Biomedical subjects
Publications and source records attributed to B M Rodgers.
The roentgenographic features of a paramediastinal air cyst following chest trauma are reported. After an initial period of enlargement the lesion completely resolved in one month. Experience with this patient and a review of similar cases reported in the literature suggests that lesions of this type may be observed for spontaneous resolution.
From July 1971 to March 1975, elevan infants receiving total or partial parenteral alimentation at the University of Florida showed histologic evidence of intrahepatic cholestasis. The clinical records of these patients have been examined. These infants were critically ill and had protracted hospital courses with only two survivors. Liver biopsies demonstrated marked cholestasis with some fibrosis and thickening of the limiting membrane of the hepatocyte. In those patients in whom serial liver biopsies were obtained, hepatic histology returned toward normal, paralleling improvement in liver function studies, as intravenous alimentation was discontinued. Careful monitoring of the liver function tests is essential to detect this progressive abnormality as early as possible and discontinue intravenous alimentation. Follow-up as long as two and a half years in the two surviving patients has demonstrated no chronic dysfunction.
Disenchantment with available techniques for specific diagnosis of intrathoracic pulmonary lesions in children has led us to explore the usefulness of thoracoscopy. We have performed this technique in nine patients ranging in age from 17 mo to 16 yr. The procedure is performed under intravenous anesthesia with the patient spontaneously breathing oxygen. A fiberoptic rod lens system is employed for the direct observation and biopsy of pulmonary parenchymal or chest wall lesions. Adequate tissue has been obtained in each case to allow a specific diagnosis. There has been no mortality from this procedure and only minor morbidity. We believe that this technique offers a rapid and simple method for the diagnosis of diffuse or localized disease of pulmonary parenchyma or chest wall in children.
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Although the diagnosis of peptic ulcer disease may be difficult in the pediatric age group, this problem is being faced increasingly by the physicians charged with the care of these children. Chronicity of symptoms has been documented in over 50 per cent of the patients demonstrating early peptic ulcers and therefore an aggressive approach to management has been advocated. Although the numbers are small, postgastrectomy syndromes of mechanical and nutritional nature appear less common in the young patient than in adults. Satisfactory growth and development are reported in nearly all series of patients followed after various gastric procedures. Both pyloroplasty and vagotomy and vagotomy and antrectomy appear to be extraordinarily well tolerated by the pediatric patient. Experimental evidence suggests that these patients should enjoy normal growth and development.
Achalasia of the esophagus is an unusual lesion in childhood and is quite rare under the age of one year. The case of a 3-month-old child with esophageal achalasia treated with a Heller esophagomyotomy is illustrated. Seven previously documented cases of achalasia in children under the age of one year are reviewed and the difficulties of diagnosing this lesion in childhood are discussed.
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