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Biomedical subjects

D Filiatrault

Publications and source records attributed to D Filiatrault.

At least 55 records · Page 3Linked to original sources
PubMed1987

Investigation of childhood blunt abdominal trauma: a practical approach using ultrasound as the initial diagnostic modality.

During a 5.5-year retrospective study (1979-84) 170 children with blunt abdominal trauma were investigated with intravenous urography (IVU), ultrasound (US) and scintigraphy. For the investigation of the last 71 children (after 1982) a 4th generation CT scanner was available in the same department. The results of radiologic investigations were compared with clinical outcome in 157 and results at laparotomy in 13 children. During the study period, real time US became the first line screening tool, and was combined with IVU in suspected renal trauma. In spite of permanent accessibility of CT since November 1982, the latter was used only in complex diagnostic problems or in children with multiple injuries (8% of the series). There were no deaths resulting from abdominal trauma. During the study, the incidence of splenectomy and exploratory laparotomy decreased, and no diagnostic peritoneal lavage were performed after 1980.

Abdominal Injuries↗
PubMed1986

Intrarenal epidermoid cyst.

Epidermoid cyst is a very unusual cause of renal mass. Only two cases have been reported in the English or French literature. We have encountered this entity in a 4-year-old Haitian boy investigated for urinary frequency. This diagnosis must be included in the differential of coarse calcified intrarenal masses.

Child, Preschool↗
PubMed1986

CT localization of an aldosteronoma in a 10-year-old boy.

Primary aldosteronism in children under 16 years of age is usually due to adrenal hyperplasia. We could find only seven cases in the literature where it was caused by a solitary adrenal adenoma; all but one were female. We describe the case of a 10-year-old Caucasian boy in whom a unilateral adrenal adenoma was demonstrated by high resolution computed tomography (CT) alone. The literature is reviewed.

Adenoma↗
PubMed1986

Sonography of neck masses in children: is it useful?

111 patients aged two days to 20 years with neck masses were examined by ultrasound. Results were compared to subsequent histo-pathological or clinical diagnosis. Sonography allowed us to divide neck masses into two groups, a sonospecific group in which an accurate presurgical diagnosis was made in 92%, and a non-sonospecific group. The sonospecific group contained 48 patients and included thyroid masses, cystic hygromas, certain cases of adenopathy and a cervical myelomeningocele. The non-sonospecific group contained 63 patients and included a variety of neck masses such as dermoid cysts, branchial cleft cysts, the majority of cases of adenopathy, hemangiomas, lymphangiomas and various other neoplastic masses. Sonography serves to delineate the extent of neck masses, define the relationship of the mass to the thyroid and major neck vessels and guide fine needle aspiration biopsy.

Adolescent↗
PubMed1986

Urinary tract dilatation in utero: classification and clinical applications.

A morphologic classification of in utero urinary tract dilatation is presented. Ninety-two hydronephrotic fetal kidneys diagnosed with ultrasound were graded according to the proposed classification. The findings suggest that grade I dilatation (anteroposterior diameter of the renal pelvis less than 10 mm) should be considered normal. Grades II and III constitute an intermediate hydronephrosis, requiring postnatal urologic surgery in nearly half the cases. Grade IV (moderate dilatation of the calyces, with easily identified residual renal cortex) and grade V (severe dilatation of the calyces with atrophic cortex) are clearly pathologic and require neonatal corrective surgery. It is hoped that use of this simple and practical classification will facilitate communication and comparison of results in the literature.

Dilatation, Pathologic↗
PubMed1986

Ureteropelvic junction stenosis: antenatal ultrasonographic diagnosis, postnatal investigation, and follow-up.

Between January 1981 and October 1984, the diagnosis of ureteropelvic junction (UPJ) stenosis was suspected in 39 fetuses after routine obstetrical ultrasound (US) examination. Postnatal investigation revealed that the initial diagnosis had been accurate in 30 cases (77%). There were 35 UPJ stenoses in 30 patients. The degree of dilatation of the renal pelvis (grades III, IV, or V) observed postnatally with sonography as well as the obstructive excretory pattern noted by renal isotope scanning were used as criteria to determine the need for early postnatal pyeloplasty (performed in 25 patients), which relieved the obstruction and, in the majority of patients, improved renal structure and function.

Diuresis↗
PubMed1985

Urinary milk of calcium in children and adults: use of gravity-dependent sonography.

