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Biomedical subjects

J M Babut

Publications and source records attributed to J M Babut.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Accidental ingestion of caustics in children. Apropos of 100 cases].

One hundred children (67 boys, 33 girls) underwent early fiberoptic endoscopy (without general anesthesia in 96 cases) for caustic ingestion between January 1985 and June 1988. The intended use of the product was household (83) industrial (4) farm (6) or medicinal (7). Caustic burns were classified as grade 1 (mucosal hyperaemia), grade 2 (ulceration) and grade 3 (necrosis). Endoscopy was negative in 52, grade 1 in 41 who had evidence of esophagitis and/or gastritis, grade 2 and/or grade 3 in 7 cases, 4 of whom had ingested farm products. Eighty-seven children were discharged after examination, 6 were hospitalized for 24 hours. Outcome was favorable for the 5 cases with grade 2 lesions after total parenteral nutrition for an average period of 79 days. The 2 cases with grade 3 injuries went on to develop an esophageal stricture requiring endoscopic dilation and an antral stricture which was treated by antrectomy. Authors emphasize the severity of lesions secondary to the ingestion of dairy pipeline cleaners, the advantages of fiberoptic endoscopy and the role of parenteral nutrition.

Accidents, Home↗
PubMed1989

[Diffuse esophageal leiomyomatosis. Apropos of 5 cases with 2 familial cases].

Diffuse esophageal leiomyomatosis is characterized by diffuse muscular hypertrophy chiefly marked in the lower end of the esophagus looks at a large tumor. It involves the entire length of the esophagus and down to the upper part of the stomach (esogastric leiomyomatosis). Diffuse leiomyomatosis is a extremely rare pathology encountered in children (13 previous report cases) and young adults. Il may be isolated or found in association with other intrathoracic and genital localisations or Alport syndrome (nephropathy, sensorineural deafness, ocular lesions). Extensive leiomyomatosis, engulfing the trachea and stem bronchi, may involve acute respiratory insufficiency. Genital localisations, exclusively in women (clitoral hypertrophy, vulvar leiomyomatosis), in association with esophageal leiomyomatosis, realize the esophago vulvar syndrome. Recently, familial diffuse leiomyomatosis cases were described with, in association, esophageal and extra-esophageal leiomyomatosis and Alport syndrome. The majority of the patients developed esophageal or respiratory symptoms. The radiological appearance is that of a mediastinal tumor or achalasia. CT Scans findings can give evidence diffuse muscular thickening of esophageal wall. Prognosis depends on the associated lesions. In that reports, two young adults (27 and 39 years old) died of inhabitual carcinomas (esophageal and gallbladder carcinoma). The only surgical treatment for symptomatic esogastric leiomyomatosis is subtotal esophagectomy with proximal gastrectomy and esocoloplasty. Myotomy is ineffective (2 cases). Five cases of esophageal leiomyomatosis are described (3 children, 2 young adults). Among these, two are familial leiomyomatosis cases. An esophageal resection was performed in four patients.

Adult↗
PubMed1989

[The multiseptate gallbladder. A rare malformation of the biliary tract].

Multi-septate gallbladder is a very rare anomaly. In this 13-years-old girl with a complaint of nausea, vomiting and abdominal pain, sonographic examination and oral cholecystogram demonstrated a normal size gallbladder with many thin septa. The longitudinal section of the removed gallbladder revealed multiple inter-communicating lobules divided by many thin septa. She has been free of the previous complaints after surgery. Only two pediatric cases have been reported previously. Our case illustrates the main features of this entity.

Adolescent↗
PubMed1989

[A duplication of the alimentary tract with unusual localization in the submaxillary region].

Duplication cysts developed from the intra-oral digestive tract are exceedingly rare lesions of which only 15 cases have previously been reported. We report an additional case in a neonate with a large cystic lesion in the right submandibular area. Clinico-pathologic findings are described and the literature is reviewed. Criteria for the diagnosis of digestive tract duplication are recalled. Differential diagnosis and etiopathogenic theories are discussed.

Choristoma↗
PubMed1988

Primary megaureter in the neonate with prenatal or postnatal diagnosis.

