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Biomedical subjects

J Bennek

Publications and source records attributed to J Bennek.

At least 37 records · Page 2Linked to original sources
PubMed2000

The use of upper limb external fixation in paediatric trauma.

External fixation is an alternative method of treatment for paediatric fractures of the upper extremity. We report our experience of the management of 23 children with an average age of 10 years 1 month and review the literature. The method is indicated for second and third degree open fractures, open multiply injured patients and severely comminuted fractures. External fixation has proved unequalled for correction of limb deformities and lengthening procedures.

Adolescent↗
PubMed2000

Choledochocele--a rare cause of necrotising pancreatitis in childhood.

Recurring complaints of unknown origin in the upper abdomen during childhood are not frequent. Choledochoceles, or type III choledochal cysts, are rare congenital abnormalities of unclear aetiology. They are rarely considered in the differential diagnosis of upper abdominal symptoms in childhood. Only 130 cases of choledochoceles have been reported in world literature to date. Only 20% of these patients were children or adolescents. The symptoms do not specifically suggest a choledochocele, and are usually attributed to other disorders of the upper intestinal tract, frequently resulting in a delayed diagnosis. We present the case of a 10-year old girl in whom a congenital choledochocele was diagnosed by gastro-intestinal studies and endoscopic retrograde cholangiopancreatography (ERCP) following a 2-years history of recurrent pancreatitis. Various types of choledochoceles are presented in the literature, classified according to morphology and histology. Most authors consider them to be a form of choledochal cyst. Their embryonic development is related to that of congenital duodenal diverticula. Although congenital intraluminal duodenal dilatations are of known oncogenic significance, only two cases of adenocarcinoma arising from a choledochocele have been described to date. Established treatment of large choledochoceles in childhood is transduodenal marsupialization.

Child↗
PubMed1999

Fibrosarcoma in infants and children: a retrospective analysis - overdiagnosis in earlier years.

During a 30-year period, 22 patients considered to have a fibrosarcoma (FS) were treated. In a retrospective study the clinicopathologic findings were summarized. With histologic and immunohistochemical re-evaluation, the diagnosis was confirmed in 8 cases. For 6 further patients FS was very probable but specimens were not available. In 8 cases the diagnosis was revised and benign lesions were found in 7. Two patients with irresectable tumors died (infantile FS, FS of mesentery and retroperitoneum). After repeated local recurrences and spread on the affected extremity, an amputation was life-saving in 1 boy. In earlier years many tumors were classified as FSs. Today, immunohistochemistry and molecular-biological methods are valuable tools to clearly identify these tumors. Wide local excision or en-bloc resection without sacrificing any significant function of the part should be the primary form of treatment in infants. Primary re-excision after incomplete excision should have priority over any adjuvant treatment. Preoperative chemotherapy may avoid incomplete resection or mutilation in cases with extended congenital FS.

Child↗
PubMed1999

Changing pattern of osteomyelitis in infants and children.

A retrospective analysis of 332 children with osteomyelitis (OM), managed from 1966 to 1996, was undertaken to evaluate etiology, clinical course and treatment results. In 64% of all patients positive bacterial cultures were obtained, Staphylococcus aureus, streptococci, pneumococci, and Haemophilus influenzae were the most frequently cultured pathogens. In two-thirds of the cases long bones (femur, tibia, humerus) were affected. Osteoarthritis or suppurative arthritis was evident in 27%; 32 of 170 (19%) re-evaluated patients had moderate or severe sequelae. Risk factors for an unfavorable course were the onset of disease in early infancy, suppurative arthritis, and an affected epiphysis. Suppurative arthritis, in particular, needs early evacuation to prevent sequelae. In recent years we observed an increasing number of patients presenting with atypical forms of OM. Since 1989 10 patients were considered to have chronic recurrent multifocal OM (CRMO). In 6 of them the clavicle was involved; their ages ranged from 3 to 14 years. The erythrocyte sedimentation rate was elevated (median 48, range 9-110 mm), while other inflammatory parameters like C-reactive protein (median 9, range <5-85 mg/l) or leucocyte count were slightly elevated or normal. Histopathology was stage-dependent, with a predominance of lymphoplasmacellular infiltration. A nonbacterial origin of CRMO is probable but not proven. Histopathology is not suitable for differentiation between bacterial and nonbacterial forms of bone inflammation.

Acute Disease↗
PubMed1999

Chondromatosis of the ankle joint (Reichel syndrome).

A case of chondromatosis of the upper ankle joint in childhood is described. It is a monoarticular disease with a good prognosis, frequently without known prior trauma or inflammation, although often free fragments of cartilage are seen in the joint cavities. It originates from the synovium of the joint, and is known in the literature as Reichel syndrome.

