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C Festen

Publications and source records attributed to C Festen.

At least 55 records · Page 3Linked to original sources
PubMed1990

Atypical mycobacterial infection of the parotid gland.

A localized atypical mycobacterial infection of the major salivary gland is a rare disease. In this report the cases of three patients with this lesion are presented. The diagnosis was based on the clinical picture, skin testing with specific antigens, bacteriologic culture, and histopathologic findings. The patients were successfully treated by total parotidectomy with facial nerve preservation, which in our opinion is the therapy of choice in localized atypical mycobacterial infections.

Child, Preschool↗
PubMed1990

Intussusception complicated by bowel perforation during hydrostatic reduction.

Most perforations of the bowel during attempt at hydrostatic reduction of intussusception occur in an area of localised infarction in the normal transverse or left colon. An animal model of intussusception was used to find indications for the cause of this phenomenon. We submitted the intussuscipiens of 10 strangulated intussusceptions in 6 dogs to a histological examination. In 6 of 10 intussusceptions we found ischaemic changes in the mucosa of the intussuscipiens. In 3 cases these lesions were multiple. All lesions were found in locations where there was a close contact between the intussusceptum and the intussuscipiens. We did not find signs of impaired circulation of the whole intussuscipiens. We conclude that our findings give an indication that perforation of the intussuscipiens during attempt at hydrostatic reduction occurs through areas of localised ischaemic infarction on the basis of direct pressure by the intussusceptum.

Animals↗
PubMed1990

Intussusception: factors related to treatment.

To provide guidelines for the choice of treatment of intussusception, 10 factors that are known to be related to the outcome of treatment were studied in a series of 146 children with intussusception. The length of history, vomiting, rectal bleeding, small bowel obstruction, ileoileocolic intussusception, and the presence of a leading point were all significantly related to failure of hydrostatic reduction. Only 'rectal bleeding' and 'duration of symptoms of more than 48 hours' contributed significantly to the prediction of failure of hydrostatic reduction by logistic regression analysis. We believe that as well as the generally accepted contraindications--signs of peritonitis or bowel perforation--the presence of rectal bleeding when symptoms have lasted more than 48 hours is a contraindication to hydrostatic reduction.

Adolescent↗
PubMed1989

Chronic intussusception in children.

Nine children presented with intussusception lasting for 14 days or more. Their mean age was 8.5 years. Diagnosis of intussusception was delayed considerably, probably due to an unusual presentation. Compared with acute intussusception, symptoms consist of infrequent attacks of abdominal pain, sporadic vomiting and no, or small, changes in defecation. Marked weight loss and an abdominal mass assume diagnostic significance, in contradiction to bloody stools. Ultrasonography can be of diagnostic value. An attempt at hydrostatic reduction is often unsuccessful. A high frequency of organic lesions precipitating intussusception warrants early surgical intervention.

Adolescent↗
PubMed1989

Total colonic aganglionosis: treatment and follow-up.

We reviewed the problems during diagnosis and therapy of 11 patients with total colonic aganglionosis. Better knowledge of the clinical picture and greater alertness for the occurrence of this disease has led to an earlier diagnosis. Definitive operative therapy is still controversial. After ileostomy, a crucial point seems to be the allowance of sufficient time for the small bowel to adapt its absorptive ability. Little seems to be gained by performing a difficult procedure, such as Martin's operation, which involves the risk of serious complications. Our experience confirms that a standard Hirschsprung's operation is, in general, satisfactory. At present (mean follow-up 6.7 years), all our patients show normal growth and development, have no serious peri-anal problems, and are (with one exception) continent for faeces.

Child↗
PubMed1989

Causes of late complications in children operated on for Hirschsprung's disease: a preliminary immunohistochemical investigation using polyclonal antibodies against S-100 protein.

