Biomedical subjects
Publications and source records attributed to G Gaisie.
Spontaneous pneumothorax as the initial manifestation of cystic adenomatoid malformation of the lung is rare. Only four cases have been reported in the English literature. We add one more case, and review the clinical and roentgenographic findings. All the patients presented later in infancy or childhood and the cyst type appear to belong to Madewell's dominant cyst type.
Complications in voiding cystourethrography are infrequent and may include infection, catheter-induced trauma, bladder rupture, and allergic reaction to contrast. We report a case in which the catheter formed a knot within the bladder lumen. To our knowledge, this is the first complication of this type to be reported. We believe this particular complication can be avoided by inserting a catheter within the bladder lumen short enough to prevent looping and possible knot formation.
Three patients with late-onset Bochdalek's hernia are presented. All three had obstruction of the herniated bowel and, in two patients, this was complicated by strangulation and necrosis. The spectrum of roentgenographic manifestation included obvious findings of bowel in the chest in one patient; in another, the findings simulated pneumonia associated with reflex bowel ileus in the abdomen. The third patient had a massive pleural effusion, with what appeared to be associated bowel ileus. In spite of the misleading presentation it is imperative that the correct diagnosis be made early since the incidence of strangulation and severe morbidity is high.
Computed tomography was used to examine the three paraspinal interfaces (lines), consisting of the right and left paraspinal areas and the prespinal area in the lower thorax in 20 children. The abnormal CT findings were correlated with plain radiographic findings. The various disease contributing to paraspinal abnormality included malignant and benign neoplasm and inflammatory disease. Neuroblastoma was the most common entity. Fourteen of 20 patients had paraspinal masses representing either metastasis or lymphoma. Four had small pleural effusions and two had a combination of small pleural effusion and masses. Plain radiographs also showed the paraspinal masses, except in the prespinal area, where four of seven abnormalities seen with CT were not detected with plain radiographs. CT also better demonstrated the extent of involvement than did plain radiography.
We present two cases of benign retroperitoneal lipomas in children. Intravenous urography in both revealed large masses of fat density displacing the ipsilateral kidney superomediad. Angiography in one showed an avascular mass. The other patient had a markedly echogenic mass with indistinct margins on ultrasonography, and a computed tomographic scan confirmed the fatty composition of the tumor. Nineteen previously reported cases of retroperitoneal fatty neoplasms in children are reviewed. The urographic findings of a radiolucent mass displacing the ipsilateral kidney or ureter are highly specific for retroperitoneal lipoma and usually obviate the need for additional imaging procedures.
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A study of 29 neonates with intestinal obstruction has shown that a massively dilated, bulbous terminal segment of bowel is characteristic of neonatal infestinal obstruction of congenital origin. The sign is an important diagnostic indicator but its absence does not exclude intestinal atresia.
Abnormalities of neural crest development may be manifested in a wide variety of ways ranging from von Recklinghausen's disease to Sipple's syndrome -- pheochromocytoma and medullary thyroid carcinoma. We report here yet another manifestation -- coexistent multiple neuroblastomas and Hirschsprung's disease in a newborn. In a review of the English literature we have found the combination of neuroblastoma and Hirschsprung's disease recorded only once previously [2]. However, the relationship between the two diseases was not discussed. The two diseases may be at the extremes of a spectrum of neural crest development pathology, i.e., Hirschsprung's representing a deficiency and neuroblastoma representing malignant proliferation of cells of neural crest origin.
Measurement of femoral torsion by ultrasound was compared with measurements by standard roentgenographic techniques in a femoral model and in a clinical study. Magilligan, Ryder-Crane, and fluoroscopic determinations on the femoral model demonstrated acceptable interobserver and intraobserver variance. With high degrees of femoral torsion, ultrasound readings were less accurate and significantly lower than the actual angle of femoral torsion. In the clinical study, ultrasound measurements were compared with Magilligan measurements in 29 hips. Similar to the model, ultrasound readings were lower and discrepancy was greater at higher angles of torsion.