Acute Disease↗
PubMed1999

Congenital hernia of the abdominal wall: a differential diagnosis of fetal abdominal wall defects.

A 28-year-old woman was referred at 33 weeks of gestation with suspected fetal intestinal atresia. Sonography showed a large extra-abdominal mass on the right of the normal umbilical cord insertion. Following Cesarean section at 36 weeks and immediate surgical treatment, the malformation was not definable either as an omphalocele or as gastroschisis. This reported case involves a previously undocumented malformation of the fetal abdominal wall described as a 'hernia' of the fetal abdominal wall.

Abdominal Muscles↗
PubMed1999

Laparoscopic bilateral adrenalectomy in a child.

Laparoscopic adrenalectomy is an established technique--in adults. This report describes a bilateral laparoscopic adrenalectomy in a child. As in adults, it indicates that the technique is superior in anatomic exposure and postoperative recovery, and is well suited for children.

Adolescent↗
PubMed1998

Partial splenectomy, transposition of the spleen to the abdominal wall or splenohepatoplasty in portal hypertensive rats. Effects on portal venous pressure and homeostasis--microscopical appearance of the transposed spleen.

Reduction of the splenic volume by partial resection and collateral development after transposition are of potential value in the elective treatment of esophageal varices, hypersplenism and ascites. A study was performed on young Wistar rats. A simple animal model of extrahepatic portal hypertension was used, narrowing the portal vein to an outer diameter of one millimeter (PVS). One day, three weeks and seven weeks after this operation the portal venous pressure was elevated as compared with the sham-operated controls. The portal hypertension was statistically significant at week three (1.31 +/- 0.04 vs. 0.72 +/- 0.18 kPa, p = 0.01). Portocaval pressure gradient after partial resection of the spleen (SR) and intramuscular transposition (IMTrans) was compared with the pressure gradient after graded portal vein stenosis. Three weeks after intramuscular transposition portocaval pressure gradient was reduced (1.46 +/- 0.38 vs. 1.74 +/- 0.13 kPa, n.s.). This data supports the hypothesis that the portal venous high-pressure compartment and the systemic venous low-pressure compartment are maintained after development of natural shunts to the systemic circulation. In the following experiment different types of splenic transposition were tested and compared to each other and a normal control group or to rats with protal vein stenosis (PVS), respectively. After PVS, the animals were reoperated, an SR was performed and the wound surface of the spleen was transposed into the left abdominal wall subcutaneously (SCTrans) or intramuscularly (IMTrans) or to the left liver lobe (splenohepatoplasty, SHP), respectively. After three weeks the animals underwent measurements of organ weights, collections of blood samples and the spleen was investigated histologically. Blood cell counts were nearly normal but total serum protein, albumin and the colloid osmotic pressure were slightly diminished or significantly reduced (COP in the groups PVS + SR + IMTrans or SCTrans, p < 0.05) compared to the controls. Differences to the group with portal vein stenosis (PVS) were not significant. Serum protein electrophoresis after splenic transposition revealed an unobtrusive distribution pattern. Animals after SHP had the best increase in weight and high protein levels, but splenohepatic collateral development seemed sparse. Differences of plasma ammonium levels were statistically not significant, but some animals had elevated levels after transposition. Morphometry of routine-stained spleen specimens showed an intact immunoarchitecture of the transposed spleens.

Abdominal Muscles↗
PubMed1998

[Endocrine surgery from the viewpoint of the pediatric surgeon].

The extent of surgery for thyroid tumors is discussed. Prophylactic thyroidectomy in MEN II a and b is advocated. Pancreatic surgery is necessary in cases of nesidioblastosis, islet cell carcinoma, papillary-cystic neoplasia and pancreaticoblastoma. Gastrointestinal tumors with hormonal activity are very rare. "Incidental carcinoid" is occasionally found. Early detection of Zollinger-Ellison syndrome in childhood usually allows for complete removal of a gastrinoma. Benign and malignant neoplasms of the adrenals warrant radical surgery. We report one case of minimally invasive bilateral removal of the adrenals for nodular hyperplasia. Pheochromocytoma in childhood presents several peculiarities influencing perioperative management. It may occur as part of MEN II a.

Adolescent↗
PubMed1997

[Spiral computerized tomography diagnosis of abdominal seat belt injuries in children].

