Biomedical subjects
Publications and source records attributed to C Baunin.
A case of Gaucher's disease is reported in a 12 year-old girl. Presenting signs consisted of relapsing hip arthritis, while no splenomegaly was detectable. The authors comment the inflammatory or moderately hemorrhagic nature of articular fluid and the diagnostic value of an early decreased uptake on bone scintiscan. The value of magnetic resonance imaging for evaluating bone involvement is emphasized.
Two cases of prenatal detection of congenital biliary cysts are reported. Prenatal and postnatal ultrasonography demonstrate a solitary sonolucent cystic lesion. The differential diagnosis in fetus and infant includes any abdominal cystic lesions: ovarian cyst, duplication cyst, cystic lymphangioma, choledochal cyst and other congenital cysts of the liver. In opposite to the difficulty of diagnosis, the choice for treatment is easy: surgery is the only way to allow histologic diagnosis and to avoid any relapse or complications.
The authors report the value of MRI in the long-term follow-up of two cases of mesenterico-atrial shunt for Budd-Chiari syndrome. They discuss the problems of differential diagnosis between slow flow and thrombosis, a significant risk with this type of shunt.
One hundred eleven patients underwent a surgical procedure for correction of intractable gastroesophageal reflux. Twenty children were severely mentally retarded. The range of follow up was 6 months to 15 years. Upper gastro-intestinal series was realised at tenth post-operative day for 111 children, then during the first year for 97 children, between the first and fifth year for 62 children and after the fifth year for 25 children. The first upper gastro-intestinal control (at tenth day) was normal for 111 patients. Next controls revealed, usually during the first post-operative year, an esophago-gastric junction anomaly for 49 patients (44%). Most of them are light (41/111 = 37%): occasional reflux (9 children; more frequent without pyloroplasty) of little paraesophageal hernia (32 children; more frequent with closure of esophageal hiatus by two suture lines, with esophageal fixation on median arcuatum ligament or without esophageal fixation on esophageal hiatus); these light anomalies are symptom free and sometimes transitories. Rarely, anomalies are important (8/111 = 7%): big paraesophageal hernia of recurrence (more frequent with partial posterior fundoplication and in children severely mentally retarded); five patients were symptomatic and had to be reoperated. Also now, we don't use partial posterior fundoplication and in mentally retarded children we prefer a Collis procedure.
The purpose of this study was to analyse the accuracy of combined arthrography and computed tomography in pediatric radiology. 23 patients were selected and the joints studied (n = 25) were: elbow (1), shoulder (2), knee (8) and hip (14). The contribution of computed arthrography varies according to the joint and the disease concerned. Osteochondritis dissecans of the knee appears to be the best indication.
The authors report their experience concerning nuclear magnetic resonance imaging (NMR) in 7 children. They emphasize its importance in the post-operative study of portal hypertension. All those children got surgically created porto-systemic shunts. NMR imaging is easy, safe and trustable. It is able to visualise the shunt itself and to demonstrate the patency of this shunt. So, it is interesting when the usual controls have failed, particularly abdominal ultrasonography.
Two cases of ureteral triplication are reported, on in a child of 4 years the other in a 2-week-old baby. In both cases the triplication was associated with one or two ureteroceles. A literature review is used as a basis for describing the characteristics of this rare malformation.
The authors report their experience concerning echography in 40 children. They emphasize its importance in the painful hip. All patients suffered with a painful limping with normal standard front and profile X-Rays. Echography appears to be a test both simple and reliable to discern synovial extravasation (no false positive). Yet, it is not able to predict the kind of effusion. More especially, echography is not limited to the very diagnosis of extravasation: in acute transient synovitis, it shows an enlargement of the joint cavity, with no effusion, giving evidence of the inflammatory synovial reaction, in arthritis, it allows a good survey, pointing out healing under treatment, persistent extravasation commanding iterative succions, and the coming out of an articular septation.
The aim of the radiological exploration of an infant born with an ano-rectal malformation is the definition of the level and the type of the anomaly. At first a lateral abdominal roentgenogram is performed in an head-down position. The relation of the rectal cul-de-sac to the levator ani muscles is determined by its relation to the bony landmarks of the pelvis as reported by Stephens and Cremin. A real time perineal sonography is a useful complement, and permits the recognition of the same landmarks sought for by X-Ray. The research of a perineal or urinary fistula is performed at that time. In a second time, the research of associated malformations, mainly vertebral and urinary, is done.
We report one case of percutaneous extraction of an osteoid osteoma of the lumbar spine under CT guidance. We describe the procedure of nidus extraction. This technique allows precise removal of the nidus with pathologic verification after extraction.