Search PubMed⌕ Search

Biomedical subjects

D J Alton

Publications and source records attributed to D J Alton.

36 records · Page 2Linked to original sources
PubMed1988

Transient opacification of the urinary pathways by amorphous debris in children with leukemia.

Our index patient, a 14-year-old male on chemotherapy for acute lymphatic leukemia had extensive opacification of the urinary tract on the preliminary film for an intravenous urogram. Sonography and computed tomography also demonstrated dense material in the calyces, renal pelves and ureters. Since then, we have found another patient, a 9-year-old female with acute lymphatic leukemia who was not receiving chemotherapy, with a similar pattern on sonography and computed tomography. These densities unlike those in our first patient were not visible on a plain film of the abdomen. All of the material disappeared spontaneously in both patients.

Adolescent↗
PubMed1988

John Caffey Award. Intussusception reduction in children by rectal insufflation of air.

Air was used as the contrast medium for colonic studies in 282 patients with suspected intussusception. Intussusception was documented in 118 of these patients (42%), and reduction was achieved in 89 (75%) of those 118. Twenty-nine patients, in whom the intussusception could not be reduced with air, underwent surgery. Seven of these patients required surgical resection of devitalized bowel. In seven others, the intussusception was reduced by the surgeon with difficulty; in 12, surgical reduction was achieved easily. Three perforations occurred with the use of air. These patients were treated surgically without sequelae. This pilot study of 282 patients suggests that air is a safe substitute for hydrostatic reduction of intussusception.

Administration, Rectal↗
PubMed1986

Prolapse of an ectopic ureterocele into both urethra and ipsilateral orthotopic ureter.

Ectopic ureteroceles frequently prolapse into the urethra. Inversion of ureteroceles into their own ureters has also been described. This patient showed a ureterocele which not only prolapsed into the urethra but also into the ipsilateral orthotopic ureter. We have not seen nor found a description of prolapse of a ureterocele into the ipsilateral orthotopic ureter.

Humans↗
PubMed1983

Acquired renal scars in children.

To determine the important factors involved in the etiology of renal scarring we studied 37 children with renal scars seen at our hospital since 1965. This is the second largest series reported to date. Children who had neurogenic bladders or any structural abnormalities of the urinary tract other than vesicoureteral reflex were excluded. The study group included 36 girls and 1 boy. The average age at first detection of renal scars was 5.7 years. Acute pyelonephritic episodes, which were treated early and aggressively, infrequently led to renal scarring. However, the initial prolonged or poorly treated episode of acute pyelonephritis was followed invariably by the development of renal scarring. The severity of renal scarring was related to the grade of vesicoureteral reflux (p less than 0.05), although some scars did develop in the absence of reflux. Neither the shape and position of the ureteral orifice nor the ureteral tunnel length correlated with the severity of renal scarring. Treatment with prophylactic antibiotics may have lessened the severity of renal scarring (0.1 less than p less than 0.2) but treatment with reimplantation surgery did not appear to alter the course of renal scarring. This study suggests that the key to the prevention of renal scarring is the early and aggressive treatment of acute pyelonephritis.

Adolescent↗
PubMed1982

Unusual renal distortion and displacement due to the spleen.

Occasional normal anatomic variations may produce radiographic appearances that closely simulate disease and visceral enlargement may cause unusual displacements of adjacent organs. Two cases are reported in whom prominent splenic lobulation caused flattening of the upper pole of the left kidney. The appearance simulated that produced by a supra-renal mass. The value of CT in differentiating this normal variation from disease is discussed. A third patient in whom massive splenomegaly caused upward displacement of the left kidney is also reported. The literature concerning visceral relationships in the left upper quadrant and the normal variations that simulate disease is reviewed.

Adolescent↗
PubMed1982

Radiologic investigation of the urinary tract in the neonate with myelomeningocele.

A significant number of neonates with myelomeningocele are born with potentially damaging abnormalities of the urinary tract. Therefore, it is logical to investigate these patients aggressively and initiate therapy as early as possible to preserve renal function and maintain lower tract integrity for future continence management. Results of excretory urograms and voiding cystourethrograms were reviewed in 68 consecutive neonates with myelomeningocele. They indicate clearly that only a third of the patients with normal excretory urograms had a normal voiding cystourethrogram, which implies that both studies be performed for complete evaluation of the urinary tract. In other words, of these 68 patients 55 (80.9 per cent) had a normal excretory urogram but only 17 (30.9 per cent) had a normal voiding cystourethrogram. Of the 13 patients (19.1 per cent) with an abnormal excretory urogram 12 (92.3 per cent) had an abnormal voiding cystourethrogram. Reflux occurred in 16.2 per cent of patients; 6 of 7 patients with grade II reflux and 1 of 3 patients with grade III reflux had a normal excretory urogram.

Humans↗
PubMed1981

Prolapsing ectopic uretroceles in boys.

Five cases of prolapsing ectopic ureterocele are described. All five patients were boys and all had duplex kidneys; in four cases this duplication was bilateral. There was significant obstructive uropathy in all of the cases. It is easy to overlook the diagnosis of prolapsing ectopic ureterocele or to misdiagnose the condition as posterior urethral valves. The importance of careful cystourethrographic evaluation is emphasized.

Child↗
PubMed1980

Renal function in continent patients after surgical closure of bladder exstrophy.

We assessed the upper urinary tracts and renal function in 22 children who had achieved continence after staged correction of bladder exstrophy. All patients had been followed for an average of 8 years after completion of the reconstructive operation. In 15 patients the upper urinary tract was normal and only 1 of the remaining 7 required surgical correction (transureteroureterostomy) of the residual anomaly. Renal function was normal in all children. We attribute these satisfactory results to careful selection of patients, improved surgical techniques and good postoperative care.

Adolescent↗
PubMed1980

Adrenal hemorrhage in neonates: report of 5 cases and review of the literature.

The differential diagosis of masses in the suprarenal area in neonates is discussed in relation to clinical, laboratory and radiologic findings. Neonatal adrenal hemorrhage can be accurately diagnosed clinically. In the neonate neuroblastoma in situ is self-limiting and exploration to exclude it is unnecessary. Operative intervention should be reserved for controlling massive adrenal hemorrhage or if an abscess forms.

Adrenal Gland Diseases↗
PubMed1980

Primary hydronephrosis. Assessment of diuretic renography, pelvis perfusion pressure, operative findings, and renal and ureteral histology.

Hydronephrosis generally implies ureteropelvic junction obstruction, but may be mimicked by a variety of other disorders. The authors have attempted to determine the relative diagnostic value of diuretic renography and the pelvis perfusion test in children with hydronephrosis by correlating the results with operative findings, renal and ureteral histology, and postoperative results.

Child↗
PubMed1979

Crossed fused renal ectopia.

An unusual form of crossed renal ectopia is presented. Both kidneys are at the same level on the same side with fusion throughout their entire lengths.

Humans↗
PubMed1977

Pelviureteric obstruction in childhood.

Pelviureteric junction obstruction is a common cause of intra-abdominal mass in childhood. The diagnosis is usually apparent when the characteristic signs of obstruction are seen at intravenous urography. A voiding cystourethrogram should be performed to exclude vesicoureteral reflux as the underlying condition. Obstruction may be further assessed by a diuretic load or by pressure-flow studies.

Adolescent↗