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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    International journal of colorectal disease 12 (1997), S. 256-258 
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Une complication congénitale cystique du caecum survient classiquement au cours de l'enfance ou de l'adolescence. Nous avons identifié un patient qui a déve-loppé un volvulus du caecum à l'âge de 91 ans en raison d'une communication large avec une duplication cystique du caecum. Une revue de la littérature montre que les duplications cystiques du caecum peuvent devenir sympto-matiques de manière précoce en raison de la survenue de complications mais jusqu'à l'étude de ce cas présent, le volvus n'avait pas été reconnu comme une modalité de présentation d'une duplication cystique du caecum.
    Notes: Abstract. Congenital caecal cystic duplication of the gastrointestinal tract usually present during infancy or young childhood. We have identified a patient who presented at 91 years of life with a caecal volvulus caused by a large communicating caecal cystic duplication. Review of the literature shows that caecal cystic duplications become symptomatic early when they cause complications, but until this report, volvulus was not a recognised presentation of caecal cystic duplication.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric radiology 20 (1989), S. 4-9 
    ISSN: 1432-1998
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Forty-one children with pulmonary sequestration complex were reviewed. This disease is a spectrum of disorders involving the bronchopulmonary airway, the arterial supply to the lungs, the lung parenchyma and its venous drainage. The review showed pulmonary sequestration to be ubiquitous in its presentation: “classical” features of sequenstration occurred in 20 (49%) children studied. The early diagnosis of children with sequenstration outside infancy demands a high index of suspicion by the radiologist. The role of angiography in demonstrating an anomalous systemic arterial supply to the lung in suspected bronchial and pulmonary arterial sequestration is described in relation to alternative imaging techniques available.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric radiology 23 (1993), S. 78-78 
    ISSN: 1432-1998
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1437-9813
    Keywords: Myotomy ; Oesophageal atresia ; Oesophageal stricture ; Oesophageal diverticulum ; Gastro-oesophageal reflux
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Oesophageal continuity is often difficult to obtain in “long-gap” oesophageal atresia, and a circular myotomy may be required to achieve oesophageal anastomosis. This study compared the effects of upper and lower segmental circular myotomy on oesophageal stricture formation, oesophageal motility, and the development of gastro-oesophageal reflux (GOR) in a piglet model. Group I underwent mid-oesophageal resection with upper segment myotomy (14); group II mid-oesophageal resection with lower segment myotomy (8); and group III oesophageal transection and anastomosis without resection (6). Normal motility data were obtained from 8 unmanipulated piglets. The incidence of stricture formation was high in all operated groups. Pseudodiverticula developed in all piglets after proximal myotomy, but not after transection or distal myotomy. Lower oesophageal sphincter pressure and mean amplitude of upper oesophageal contractions were similar after operation in all groups and in controls. GOR (number of reflux episodes/24 h, number of episodes of reflux lasting more than 5 min, and fraction of time pH less than 4.0) was worse after operation compared to controls. Within each group most manometric parameters and GOR worsened with time. We found no evidence that the level of circular myotomy (upper or lower) resulted in any significant difference in stricture rate, oesophageal motility, or severity of GOR. Given the difficulty of performing an upper myotomy in long-gap atresia, where the upper segment is often very short and pseudodiverticulum formation is common, a lower-segment circular myotomy would appear to be a reasonable alternative.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 12 (1997), S. 550-551 
    ISSN: 1437-9813
    Keywords: Oesophageal atresia ; Chromosomal abnormality ; Trisomy 18 ; Trisomy 21
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Recognisable chromosomal abnormalities occur in over 5% of patients with oesophageal atresia (OA). In a review of 670 patients with OA chromosomal abnormalities were identified in 35 (5.2%); of whom 16 had trisomy 18 and 12 had trisomy 21. In patients with trisomy 18, the diagnosis should be suspected on clinical grounds and confirmed on analysis of chromosomes; no active treatment of the OA is justified because of the extremely poor prognosis. In Down syndrome (DS) 50% will have pure OA with no tracheo-oesophageal fistula. In addition, many of these infants will have associated anomalies typical of those normally seen in DS, eg., Hirschsprung's disease, duodenal atresia, and congenital heart disease. Despite treatment, OA with DS has a high mortality.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 14 (1998), S. 163-167 
    ISSN: 1437-9813
    Keywords: Key words Intussusception ; Leadpoint ; Postoperative ; Air enema