Twenty-nine cases of primary megaureter diagnosed before the age of 3 months are grouped in this diagnostic and therapeutic study. Seventy-five per cent were discovered by antenatal sonography due to the presence of pelvicalyceal dilatation without localising precisely the position of obstruction, twenty-five per cent were detected by the occurrence of early urinary tract infection. Four patients were operated during the first few months. 2 diversions and 2 reimplantations. Fifteen including the 2 with early diversion were submitted to later reimplantation at the average age of 15 months. 12 patients were treated conservatively by antibiotics and regular supervision. The respective results of the operated and non-operated patients were evaluated comparing the initial dilatation and the last IVU using the classification of Beurton. Regardless of the marked initial dilatation, significant spontaneous regression or complete resolution were often seen during the first year of follow-up. Thus surgery should be deferred initially even for the severely dilated forms, except in a few critical cases where a diversion is indicated. Reimplantation should be deferred for some months unless deterioration is noted, or performed only after one year or 18 months if regression is insufficient, thus optimising operative conditions.

Child, Preschool↗
PubMed1988

[Primary obstructive megaureter in infants: medical or surgical treatment? Apropos of 24 cases].

The authors analyse 24 cases of primary obstructive megaureter diagnosed before the age of 3 months. 18 were discovered by antenatal echography between 28 and 39 weeks, whereas 6 were detected by the occurrence of early urinary tract infection. Initial investigations included echography, intravenous urography and micturating cystouretrogram. Primary megaureter was bilateral in 14 cases, unilateral in 12. According to the urographic classification of Beurton, there were 12 ureters stage III, 12 stage II, 10 stage I. 15 patients were operated, 4 of them during the first months (2 reimplantations, 2 urinary diversions). 12 were submitted to later reimplantation at the mean age of 15 months, one had a non functioning kidney removed. 9 were non operated and treated conservatively by antibacterials and regular supervision. Results analysis evaluated according to radiological stage and treatment showed that in more cases, surgery should be differed initially. Complete clinical and radiological resolution is possible even in severe obstructions. Antibacterial treatment beginning at birth favorises regression of dilated ureter. Thus reimplantation should be deferred undercover of regular biological and radiological survey. The age of 12 to 18 months is the most technically favorable time to ureteric reimplantation.

Female↗
PubMed1988

[The treatment of drooling in handicapped children. Observations apropos of 12 operated cases].

The authors report their experience about the surgical treatment of drooling in handicapped children. They operated on twelve patients suffering from cerebral palsy, ranging from eleven to nineteen years of age. The procedure included the posterior rerouting of parotid ducts to the anterior pillars as in the Wilkie's operation but with tubularization of the mucosal flaps. The excision of the distal part of the submandibular duct on both sides was performed in a second operation, one to five years later in four patients, but in the initial operation for the last six cases. A successful control of drooling was reached in ten patients. But the two parts of the procedure are necessary to get a good result. The only first part is always insufficient as in the other two cases. There were few complications: one salivary cyst after rerouting of a parotid duct which required marsupialization, another one with spontaneous regression. Only one patient is complaining of feeling an excessive dryness of his mouth and lips. Other methods of treatment: physiotherapy and different kinds of surgical procedures are recalled. However, this series is too short to permit a valid conclusion and to define the place of the procedure in the treatment of drooling.

Adolescent↗
PubMed1987

[Tumors of the liver secondary to androgen therapy. Apropos of 2 cases in children].

The authors report 2 cases of hepatocellular tumour in children treated with anabolic androgens for aplastic anemia. In both cases, the presentation was by a picture of acute abdomen due to hemoperitoneum caused by tumour rupture. In the first case, there was multiple hepatic adenomas necessitating right hepatic lobectomy. The second infant had a single tumour of segment IV treated by simple excision of the tumour. It was a hepatocellular-carcinoma. Follow-up for one year after the initial operation showed no signs of recurrence in both infants. The review of the literature permitted us to find 48 other cases of hepatocellular tumour secondary to androgen therapy. In order of frequency, the hepatocellular-carcinoma is the most frequent and it is usually single; followed by the adenoma which is usually multiple. The other types of tumours are rare: focal nodular hyperplasia, angiosarcoma and cholangiocarcinoma. The hepatocellular-carcinoma and adenoma have some characteristic features: spontaneous regression may occur after withdrawing of androgens; the risk of rupture is important; their evolution is almost always favorable despite of a severe histopathological picture; the alpha-foeto-protein is nearly always negative; and the metastasis are exceptional. The hepatocellular-carcinomas associated with androgen therapy are probably just adenomas with marked dysplasia, but their long term malignant potential remain unknown. Except in case of rupture, surgical intervention should be postponed until the effect of discontinuing the hormonal therapy is assessed, because of the potential for spontaneous regression. The administration of antineoplastic chemotherapeutic agents should be reserved for the tumours showing evidence of malignancy.