Fifteen cases with urinary milk of calcium (UMC) are presented, all of them secondary to urinary obstruction: ureteropelvic junction stenosis (three cases), staghorn calculus (two), caliceal diverticulum (five), and pyelogenic cyst (five). Four patients (aged 7-19) are the youngest with this affliction reported to date. Milk of calcium proximal to a staghorn calculus has not been described previously. Gravity-dependent sonography was the most efficient and sensitive method of diagnosis. Follow-up of 1-16 years showed the formation and gradual increase in the quantity of UMC without evidence of gross calculus formation within the milk. In two patients, there was spontaneous, partial drainage of UMC.

Adolescent↗
PubMed1985

[Subpleural lipoma in children].

Primary extrapleural intrathoracic tumors are extremely rare in the pediatric patient. The authors report one observation of intrathoracic subpleural lipoma in five-year-old asymptomatic girl. A thoracic CT-Scan was particularly helpful by demonstrating the homogeneous fatty nature of the mass, the density of-120 Hounsfield Units being specific. This allowed us to limit ourselves to a brief non-invasive diagnostic workup. Complete surgical excision is curative and provides histological certainty about the benign nature of the tumour. It remains the current recommended approach.

Child, Preschool↗
PubMed1984

Urinary tract infection in children. A reappraisal of its radiologic investigation.

In a prospective study, 100 children with either an acute or a previous history of urinary tract infection were investigated by intravenous urography, micturition cystourethrography, and ultrasonography. The results from the three diagnostic modalities were compared: The urinary tracts in 59 patients were normal, and revealed some abnormality in 41. Ultrasonography proved to be superior to intravenous urography in outlining renal contours and in detecting subtle cortical changes secondary to urinary tract infection (such as slight increases in cortical thickness and edema or cortical scarring). The mucosa of the renal pelvis and bladder was more easily assessed by ultrasound than by intravenous urography. Both modalities were "equally" accurate in detecting important congenital malformations of the urinary tract. Ultrasound failed to detect 24 of 28 ureters demonstrating reflux on voiding cystourethrography. We propose that carefully performed abdominal ultrasonography can replace intravenous urography in the initial investigation of urinary tract infection in children. It should be done in association with a radiographic or radionuclide voiding cystogram. Intravenous urography would then become a complementary examination for abnormal or problematic patients.

Adolescent↗
PubMed1984

[Echography of pyloric stenosis].

In order to assess the accuracy of ultrasonographic (US) criteria for the diagnosis of pyloric stenosis (PS), the record of 78 infants admitted to Hôpital Sainte-Justine with the clinical diagnosis of PS during the past year was reviewed. Fifty-eight patients had PS at laparatomy. Thirty-four of these had US with 30 true positives and four "doubtful" findings. Twenty-two had normal US. Two of these had PS, nine gastroesophageal reflux and five normal barium studies of the upper gastrointestinal tract (the last six were followed clinically and remained well). The following were criteria for US diagnosis of PS: pyloric anteroposterior diameter greater than or equal to 1.5 cm, length greater than or equal to 2 cm or a muscle thickness greater than or equal to 4 mm. This series contains no false positive US studies and two false negatives, for a positive predictive accuracy of 94% and a negative predictive accuracy of 100% when we measure the length greater than or equal to 2 cm or combine a length of less than or equal to 2 cm with a muscle thickness greater than or equal to 4 mm.

Female↗
PubMed1984

[The role of echography in splenic injuries in children].

We have reviewed 39 cases of ruptured spleen in children from 1979 to march 1983 at Ste-Justine Hospital in Montreal. We were mainly interested in the role of ultrasonography, its value and limitations. The practical management is exposed. To the best of our knowledge, it is the first report of this kind in pediatrics.

Child↗
PubMed1984

[Splenic injuries: therapeutic orientation. Apropos of 46 cases].

Between 1979 and june 1983, 46 splenic trauma, with or without associated lesions, have been treated at Sainte'-Justine's Hospital. 8 children had a splenectomy, 3 had a laparotomy for other lesions without a splenectomy was done. 35 had a non operative management of splenic trauma. The ultrasound shows the splenic lesions and the blood in the peritoneal cavity. So, the "Routine Abdominal TAP" does not seem necessary in every abdominal trauma. The splenic scintigraphy is, for, now, the best exam to confirm the diagnosis and to assess the resolution of splenic lesion in 1 to 4 months. Transfusions were done in 8 of 11 operated patients and in 11 of the 35 children wo underwent a conservative management. The average stay in the hospital was 11 days in these 35 last patients. No mortality or morbidity were in relation with the conservative management in our series. The exact diagnosis of splenic trauma by ultrasound and scintigraphy allows the pediatric surgeon to choose a non operative treatment, when the child has stable vital signs. Monitoring these patients in intensive care unit is mandatory and allows a careful evaluation of the course of these splenic trauma.

Adolescent↗