Seat belt injury (s.b.i.) arises from not properly applied seat belt in case of car accidents. The importance of spiral CT for the diagnosis of s.b.i., especially of hidden traumatic lesions, will be demonstrated. Our experience includes 9 children in the age of 4 to 13 years suffering from life-threatening s.b.i. After life-saving treatment we took a spiral CT (Somatom plus S): first spiral CT, 10 mm slice thickness, without contrast medium (c.m.) and second spiral CT, 5 mm slice thickness, start delay 35-45 s after a large volume of c.m. Of these, 8 of 9 children survived. Besides bruising signs head injuries, and knee joint lesions in 4 of 9 cases, a combination of ruptured duodenum, ruptured liver or spleen, and chance fractures of the spine was found which is typical for s.b.i. In the remaining 5 cases, two of the lesions were combined. Rupture of the small bowel was manifested mainly as the discrete finding of free air or inhomogeneous ascites with a high density (bowel contents mixed with blood). Not only the emergency doctor but also the radiologist should take into account the complexity of seat belt injuries. Spiral CT is the imaging method of choice in the case of polytraumatic children.

Abdominal Injuries↗
PubMed1996

[Results of partial splenic resection and transposition to the lateral abdominal wall in portal hypertension in childhood].

Between 1977 and 1995, 19 children with portal hypertension (nine extrahepatic, ten intrahepatic) were treated by transpositioning the spleen into the left abdominal wall. Among the patients with intrahepatic portal hypertension three died. Two patients underwent secondary diminuition of the transposed spleen due to relapsed hypersplenism. In one of our first patients the transposed spleen atrophied after tangential resection. All surviving patients except one preserved hepatic function. The serum colloid osmotic pressure was stable. Plasma ammonia levels were normal. Serum immunoglobulins (IgG, IgM, IgA and IgG subclasses) and complement components (C3c, C4) were analyzed. After transposition patients had normal or slightly elevated values of these proteins compared with controls.

Abdominal Muscles↗
PubMed1991

[Diagnosis, therapy and prevention of necrotizing enterocolitis in newborn infants].

The necrotizing enterocolitis is a severe and frequently fulminant disease with a considerable mortality. The main event is the enteral septicemia. Only prompt diagnostics and adequate therapy permit the survival of the newborns. The most important aspects of signs and symptoms, diagnostics and therapy as well as course of disease and prophylaxis are delineated, whereas the problems of pathogenesis are excluded.

Combined Modality Therapy↗
PubMed1991

[Ovarian cyst. A predisposing factor for ileus in the neonatal period and early infancy].

Cystic and solid tumors of the ovary are rare during the new born period and infancy and usually become clinically apparent only during childhood adolescence. Any cystic ovarian enlargement is almost always benign but can cause signs of an acute abdomen because torsion of the ovarian cyst can lead to small bowel obstruction. This may be the first clinical sign of the cyst if it had not yet been detected by prenatal or postnatal ultrasonography. On the basis of our own observations and a review of the literature it appears that ovarian cysts predispose to mechanical small bowel obstruction in new borns and infants.

Female↗
PubMed1991

[Bacterial bone and joint infections in childhood--a review. 3. Bacterial arthritis].

This overview presents the most important topics of etiology, pathogenesis, diagnostics, differential diagnostics and treatment of septic arthritis in children. A child with bacterial arthritis is always a case of emergency. Only immediate and adequate treatment can avoid permanent sequelae. Medical care for these patients should be done always in close cooperation of pediatricians, pediatric surgeons, radiologists, and sometimes orthopedists.

Arthritis, Infectious↗
PubMed1991

[Bacterial bone and joint infections in childhood--a review. 4. Subacute and primary-chronic osteomyelitis, rare forms of osteomyelitis].

This is an overview of the most important aspects of pathogenesis, etiology, diagnostics, therapy and differential diagnostics of the subacute and primary chronic osteomyelitis in children. This group of disease includes Brodie's abscess, plasma cellular osteomyelitis, sclerosing osteomyelitis (Garré) and the chronic recurrent multifocal osteomyelitis. The treatment of children with these not completely understood diseases requires a close cooperation between pediatricians, pediatric surgeons and radiologists.

Adolescent↗
PubMed1990

[Current status of surgery for abnormalities in newborn age and infancy].

Own experiences about the modern standard of malformation surgery in newborns and young babies are demonstrated. Progress in prenatal diagnosis, perioperative management, operative strategy and operative technique improved the prognosis. Necessary is optimal interdisciplinary cooperation of all participants and special responsibility of the surgeon.

Congenital Abnormalities↗
PubMed1990

[Are there new aspects in thoracic surgery in children?].

A comparison was made between the operations of the respiratory tract in childhood and their associated bronchological examinations were analyzed and also there were other kinds of indication for examination and operation. The surgical therapy of abnormalities has the priority.

Child↗