Adenoma↗
PubMed1986

Obstructive uropathies diagnosed in utero. The postnatal outcome--a study of 43 cases.

The ultrasonic antenatal diagnosis of obstructive uropathies is now common. This study of 43 cases in which the mean follow-up is more than 2 years already allows us to show the importance of early diagnosis. The importance of a thorough postnatal examination is emphasised as well as the importance of preventing urinary tract infection. Although relief of the obstruction in the neonatal period in many cases allows an excellent recovery due to the exceptional qualities of the urinary tract at this age, there remain serious uropathies associated with significant renal dysplasia, for which ultrasonic diagnosis in utero is still insufficient. The results obtained allow us to be optimistic regarding the prognosis for many of these children.

Female↗
PubMed1986

[Ectopic insertions of single ureters in children. Apropos of 9 cases].

The authors present 9 cases of ectopic implantation of a single ureter in children. Ureteric ectopia is part of a congenital anomaly of the whole of the urinary tract, which explains the incidence of renal ectopia and associated dysplastic lesions of the renal parenchyma. The authors stress the importance of ultrasonography and, more recently, the CT scan for the localisation of the kidney homolateral to the ureteral ectopia. An analysis of the treatment and the results demonstrates the contrast between the unilateral forms which are easily treated and which have a good prognosis and the bilateral forms which are more difficult to treat and have a less favourable prognosis.

Abnormalities, Multiple↗
PubMed1986

[Prenatal diagnosis of ovarian cysts].

The authors report 10 cases of ante-natally diagnosed ovarian cysts. Ultrasonography greatly contributed to the diagnosis of this condition rarely described before. These cysts are usually follicular cysts. Physiopathological explanation still remain unclear: excessive fetal gonadotrope activity, enzymatic abnormality of the theca interna, abnormal stimulation by the mother's HCG are the main hypothesis. Ultrasonographic prenatal diagnosis is based on the discovery of an intra-abdominal round liquid area in a female fetus with normal kidneys and bladder. Obstetrical management is very simple: observation and vaginal delivery. After birth, diagnosis is assessed by clinical examination and ultrasonography which may be able to recognize a possible torsion (intracystic fluid septation). Treatment is conditioned by two facts: first these cysts are usually follicular benign lesions, second there is a high risk of complications, mainly torsion or rupture. Non-operative treatment and observation can be justified for very small cysts which have low risk of torsion. Laparotomy confirms the diagnosis: regarding non complicated cysts, surgery must be as conservative as possible: cystectomy is often feasible, leaving a laminated but functional ovary. Percutaneous puncture under ultrasonography could be considered.

Female↗
PubMed1985

[Primary perirenal suppurations in children: surgical or percutaneous drainage?].

Renal and perirenal staphylococcal suppurative processes are rare since antibiotic era. Three cases are reported. Gram negative organisms are nowadays the most prevalent bacterial species: a urinary tract disease must then be suspected. Early diagnosis is easier with recent event of new imaging techniques. (Ultrasonography and computerized tomography). Percutaneous drainage with the help of antibiotics is the treatment of choice: it is actually a very safe and efficient procedure.

Adolescent↗
PubMed1985

[Congenital esophagotracheal fistulas without esophageal atresia in children].

Ten cases are reported of children presenting isolated, congenital esophagotracheal fistulae without esophageal atresia, or "H-type-fistula" of Anglo-Saxon authors. The malformation is rare, of difficult diagnosis and often associated with other malformations. Respiratory symptomatology is sometimes dramatic, but diagnosis is based on data from radiologic imaging of the esophagus and from esophageal and tracheobronchial endoscopy. Treatment is surgical by a cervicotomy approach due to the almost constant high localization of the lesion.

Abnormalities, Multiple↗
PubMed1985

A new method of ventilation with a mixture of helium and oxygen in the management of congenital diaphragmatic hernia. A preliminary study.

To prevent the severe prognosis of pulmonary hypoplasia in congenital diaphragmatic hernia, the authors developed a new method of ventilation, using a modulated mixture of helium and oxygen. Associated with a leptanalgesia (Chlorpromazine-Morphine), the authors observed with this method two good results. Efficiency of this technique has been confirmed by X-rays and successive pulmonary scintigraphies (Xenon 133).

Female↗