[What does sonography contribute to the diagnosis of upper abdominal diseases in childhood?].
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Child↗
Biomedical subjects
G Alzen
Publications and source records attributed to G Alzen.
[On the importance of B-scan-ultrasound for the diagnosis of nephrological and urological diseases in childhood (author's transl)].
Kidneys of 118 children of all age groups, and of 2 adults were investigated by means of senography. Normal kidneys could be identified on account of a typical echo-pattern. Deviations from this pattern were interpreted as evidence for pathological changes in the kidneys; they were correlated to the radiological and in some cases to the pathologic-anatomical findings. Typical deviations of the echo-pattern were found in cases of hydronephrosis, duplex kidneys, duplex kidneys in combination with hydronephrosis, polycystic renal diseases and other renal diseases. It was even possible to demonstrate decrease and increase of hydronephrosis by means of sonography. Indications for the application of this method are pointed out. In addition its accuracy and importance in relation to other diagnostics methods are discussed.
Adolescent↗
CO2 spray mini-injector for digital subtraction angiography versus PC-controlled injection system: experiments in dogs.
A personal computer (PC)-controlled CO2 injector (consisting of a pneumatic unit, electric/electronic system, and calculator) and a spray mini-injector (consisting of a CO2 spray can and a dosage chamber) were used in 10 dogs to determine their efficacy regarding imaging quality and ease of handling. CO2 was injected into the abdominal aorta, renal artery, and femoral artery. The vessel diameter was determined on each CO2 arteriogram and compared with that determined on a reference arteriogram obtained using an iodinated contrast agent. The filling ratio (CO2/iodine) was calculated for each set of injection parameters. Both injection systems provided good visualization (filling ratio > 0.9) of large and small arteries within a range of injection parameters. In terms of practicality, the spray mini-injector is more appealing, because it is easier to handle and does not require any preparation.
Aerosols↗
CT-guided percutaneous large-bore biopsies in benign and malignant pediatric lesions.
Thirty-nine consecutive pediatric patients underwent large-bore biopsies of 41 lesions under computed tomography (CT) guidance; general anesthesia was not required. Adequate material was obtained in all patients. There were no false-negative or false-positive results. Typing accuracy was 100% in malignant disease and 92% in benign lesions. No significant complications occurred. Percutaneous large-bore biopsy is a safe, reliable, and time-saving method that obviates the need for open surgery and general anesthesia in the diagnosis of primarily non-resectable lesions, or lesions that do not require resection. Another major advantage over open surgery in malignant disease is the absence of delay in starting urgently needed chemotherapy.
Adolescent↗
[Wilson-Mikity syndrome as a cause of respiratory insufficiency of prematurity].
The Wilson-Mikity syndrome is a differential diagnosis of chronic lung disease in the neonate and primarily related to immaturity. It is characterized by the absence of typical clinical and radiological findings of the respiratory distress syndrome (RDS). Infectious causes are being discussed.
Bronchopulmonary Dysplasia↗
[Hereditary deficiency of C1-esterase inhibitor presenting with recurrent abdominal pain].
Hereditary deficiency of C1-esterase inhibitor (C1-INH) which clinically manifests as hereditary angioedema is a rare disorder. In previously not diagnosed cases, a fatality rate of up to 30 % has been reported. The diagnosis of C1-esterase inhibitor deficiency should not be missed in patients presenting with angioedema in the face, stem or extremities. We report the case of a 17-year-old girl with recurrent abdominal pain and swelling of the hands.
Abdominal Pain↗
[Congenital, solitary hepatic cyst: Observation of the development from birth upon the intervention in the 5th year of life].
BACKGROUND: Sonographic screening helps to discover pathological findings in asymptomatic patients. In these cases the decision about diagnostic and therapeutic consequences is difficult. CASE REPORT: We describe a girl with a congenital small solitary hepatic cyst with rapidly increasing size after the second year, which was interventionally sclerosed at the age of five years. CONCLUSION: Even in cases of small cysts long term follow up investigations are necessary, because the growth rate of the cyst can change.
Age Factors↗
[Small bowel intussusception in childhood].