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A pathological lesion can be identified at the leadpoint of intussusception in about 6% of episodes. Occasionally, general manifestations of an underlying disease indicate the specific cause of an intussusception (e.g., perioral pigmentation in Peutz-Jeghers syndrome), but usually the clinical features provide no clues as to the aetiology. Neonatal intussusception may be caused by a duplication cyst or Meckel's diverticulum. Beyond 12 months, the proportion of intussusceptions due to a pathological lesion at the leadpoint increases with age. There is an identifiable lesion in the majority of children over 5 years of age. Postoperative intussusception accounts for between 0.5% and 16% of intussusceptions, although it has a variety of causes; it typically follows retroperitoneal dissection. It is unusual for an intussusception due to a pathological lesion at the leadpoint to be reduced by enema. If it is reduced, the lesion may be seen at the time of reduction or fluoroscopy, or subsequently on ultrasonography.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1437-9813
    Keywords: Key words Cardiovascular abnormality ; Oesophageal atresia ; Tracheo-oesophageal fistula ; Adriamycin ; Fetal rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Associated congenital anomalies have emerged as the most significant prognostic factor in babies born with oesophageal atresia and/or tracheo-oesophageal fistula (OA-TOF). The most frequently encountered groups of anomalies are cardiovascular (CV) and gastrointestinal, the former being more significant from a prognostic point of view. Some, such as a right-sided aortic arch (RAA), vascular ring, or major heart defects, may alter the timing and surgical approach for the repair of OA-TOF or adversely affect the prognosis. The rat fetal OA model induced by adriamycin (Adr) has been described previously. In the present experiments, information was sought regarding the incidence and type of CV abnormalities in fetal rats obtained from Adr-treated dams. OA-TOF was induced in 24 of 36 fetal rats from Adr-treated dams. DV abnormalities were found in 18 (75%) OA-TOF fetuses and 10 (83%) Adr-treated fetuses without OA-TOF. The difference was not significant (P 〉0.05). The most frequently found anomalies were ventricular and atrial septal defects. A RAA was present in 8/36 fetuses and a double aortic arch in 2/36. A patent ductus arteriosus was present in all treated fetuses compared with two-thirds of controls. The findings in the present study emphasise the importance of CV anomalies in association with OA, and reinforce the value of the Adr-induced rat fetal OA model by adding to our knowledge of the basic embryogenesis of both OA and CV anomalies.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 15 (1999), S. 1-1 
    ISSN: 1437-9813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 15 (1999), S. 17-20 
    ISSN: 1437-9813
    Keywords: Key words Oesophageal atresia ; Tracheal agenesis ; Adriamycin ; Rat fetus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There have been few studies of tracheal agenesis (TA) because it is an extremely rare condition and is invariably fatal. However, it is recognised to be associated with a variety of oesophageal abnormalities, including oesophageal atresia (OA) and communicating bronchopulmonary foregut malformations (CBPFM). Except for some gross pathological reports, there has been no detailed histological investigation of this congenital abnormality. Adriamycin-induced TA in fetal rats provides a means of studying this uncommon condition, including its relationship to oesophageal abnormalities. TA was induced in rat features by intra-peritoneal injection of adriamycin (2 mg/kg) into timed-pregnant rats on days 6–9. Their 33 fetuses were removed by caesarean section, cut transversely, and stained after which the slides were examined. OA developed in 27/33 adriamycin-treated fetuses, TA occurred in 5. Four had type III while the 5th had type II TA. The oesophagus of fetuses with TA acquired tracheal features in the region where both ectopic bronchi originated. Two fetuses with TA also had OA, and 4 had a CBPFM. Other abnormalities detected involved the gastrointestinal, urinary and cardiovascular systems. The association of TA and oesophageal abnormalities suggests that there may be a spectrum of abnormalities comprising a number of variants, which may have a common aetiology. The other abnormalities co-existing in this animal model mirror those found in reported cases of human TA. Ultimately, the rat model of OA and TA may give insight into the embryogenesis of these malformations.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 15 (1999), S. 24-27 
    ISSN: 1437-9813
    Keywords: Key words Oesophageal atresia ; Tracheo-oesophageal fistula ; Prematurity ; Gastric perforation ; Pneumoperitoneum ; Balloon catheter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gastric perforation (GP) is a well-recognised complication of oesophageal atresia (OA) with distal tracheo-oesophageal fistula (TOF), and is usually associated with extreme prematurity, hyaline membrane disease, and the requirement for assisted ventilation. The presentation is sudden, and leads to further deterioration in respiratory function because of increasing abdominal distension from pneumoperitoneum and splinting of the diaphragm. Unrelieved, the infant becomes increasingly hypoxic and may die. A review of six infants with OA and distal TOF in whom GP occurred has enabled us to develop the following guidelines for the appropriate initial surgical management of this complication: (1) Needle paracentesis of the abdomen en route to surgery if the infant continues to deteriorate; (2) Urgent laparotomy to decompress the abdomen and to occlude the lower oesophagus with a catheter introduced through the GP; (3) Thoracotomy and division of the fistula; (4) Oesophageal anastomosis if the infant's condition improves sufficiently and the anatomy is favourable; and (5) Repair of the GP and formation of a gastrostomy.
    Type of Medium: Electronic Resource
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