomy with intraoperative cholangiography and liver biopsy. Cases were divided into isolated type BA and BA with associated anomalies, including polysplenia, situs inversus, intestinal malrotation, and cardiovascular anomalies...
May 19, 2016: Asian Journal of Surgery
R Angotti, F Molinaro, M Sica, F Mariscoli, E Bindi, O Mazzei, F Ferrara, M Messina
Duodenal atresia is the frequent cause of neonatal intestinal obstruction. The association between duodenal atresia, intestinal malrotation, cardiac anomalies and Down syndrome is infrequently reported. We present a prenatally suspected case of duodenal atresia which was associated with malrotation and atrial septal defect in a patient of Down syndrome. Duodenotomy and resection of web was performed in addition to Ladd's procedure. Postoperative course remained uneventful.
May 2016: APSP Journal of Case Reports
Ufuk Ates, Gulnur Gollu, Gonul Kucuk, Deniz Billur, Meltem Bingol-Kologlu, Yavuz Yılmaz, Hulya Ozkan-Ulu, Pinar Bayram, Emin Bagriacik, Huseyin Dindar
BACKGROUND/AIM: The aim of the present study was to find out if there is an increase in the expression of pro-apoptotic Bax and reduction in expression of anti-apoptotic Blc-2A1 in newborn intestines with necrotizing enterocolitis (NEC). MATERIALS AND METHODS: We compared 8 consecutive newborn patients undergoing bowel resection for NEC with 8 neonates undergoing intestinal resection for ileal atresia. Histopathological evaluation of tissue injury and apoptosis was performed by using light microscopic examination and TUNEL method...
June 1, 2016: Archivos Argentinos de Pediatría
Christine Burgmeier, Felix Schier
IntroductionThe surgical treatment of the acute neonatal abdomen still poses a challenge in pediatric surgery. Various underlying etiologies require different surgical procedures. Until today the role of laparoscopy in the surgical treatment of the acute neonatal abdomen is controversial. The aim of this study was to analyze our experiences with laparoscopy and to perform a review of the literature. Methods Retrospective, single-institution study including all term and preterm neonates initially undergoing laparoscopy due to an acute abdomen...
April 28, 2016: Surgical Innovation
Rahul Gupta, Shilpi Gupta, Pramila Sharma, Anu Bhandari, Arun Kumar Gupta, Praveen Mathur
Gallbladder duplication in association with other GIT anomalies is a rare entity. We report two neonates; one with duodenal atresia and the other newborn with pyloric atresia, ileal atresia and colonic atresia, both were associated with gallbladder duplication which has not been reported earlier.
April 2016: Journal of Neonatal Surgery
Kamal Nain Rattan, Jasbir Singh, Poonam Dalal
BACKGROUND: Congenital duodenal obstruction is one of the commonest causes of neonatal intestinal obstruction. We are presenting our 15-year experience by analyzing clinical spectrum and outcome in neonates with duodenal obstruction admitted at our center. MATERIAL AND METHODS: The hospital records of all neonates admitted with duodenal obstruction from June 2000 to June 2015 were reviewed. The patient records were analyzed for antenatal diagnosis, age, sex, clinical presentation, diagnosis, associated anomalies, surgical procedures performed; postoperative morbidity and mortality...
April 2016: Journal of Neonatal Surgery
P A Lobos, S E M Calello, V B Busoni, M M Urquizo Lino, S G Prodan, R Sanchez Claria
CASE REPORT: Gastroschisis is the most frequent congenital abdominal wall defect. When associated with intestinal atresia (complex gastroschisis), short bowel syndrome may occur. Complicated gastroschisis is the most frequent cause of short bowel syndrome in our series. The serial transverse enteroplasty procedure has been used to lengthen the bowel and achieve intestinal rehabilitation in patients with dilated gut. The use of this technique in the newborn period, for tailoring the bowel while preserving absorptive mucosa, has been recently described...
March 2016: Transplantation Proceedings
Silja Voutilainen, Reetta Kivisaari, Jouko Lohi, Hannu Jalanko, Mikko P Pakarinen
GOALS AND BACKGROUND: We compared liver stiffness (LS), the aspartate aminotransferase-to-platelet ratio index (APRi), and the platelet-to-spleen size z score ratio (P/SZC) in the prediction of liver fibrosis and esophageal varices in children. STUDY: LS, APRi, SZC, and P/SZC were prospectively determined in 99 unselected consecutive children, who underwent liver biopsy for the follow-up of chronic liver disorders. LS was assessed by transient elastography. The spleen size was evaluated as the SD from age-specific and gender-specific normative values...
September 2016: Journal of Clinical Gastroenterology
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