BACKGROUND: Intussusception is the most common cause of abdominal emergency in early childhood. The majority of cases are ileocolic type of intussusception. Only few reports concerning small bowel intussusception have been reported. PATIENTS AND METHOD: We retrospectively reviewed the clinical records and imaging findings of all patients with the diagnosis of intussusception (comparing small bowel intussusception with ileocolic type of intussusception), which were documented by ultrasound in the period April 1997 to January 2001. The routine ultrasound scans included an evaluation of the entire abdomen using sector and linear transducers of high frequency (5 - 7.5 MHz) and power doppler ultrasound. RESULTS: A total of 22 patients with small bowel intussusception (9 female, 13 male) and 29 patients diagnosed to suffer from ileocolic intussusception (10 female, 19 male) were identified and treated. Children with small bowel intussusception were significant older in comparison to children with ileocolic type of intussusception (median age 50 vs. 11 months). In our series the presenting symptoms of patients with small bowel intussusception consisted of abdominal pain (86 %) and vomiting (36 %). The initial clinical symptoms of patients with ileocolic intussusception were abdominal pain (100 %), vomiting (72 %) and/or rectal fresh blood (35 %). Small bowel intussusception was an incidental finding in 3 asymptomatic patients (14 %). Hydrostatic reduction was attempted in 14 % of children with small bowel intussusception (vs. 93 % of children with ileocolic intussusception), one patient needed operative treatment (vs. 21 %). Outcome in all patients was favorable. CONCLUSION: The high percentage of patients with small bowel intussusception observed may relate to increased use of abdominal ultrasound in children presenting with abdominal pain and improvements in resolution and quality of the images. Small bowel intussusceptions in our series were in the majority of cases short-segmented, self-limited and without a lead point. In comparison to patients with ileocolic intussusception the presenting symptoms of small bowel intussusception are less acute.
Abdomen, Acute↗
[Percutaneous sclerotherapy of varicocele--results in children and adolescents].
65 percutaneous transvenous sclerotherapy of the internal spermatic vein in 58 children and adolescents with varicoceles are reported. Their age ranged from 9.4 to 18 years (mean 14.7 years). The success rate of the sclerotherapy amounted 91.4% while 8.6% recidivations were seen. In three patients slight complications occurred (2 extravasations, 1 spasm of the spermatic vein) which required no further therapy. By repeating the sclerotherapy finally 94.8% of the patients were treated successfully.
Adolescent↗
[Percutaneous catheter extraction of a ruptured Port-A-Cath in a small child].
A male child with protein-losing enteropathy received the completely implanted venous access catheter "Port-A-Cath" (Pharmacia Co.) at the age of 13 months for the regular application of human albumine infusions. After 12 months of impeccable functioning the catheter ruptured. By means of a percutaneous transfemoral angiographic extraction the catheter fragment was removed from the right ventricle.
Catheterization, Central Venous↗
[Intestinal infection, the most frequent cause of invagination in childhood: results of a 10-year clinical study].
BACKGROUND: Intussusception is the most common cause of an acute abdomen in early childhood. 90% of all intussusceptions were thought to be idiopathic, because no lead points could be evaluated. PATIENTS: In our study we examined 148 children (93 boys and 55 girls) between 2. month and 18. years of age with 155 intussusceptions. METHOD: Besides epidemiological features and patients history we determined systematically all symptoms which occurred since the beginning of sickness. We performed ultrasound examinations before and after hydrostatic reduction with each child in order to find pathologic lead points. Microbiologic stool examination could be carried out at 99 specimen. RESULTS: 41 of 155 children with intussusception (26.5%) showed a pathologic finding next to the intussusception, with 29 children (18.7%) suffering from mesenteric lymphadenitis. 60.6% of examined stool specimen were abnormal. The most common germs were adenovirus, yersinia and staphylococcus aureus. Abdominal pain was the main symptom and was found in 72.6% of all children. 21% suffered from the classic trias abdominal pain, vomiting and rectal bleeding. 21.9% had diarrhea and 18% fever and signs of inflammation as unspecific symptoms. CONCLUSIONS: In our study we found mesenteric lymphadenitis as the most common lead point in intussusception. In conclusion with 60.6% pathologic germs in the examined stool specimen we assume gastrointestinal infection as the main cause of intussusception in childhood.
Abdomen, Acute↗
[Ultrasound screening of vesico-uretero-renal reflux].
A prospective study of detecting vesicoureteric reflux (VUR) by ultrasound is to be presented. In case of reflux, gas bubbles can be seen in the renal pelvis during the filling phase of a gas cystogram and during micturition, utilizing ultrasound as the imaging modality. In children under two years 52 sonographic reflux studies were performed and compared with radiographic voiding cystourethrograms (VCUG). All higher grade VUR (grades II-IV) have been detected by our method.
Female↗