Biomedical subjects

G Menardi

Publications and source records attributed to G Menardi.

At least 55 records · Page 3Linked to original sources

PubMed1986

[Sonographic monitoring in blunt abdominal injuries in children].

Sonography is nowadays the most important examination in diagnosing lesions of the parenchymatous organs after blunt abdominal trauma. Also for monitoring this method is recommended. Under the premises of 1. no clinical deterioration, 2. the possibility for repeated ultrasound investigations, and 3. readiness to operate at any moment it is possible to treat traumatized parenchymatous organs conservatively. This is of utmost importance in paediatric surgery because of the risk of overwhelming postsplenectomy infection after splenectomy especially for young children. Examples for conservative treatment for trauma to spleen, liver and kidney are discussed.

Abdominal Injuries↗

PubMed1986

[Treatment of gastroduodenal ulcers in children].

Gastroduodenal ulcers are probably no rarity in children. Clinically relevant are only those showing complications: either bleeding or perforation. They should be taken into consideration in the differential diagnosis of vague or chronic abdominal pain. Endoscopy is a reliable way of examination. Treatment should be conservative, leaving surgical therapy only for unmitigable bleeding, perforation and failing conservative management. The treatment of 34 children (in an age between one day and 14 years) is discussed. 26-17 of whom had bleeding ulcers--were treated conservatively, 8 had to be operated upon. 5 children suffered from a relapse (2 with bleeding), but conservative therapy led to the lesion's healing in these cases.

Adolescent↗

PubMed1986

Closure of gastroschisis by mesh skin grafts in problem cases.

Closure of gastroschisis can be achieved by primary adaptation of the abdominal wall, by implanting a dura patch or by covering the protruding gut with a silastic pouch. In the Pediatric Surgical Department of the University of Innsbruck this last method was used in 14 of 18 cases during the last 8 years. In three children multiple complications and infection resulted in the necessary removal of the silastic pouch from the still protruding gut. Lacking any other alternative, the defect was covered with mesh skin grafts, which took well and permanently closed the abdominal wall.

Abdominal Muscles↗

PubMed1986

Computer-tomographical appearances of the Chiari malformations of the posterior fossa.

The computer-tomography appearances of the Chiari I-III malformations are reviewed. The study is based on a series of 35 cases of Chiari I malformation, 116 cases of Chiari II malformation, and one case of Chiari III malformation. In our experience, a reliable diagnosis of all three types of malformation is possible on computer tomography. However, nuclear magnetic resonance imaging does reveal more detail and may become more important in the diagnosis of malformations of the posterior fossa structures.

Arnold-Chiari Malformation↗

PubMed1986

[Ischemic damage of the testis as a complication of incarcerated hernia in the infant].

The possibility of atrophy of testicular tissue after torsion of testis is well known. To a lesser extent it is known that an incarcerated inguinal hernia carries the risk of ischemia of the testis by pressure on the testicular vessels. Incarceration of an inguinal hernia is most common in premature and young babies. When it occurs a reposition should be tried, but, if unsuccessful an urgent operation is indicated. Between 1979 and 1983 we operated on 36 boys under the age of one with an unreducible inguinal hernia. As sign of partial or total tissue destruction the follow-ups showed a smaller testis on the operated side in five cases and a total atrophy in four cases. Early operation of inguinal hernias in babies seems to be the best prophylaxis of this above mentioned complication of an otherwise rather harmless anomaly.

Child, Preschool↗

PubMed1985

Conservative treatment of gastroesophageal reflux and hiatus hernia.

