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  • 1
    Electronic Resource
    Electronic Resource
    Hirschsprung's disease in association with trisomy 21 and duodenal obstruction (1994)
    Springer
    Pediatric surgery international 9 (1994), S. 366-367 
    Details
    ISSN: 1437-9813
    Keywords: Hirschsprung's disease ; Trisomy 21 ; Duodenal obstruction ; Child
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The association of trisomy 21 and Hirschsprung's disease (HD) is well known. In a neonate, HD characteristically presents with delayed passage of meconium and/or intestinal obstruction. However, the presence of duodenal atreasia (DA), which may present similarly, can mask the associated HD. Over an 18-year period, 17 of 135 patients with HD had trisomy 21. Three of these 17 patients presented with duodenal obstruction in the newborn period — 2 had DA and 1 a complete duodenal web. One patient developed a perforation of the jejunum 7 days after laparotomy and duodenoduodenostomy and was found to have HD while the other 2 were later investigated because of persistent unresponsive constipation and confirmed to have HD at 1 and 2 years of age. In spite of associated Down's syndrome and DA, the possibility of HD should be considered in patients who have a complicated postoperative course or persisting abnormal stooling patterns.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01686003
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Neonatal intestinal perforation in Hirschsprung's disease (1994)
    Springer
    Pediatric surgery international 9 (1994), S. 501-502 
    Details
    ISSN: 1437-9813
    Keywords: Hirschsprung's disease ; Intestinal perforation ; Neonate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Over a period of 18 years, 77 of 135 patients treated for Hirschsprung's disease (HD) presented in the neonatal period. Of these 77 patients, 8 had gastrointestinal (GI) perforations. Seven patients were born at full term and 1 at 32 weeks of gestation. Three patients had associated trisomy 21. The site of perforation included rectum in 1 patient, sigmoid in 1, descending colon in 1, transverse colon in 2, caecum in 2, and jejunum in 1. Perforations occurred in ganglionic bowel in 7 patients and in the aganglionic segment in 1. One patient died in the newborn period of overwhelming sepsis secondary to enterocolitis, and histology of the bowel confirmed HD. In 6 patients HD was confirmed on barium enema and suction rectal biopsy, and they subsequently underwent a definitive pull-through operation. The 1 patient in whom the initial barium enema was normal continued to suffer from constipation until the age of 7 years, when the diagnosis of HD was established. He then underwent a pull-through procedure with no further problems. An association between neonatal intestinal perforation and HD must therefore be recognised to avoid delay in the management.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00179451
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Testicular torsion following torsion of a hydatid of Morgagni (1993)
    Springer
    Pediatric surgery international 8 (1993), S. 65-65 
    Details
    ISSN: 1437-9813
    Keywords: Spermatic cord torsion ; Hydatid of Morgagni
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The acute scrotum is one of the commonest surgical emergencies in pediatric practice. Early diagnosis, prompt treatment, and preventive measures are important to avoid testicular infarction. Occurrence of torsion has been previously reported following orchidopexy for undescended testis and for previous torsion of the testis. We report a case of intravaginal torsion of the testis in a patient who had previously undergone exploration and excision of a torted hydatid of Morgagni without formal orchidopexy. As exploration of the scrotum does not confer protection against subsequent torsion, orchidopexy should be routinely performed in patients who are found to have high investment of the tunica vaginalis or separation of the epididymis and testis on scrotal exploration for any reason.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02353008
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  • 4
    Electronic Resource
    Electronic Resource
    Evaluation of risk factors in the development of enterocolitis complicating Hirschsprung's disease (1994)
    Springer
    Pediatric surgery international 9 (1994), S. 234-236 
    Details
    ISSN: 1437-9813
    Keywords: Hirschsprung's disease ; Enterocolitis ; Child
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Enterocolitis remains a major cause of morbidity and mortality in patients with Hirschsprung's disease (HD). Forty-one (30%) of 135 patients treated for HD from 1975 to 1992 developed enterocolitis; enterocolitis occured preoperatively in 25. It was a presenting feature in 17 infants, including 11 neonates. The proportion of patients presenting with enterocolitis in the neonatal period increased with advancing age, 6 (11%) out of 56 presenting within the 1st week and 5 (24%) out of 21 after 1 week. Episodes of enterocolitis continued in 7 of these 25 patients after a pull-through procedure. Sixteen patients had a first episode of enterocolitis after surgery: 3 after a colostomy, and 13 after a pull-through procedure. The incidence of enterocolitis was 28% in patients with rectosigmoid involvement and 38% in patients with long-segment or total colonic aganglionosis (P= 0.1). Enterocolitis occured in 8 (47%) of 17 patients with trisomy 21 as compared to 33 of 118 (28%) other patients (P= 0.1). Four of the 41 patients died as a result of enterocolitis, 3 in the neonatal period after a colostomy performed at a mean age of 22 days, although the symptoms suggestive of HD were present since birth. Prompt diagnosis and expeditious management are necessary in patients with HD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00832245
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    Paper (German National Licenses)
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