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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 13 (1998), S. 610-612 
    ISSN: 1437-9813
    Keywords: Key words Central venous catheters ; Venous thrombosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Peri-catheter calcification is an unusual and previously unreported complication of central venous (CV) catheterization in infants. A 1.9 Fr Silastic CV catheter was placed in a term infant for administration of total parenteral nutrition and antibiotics following intra-abdominal sepsis. The catheter was removed, without complication, at a later date after another septic episode. Imaging studies performed in the investigation of a possible intra-abdominal abscess revealed a cylindrical density within a clot in the inferior vena cava (IVC). The density was presumed to be a retained catheter fragment. Further investigation indicated total occlusion of the IVC. Surgical exploration of the IVC revealed only a calcified thrombus. This case represents a rare and previously unreported complication of CV catheterization in infants. Diagnosing this condition on radiographic evidence alone can be difficult. It is hoped that awareness of the potential for this complication will avoid unnecessary invasive procedures in the future. We also suggest a high level of clinical suspicion and routine Doppler ultrasound investigations to detect IVC thrombosis when indwelling CV catheters are used in infants.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 15 (1999), S. 508-509 
    ISSN: 1437-9813
    Keywords: Key words Pheochromocytoma ; Adrenal hemorrhage ; Hypertension ; Blunt abdominal trauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The diagnosis of pheochromocytoma (Pheo) can be challenging due to the variety of potential presentations of this infrequent tumor. A 16-year-old boy presented with hypertension and sudden abdominal pain after minor blunt abdominal trauma. Both computer tomography (CT) and magnetic resonance (MR) scanning identified a right suprarenal mass, and raised the possibility of a Pheo. This diagnosis was confirmed through urine catecholamine testing and 131I metaiodobenzylguanidine (MIBG) scanning. An extra-adrenal Pheo was successfully resected. The presentation of Pheos is quite variable, and patients may often be essentially asymptomatic. Pheo should be considered in hypertensive pediatric patients with a history of blunt abdominal trauma.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 15 (1999), S. 515-516 
    ISSN: 1437-9813
    Keywords: Key words Inguinal canal ; Ovarian cyst ; Lymphangioma ; Neuroblastoma ; Epidermal cyst
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Masses in the inguinal canal other than hernias are rare occurrences, and their preoperative diagnosis requires a high index of suspicion. A soft, partly reducible groin mass in a 3-month-old boy proved to be a cystic lymphangioma within the inguinal canal. A 15-month-old female who presented with an irreducible inguinal mass was found to have a neuroblastoma metastasis in the groin. An irreducible groin mass in a 6-year-old female proved to be an inguinal canal epidermal inclusion cyst. A 14-year-old female presented with a painful groin swelling that represented an incarcerated hemorrhagic ovarian cyst. An awareness of the wide spectrum of entities other than the standard bowel, testicle, and ovary in the inguinal canal can help to identify uncommon pathologies preoperatively.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 15 (1999), S. 510-511 
    ISSN: 1437-9813
    Keywords: Key words Trisomy 21 ; Esophageal motility ; Aperistalsis ; Fundoplication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gastrointestinal abnormalities are frequent in patients with Down syndrome (DS), gastroesophageal reflux (GER) being prominent among them. A 10-year-old boy with DS presented with progressive daily vomiting and an upper gastrointestinal study documenting reflux. A laparoscopic Nissen fundoplication was performed uneventfully. Postoperative inability to take solids was noted and a contrast study showed a tight gastroesophageal junction and poor peristalsis. Persistent symptoms were not alleviated by esophageal dilatation, despite a relaxing lower esophageal sphincter. Esophageal manometry documented complete esophageal aperistalsis. A percutaneous endoscopic gastrostomy was placed and the patient required long-term tube feeds. Esophageal aperistalsis is a rare condition in DS, likely superimposed on GER. Fundoplication may adversely affect the already abnormal esophageal motility in these children. Esophageal manometry preoperatively will identify motility disorders and assist in selecting the best management for these patients.
    Type of Medium: Electronic Resource
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