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Biomedical subjects

D C G Crabbe

Publications and source records attributed to D C G Crabbe.

7 recordsLinked to original sources
PubMed2006

Delayed diagnosis of appendicitis in children treated with antibiotics.

The diagnosis of appendicitis in children can be difficult. Misdiagnosis may result in empirical treatment with antibiotics. The aim of this study was to determine whether initial treatment with antibiotics hindered subsequent diagnosis of appendicitis. Retrospective review of 311 children treated for appendicitis between 1999 and 2004. Patients were divided into two groups: Group 1: (n = 45) received antibiotics prior to a definitive diagnosis of appendicitis. Group 2: (n = 266) did not receive antibiotics prior to a diagnosis of appendicitis. Group 1 patients were significantly younger and more likely to be female than in group 2. Abdominal tenderness was less marked and there was a greater reliance on radiological investigations in patients receiving antibiotics. C-reactive protein and pre-operative temperature were significantly higher in group 1 patients compared to group 2. The perforation rate and complication rate were significantly greater in group 1. The commonest misdiagnoses were urinary tract infection and respiratory infection. Initial misdiagnosis results in significant delay before appendicectomy. This study shows that the clinical signs of acute appendicitis can be masked by prior treatment with antibiotics. The diagnosis of acute appendicitis must be considered and, if necessary, excluded in all children seen with abdominal pain who have recently been treated with antibiotics.

Adolescent↗
PubMed2004

Tracheomalacia.

Tracheomalacia is a rare condition characterised by collapse of the trachea during respiration. The condition is seen most often in infants and young children. Mild cases can be managed expectantly; however, severe cases can be associated with life-threatening cyanotic attacks and intervention to stabilise the airway is invariably necessary. Most commonly this involves an aortopexy to suspend the anterior wall of the trachea but other options include endoluminal or extraluminal stenting, long-term positive pressure ventilation and tracheostomy. Although tracheomalacia resolves spontaneously in most infants within the first few years of life, severe tracheomalacia is associated with significant morbidity and mortality that should not be underestimated.

Cartilage Diseases↗
PubMed2003

Pectus deformities of the anterior chest wall.

Pectus deformities affect about 1% of the population. Despite a subjective reduction in exercise tolerance, objective physiological disturbance is very uncommon. However, there is no doubt that cultural changes have significantly altered perception and tolerance of these deformities and increasing numbers of children are actively seeking surgery. Pectus excavatum is readily amenable to correction using minimally invasive techniques and pectus carinatum can be corrected using safe established conventional techniques. Good or excellent results can be expected in over 90% of cases, and children should no longer be denied treatment.

Funnel Chest↗
PubMed2003

Isolated tracheo-oesophageal fistula.

Congenital isolated tracheo-oesophageal fistula is a rare malformation that presents with a characteristic triad of symptoms: choking and cyanosis on feeding, recurrent lower respiratory tract infection and abdominal distension. Children are invariably symptomatic from birth, although the symptoms may be intermittent and may vary in severity. A high index of suspicion is required because the symptoms are not specific. Establishing the diagnosis can be difficult and neither radiology nor bronchoscopy is infallible. Surgical division of the fistula is curative.

Bronchoscopy↗
PubMed2002

An unusual left-sided abdominal-wall defect.

Gastroschisis is a congenital abdominal-wall defect (AWD) that typically occurs to the right of the umbilicus. Rarely, a mirror variation of the above may occur with a defect to the left of the umbilical cord. This report concerns a neonate born with an unusual AWD in the left upper quadrant, distant from an intact umbilicus.

Gastroschisis↗
PubMed2002

Handlebar hernia masquerading as an inguinal haematoma.

We report a child who sustained a traumatic hernia of the lower abdominal wall after being thrown forward against the handlebar of his bicycle. This is a rare injury in children, and the clinical features mimic an inguinal haematoma. Suspicion should be raised by the immediate appearance of a mass above the inguinal canal following groin injury, particularly if the swelling then disappears with the patient supine.

Abdominal Injuries↗