Gastroesophageal reflux is a frequent occurrence in infancy. Most frequently, gastroesophageal reflux (GER) is due to a functional disturbance and lack of coordination of esophageal motility and lower esophageal sphincter incompetence. Vomiting is the sole symptom in the great majority of infants and responds readily to postural and dietary therapy. A malposition and defective fixation of the cardia and abdominal esophagus is the pathophysiologic substrate of hiatus hernia. Although most patients with hiatus hernia have GER, hiatus hernia is only symptomatic with concomitant GER. Differentiation between hiatus hernia and GER should therefore be dispelled. Treatment of hiatus hernia with GER is directed towards placing the patient in an upright position, even 24 h a day if necessary in a patient severe symptoms. The duration of therapy can be weeks to months. Small, frequent feedings are of additional importance, while thickening of formula with cereals were found unnecessary. Over the last few years, we have been able to observe 22 infants under 1 year of age with GER and hiatus hernia. In 19 of these patients-among them also patients with reflux esophagitis-this conservative treatment regimen has been successful. Drugs like antacids or cimetidine to lower gastric were considered unnecessary. Bethanechol was considered contra-indicated due to its discomforting side effects in infants. Three patients have been treated surgically during this period of time. In contrast, hiatus hernia in older children-mainly mentally retarded children-with GER has to be treated surgically; conservative therapy is usually without effect. The rare clinical condition of brachyesophagus is considered a malformation and requires surgical therapy in every instance.

Esophagus↗

PubMed1985

Late results after operations for hiatus hernia.

Thirty-two children with gastroesophageal reflux were operated by different techniques which included Nissen's fundoplication in 14 patients. Twenty-one patients could be reexamined, eighteen of whom were without complaints. Being familiar with different operative techniques provides the opportunity to decide from case to case which one to choose.

Adolescent↗

PubMed1985

[Thromboembolism complications in ventriculo-atrial drainage of cerebrospinal fluid in childhood].

This report wants to call attention to the possible risks of thromboembolic complications of ventriculo-atrial shunts (Spitz-Holter valve). Among 126 children with ventriculo-atrial shunt we found four patients with severe thromboembolic complications. Two children died. The diagnostic and therapeutic possibilities are mentioned. Prophylaxis (prevention of infection, anticoagulation therapy and frequent followup investigation) is discussed; especially echocardiography is very useful for the early discovery of thrombotic deposits on the atrial catheter.

Cerebrospinal Fluid Shunts↗

PubMed1985

Follow-up studies in 50 totally colectomised children.

We report on 50 totally colectomised children, most of whom suffered from Hirschsprung's disease. Of the 50, one child died postoperatively of enteritis. On an average, the children were re-examined 5 1/2 years after the colectomy. The findings were as follows: With the exception of four, the size and weight of the patients were within the norm; 20 passed frequent stools of pulpy consistency; 16 suffered from disturbances of continence; 14 developed severe, partially recurrent enteritis. We did not find any advantage of a single method of operation, e.g. Martin's operation.

Adolescent↗

PubMed1985

[Acute abdomen in leukemias in childhood].

During the last years the treatment of acute leukemia became more successful thanks to aggressive chemotherapeutic regimen. There are nowadays about 70% long term survivors in the literature. On the other hand, complications and infection rate following such an aggressive treatment increased. We found in our patients an accumulation of acute abdominal complaints, mostly due to an acute appendicitis. Eight patients had to undergo appendectomy. We tried to answer the question whether there is a correlation between complications and the intensity of chemotherapy. The indication for operation was always proven to be correct, and no patient was lost in the postoperative course.

Abdomen, Acute↗

PubMed1984

Bioavailability of oral antibiotics in children with short-bowel syndrome.

Absorption of orally administered antibiotics (two aminopenicillins, cephalexin, trimethoprim-sulfa) was investigated in five children with sizeable resection of small bowel in the neonatal period. The absorption was proportional to the length of the remaining bowel and independent from the resected part of the gut. For cephalexin and trimethoprim a reduction of the absorption of 10% to 50% was observed, still resulting in therapeutic serum concentrations. The absorption of aminopenicillin was reduced approximately 10% of the usually achievable concentrations. Our data suggest that oral cephalexin and trimethoprim-sulfa can be used therapeutically in children with short-bowel syndrome. If aminopenicillin is indicated, parenteral therapy is advisable.

Administration, Oral↗

PubMed1984

[Possibilities of ascites draining in childhood].

Children with congenital or acquired cirrhosis of the liver may lead a relatively normal life for a certain time due to better therapeutical measures, but the prognosis is usually unfavourable. Transplantation of the liver seems to become a possible therapy in the foreseeable future. It may be necessary to drain an ascites resistant to therapy in order to bridge the time between the onset of liver failure and transplantation. The advantages of peritoneo-venous drainage are stressed, the available shunt systems (LeVeen, Agishi , Denver, Cordis Hakim) are presented and discussed.

Age Factors↗

PubMed1983