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  • 1
    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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  • 2
    ISSN: 1573-2568
    Keywords: indium-111 ; leukocyte ; imaging in inflammatory bowel disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study was designed to evaluate the role of111In-labeled leukocyte imaging and fecal excretion in the assessment of inflammatory bowel disease. We compared these tests to various indices of disease activity in Crohn's disease, to Truelove's grading in ulcerative colitis, and to endoscopy, x-ray, and pathology in both diseases. Eleven controls, 16 patients with Crohn's disease, 13 with ulcerative colitis, and 3 with other types of acute bowel inflammation were studied (positive controls). Indium scanning was performed at 1,4, and 24 hr. Fourteen of 16 patients with active Crohn's disease had positive scans but in only five was localization accurate. One patient had inactive ulcerative colitis, and the scan was negative. Of 12 patients with active ulcerative colitis, 10 had positive scans but disease localization was accurate in only four. Disease extent was correctly defined in 1 of the 3 Positive Controls. There was no significant difference in the accuracy of scanning at 1,4 or 24 hr.111In fecal excretion was significantly higher in patients with inflammatory bowel disease than in controls, and there was correlation between111In fecal excretion and most of the indices of disease activity in Crohn's disease. In ulcerative colitis,111In fecal excretion did not correlate with Truelove's grading but reflected colonoscopic assessment of severity. In conclusion,111In-labeled leukocyte scanning lacks sensitivity with respect to disease extent, but fecal excretion of111In correlates well with disease severity as determined by other methods.
    Type of Medium: Electronic Resource
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