Transportation of neonate with surgical disorders.
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Biomedical subjects
Publications and source records attributed to K Yadav.
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Two children were admitted with partial obstruction of the duodenum due to its incomplete rotation and fixation. The colon in both cases was rotated normally. Our experience with these children, along with embryological evidence to understand the above entity, is presented.
The records of 40 infants with intrinsic duodenal obstruction have been reviewed. Of these more than half had no bile in the vomit. Persistent vomiting had been considered as the major factor of doubt regarding duodenal obstruction. The incidence of other associated congenital abnormalities was 70%. The over all mortality rate was 42.5%. The association of mongoloidism to the intrinsic duodenal obstruction was found approximately in every third infant. The low birth weight without other congenital abnormality has very little effect on the mortality rate.
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Bile peritonitis, following blunt abdomen injury to the biliary tract, is not a very common condition. The clinical features, however, are typical, the treatment is delayed due to the quiescent interval between the symptoms. The operative treatment is simple draining of the area of perforation and the site of the collection of bile. A catheter in the gallbladder is helpful in assessing the stoppage of the leak and the restoration of biliary drainage. The prompt surgical treatment on diagnosis has good prognosis.
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Three cases of cystic partially differentiated nephroblastoma (CPDN) are presented and ten cases from literature are reviewed. CPDN has been designated by various terms; it is a cystic encapsulated tumor occurring before 2 years of age. Cysts are lined by epithelium; septa of the cysts show a mixture of partially differentiated and undifferentiated metanephrogenic blastema. This histologic feature distinguishes CPDN from multilocular cyst of kidney. In seven cases simple nephrectomy, and in remaining cases nephrectomy with radiation and/or chemotherapy, had been the treatment. The disease-free interval ranged from 5 to 72 months, without reports of recurrence or metastasis. CPDN appears to take a benign course and simple nephrectomy seems to be the treatemtn of choice. However, in view of the possibility of recurrence as shown in rare instances by congenital mesoblastic nephroma, another less aggressive lesion in the spectrum of infantile renal neoplasia, regular follow up is recommended.
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