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  • 1
    Digitale Medien
    Digitale Medien
    Springer
    Pediatric surgery international 10 (1995), S. 79-81 
    ISSN: 1437-9813
    Schlagwort(e): Appendiceal mass ; Appendicitis ; Child
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A total of 198 were diagnosed to have an appendiceal mass between 1982 and 1991;9 underwent appendicectomy immediately following diagnosis. One developed a wound infection. Of the remaining 189 patients 162 (85.7%) had unevenful resolution of the mass. The mean duration of hospital stay was 9.7 days. Twenty-seven patients failed to respond to initial non-operative management; 16 developed an appendix abscedd and required drainage. One patient had percutaneous drainage under ultrasound control. One of these 16 patients developed a wound infection after interval appendicectomy. Four other patients underwent appendicectomy during the initial admission because of clinical deterioration and all of them were found to have an appendix mass at operation. Three of these 4 patients developed postoperative complications (wound infection 1, intra-abdominal abscess 1, small-bowel obstruction 1). Seven other patients required admission and appendicectomy while waiting for interval appendicectomy. At operation, 5 still had an appendiceal mass/ abscess and 2 had acute appendicitis. The child with an appendiceal abscess continued to have a discharging wound for 19 days. All others, except 3 patients who were lost to follow-up, underwent interval appendicectomy. Mean duration of hospital stay for interval appendicectomy was 301 days. Two patients who did not return for elective appendicectomy developed acute appendicitis and required appendicectomy 65 days and 8 months after discharge. Three (1.9%) of 161 patients (all in the first half of the series) developed postoperative complications following interval appendicectomy (wound hematoma 1, wound infection 1. pneumonia 1). Evidence of inflammation was present on histological examination in 47.2% of the cases. These data support the belief that initial non-operative management of an appendiceal mass followed by interval appendicectomy is a safe and effective method of management.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    Pediatric surgery international 10 (1995), S. 76-78 
    ISSN: 1437-9813
    Schlagwort(e): Appendicitis ; Active observation ; Child
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract An audit was undertaken to assess the outcome of patients aged less than 16 years who underwent appendicectomy after active obsevation. A comparison was made of the incidence of perforation, complications, and hospital stay of patients who underwent emergency appendicectomy (group A) and those who were operated upon after active observation (group B). A total of 1,672 patients were admitted with acute abdominal pain. Emergency appendicectomy following the diagnosis of acute appendicitis on admission was performed in 744 patients (group A); an appendicectomy was performed in 123 patients following active observation (group B). In group A, 140 patients (18.8%) were found to have macroscopic or microscopic perforations; a normal appendix was removed in 75 (10.1%) cases and 31 (4.2%) patients developed postoperative complications. In group B, perforations occurred in 19 (15.1%) patients, normal appendix was encountered in 25 (19.8%), and postoperative complications occured in 7 (5.5%). The overall normal appendicectomy rate was 11.5%. Mean duration of hospital stay was 3.5 days in group A and 4.7 days in group B. The remaining patients who were actively observed and did not require surgery were discharged when their symptoms and signs had resolved. The study illustrates that appendicectomy after a period of active observation in hospital fro acute abdominal pain carries no increase in morbidity compared with urgent appendicectomy.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    Digitale Medien
    Digitale Medien
    Springer
    Pediatric surgery international 4 (1989), S. 326-331 
    ISSN: 1437-9813
    Schlagwort(e): Hirschsprung's disease ; Electron-microscopy ; Schwann cells ; Monoclonal antibodies
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The pathophysiology of Hirschsprung's disease is not fully understood. Using light microscopy we have previously demonstrated the absence of a unique Schwann-cell antigen in the circular muscle of aganglionic colon identified by D7 monoclonal antibody. In an attempt to characterise the morphological changes in neuronal cells at subcellular level, we studied innervation patterns in normal and aganglionic colon by electron microscopy. The most striking observation on ultrastructural serial examination of the entire resected specimen of colon from patients with Hirschsprung's disease was the presence of grossly swollen monoaxonal or oligoaxonal Schwann cell units with loss of cellular contents in the circular muscle of aganglionic colon. The extent of subcellular changes in Schwann cells and axons corresponded with a diminution of immunoreactivity with a panel of neuronal cell antibodies. These ultrastructural findings suggest that degenerative changes in Schwann cells and axons within the circular muscle coat of aganglionic segment may be a significant factor in the pathogenesis of Hirschsprung's disease.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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