Late follow-up of 51 children operated on for the classical form of Hirschsprung's disease showed a great many unsatisfactory results. It is well known from the literature that achalasia of the anal sphincter is one of the most important causes. Twenty-five patients underwent redilatation of the anal sphincter. Complaints in the form of obstipation or diarrhoea remained in 40% of the cases after redilatation. Reinvestigation of the resected colon specimens using the conventional histological method showed the presence of ganglion cells in the proximal resection fragment in all patients. In the light of reports in the literature stating that despite normal histology, innervation disturbances can exist in the colon, we conducted a pilot study using polyclonal antibodies against S-100 protein. In three out of four patients with an adequate resection, in accordance with the conventional histological criteria, clear innervation abnormalities could be seen with the aid of polyclonal antibody staining.

Child↗
PubMed1989

Rectal prolapse in children.

Rectal prolapse in children is nowadays a rare anomaly. Potty training in young children is the common cause and the resulting prolapse can be treated conservatively. In children with refractory prolapse, sclerosing injections may be used. Operative treatment by posterior rectopexy is only indicated in the very few cases of long-standing prolapse.

Adolescent↗
PubMed1988

Neonatal jaundice in cystic fibrosis: a conservative approach is not always justified.

Biliary obstruction due to cystic fibrosis is considered to be reversible and conservative management is recommended. We present two cases of cystic fibrosis with anatomic lesions of the extrahepatic bile ducts, necessitating operative correction. In the management of prolonged neonatal jaundice in cystic fibrosis, a conservative approach is frequently successful, but in some cases surgical intervention may be mandatory.

Bile Ducts↗
PubMed1988

Subcutaneous rheumatoid nodules.

We describe seven children with subcutaneous rheumatoid nodules who had no clinical evidence of rheumatoid arthritis. Only one girl was seropositive for antinuclear factors and had a slightly raised erythrocyte sedimentation rate. Clinical aspects, risks for developing rheumatoid arthritis, and treatment of this entity are discussed.

Child↗
PubMed1988

Enterostomy complications in infants.

A retrospective review of 48 infants, less than one year of age, with enterostomies was carried out to analyse the complications. Early complications were encountered in 3 patients (5%). Stoma complications occurred in 7 patients (14.6%) and revision was required in 2 cases. Total or near total parenteral nutrition was needed in 23 patients (48%). Of the 25 who tolerated oral feeding, 16 (64%) required extra sodium in their diet. Stoma-closure in 37 patients had a leakage rate of 8% and no mortality. Careful attention to technical details, diligent postoperative stoma care and early closure of the enterostomy if possible, seems to be the best way of avoiding complications.

Enterostomy↗
PubMed1988

Management of pediatric esophageal perforation.

Esophageal perforation is a serious complication necessitating immediate therapy. In a retrospective study we have evaluated the results in 13 children treated for esophageal perforation. Eleven of 13 perforations could be managed conservatively. In one child with extrapleural effusion, tube drainage was performed. The only death in this series occurred in a child who was brought for treatment after a 60-hour delay. Thoracotomy and multiple abscess drainage eventually proved unsuccessful. On the basis of our experience with children with esophageal perforation or with complications after esophageal atresia repair, we conclude that management of esophageal perforation in children differs substantially from therapy in adults and necessitates restrictive treatment guided by clinical symptoms.

Anti-Bacterial Agents↗
PubMed1987

Intussusception in children 5-15 years of age.

Twenty cases of intussusception in children between the ages of 5 and 15 years were compared with intussusception in infancy and early childhood. They accounted for 18.5 per cent of all 108 children treated for intussusception in two large hospitals from 1964 to 1984. Diagnosis of intussusception was delayed, probably due to an unusual presentation. Fifty-five per cent had a definite predisposing factor precipitating the intussusception and 45 per cent had a small bowel intussusception, which warranted early surgical intervention. In the absence of contraindications no child should be disqualified from an attempt at hydrostatic reduction. After hydrostatic reduction careful follow-up is required to exclude an organic lesion, possibly by a small bowel follow-through meal. Surgery is indicated after hydrostatic reduction in case of chronically recurrent abdominal complaints.

Adolescent↗