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Biomedical subjects

L Garel

Publications and source records attributed to L Garel.

At least 55 records · Page 3Linked to original sources
PubMed1990

Acute appendicitis in children: evaluation with US.

During a 4-month period, high-resolution ultrasonography (US) was used to prospectively evaluate 70 children with clinically suspected acute appendicitis. Thirty-five US scans showed a noncompressible appendix with maximal outer diameters greater than 6 mm. This finding was considered positive for the diagnosis of acute appendicitis. Thirty-one of these 35 patients had acute appendicitis documented by surgical and pathologic findings. The remaining four patients were observed, and their symptoms resolved. Thirty-five patients had US scans considered negative for appendicitis. Seventeen of these patients had US findings positive for other conditions including mesenteric adenitis, ileitis, intussusception, Crohn disease, and Burkitt lymphoma. In this series US enabled diagnosis of acute appendicitis with a sensitivity of 94%, a specificity of 89%, and a predictive accuracy of 91%. Diagnosis of acute appendicitis can be made with US with the same accuracy in children as has been previously reported in series of adult patients. The use of US in clinically ambiguous cases may allow earlier diagnosis, prevention of perforation, and decreased complications in the pediatric patient with acute appendicitis.

Acute Disease↗
PubMed1990

Liver transplantation for hereditary tyrosinemia: the Quebec experience.

Sixteen tyrosinemic patients were evaluated in our institution for a possible liver transplantation. All patients showed biochemical and/or radiological evidence of liver dysfunction. Renal involvement was found to be more abnormal than expected. Seven patients have been transplanted, with two patients receiving a combined liver-kidney transplant. Hepatocarcinoma was detected in two of eight patients in whom the whole liver was examined. Six (37.5%) of the initial 16 patients have died since evaluation, one of the six dying after combined liver-kidney transplantation. Posttransplantation survival was 86%, with normal liver function, normal growth, and no recurrence of neurological crises on a normal diet.

Adolescent↗
PubMed1989

Angioplasty of renal transplant artery stenosis in children.

Systemic hypertension after renal transplantation in children is frequent, occurring in 85% of the cases and may be the cause of severe neurologic complications. This can be due to multiple factors such as: rejection, recurrence of initial disease, steroid, etc. ... Among those factors, renal transplant artery stenosis (RTAS) must be identified as it may be cured by angioplasty. We report our experience in 18 children who had undergone angioplasty for RTAS. Angioplasty was performed under general anesthesia with 3F, 4F or 5F balloon catheters. Angioplasty was successful in 14 cases (77%) immediately (10 cases), progressively (2 cases) or after a successfully redilated recurrence (2 cases). Two of the 4 failures were due to technical problems, a successful surgical treatment was then performed. The 2 others failures were explained by a severe transplant rejection. The complications were rare: 1 femoral artery thrombosis and spasms of the intra renal arteries but without repercussion on the renal function. In our experience, angioplasty seems to be the treatment of choice in RTAS in children. However the indications must be carefully established taking in account other possible causes of hypertension in such patients.

Adolescent↗
PubMed1989

Isolated complete transection of the common bile duct due to blunt trauma in a child, and review of the literature.

A case of isolated complete transection of the common bile duct due to blunt abdominal trauma in a 3-year-old child is presented. The rarity of this injury and its initial presentation as a pancreatic pseudocyst warrant its description. This patient, the fifteenth child to be reported in the literature, was diagnosed as having a biliary injury following ultrasound-guided percutaneous drainage. Choledochal transection was documented at laparotomy and was successfully treated by proximal cholecystostomy and choledochojejunostomy with Roux-en-Y reconstruction. Delayed diagnosis is common, but this injury should always be kept in mind. Early diagnosis is feasible with the use of the HIDA scan. A review of the literature, modes of diagnosis, and techniques for surgical repair are described.

Child, Preschool↗
PubMed1988

Nephrocalcinosis in Bartter's syndrome.

Nephrocalcinosis was demonstrated by computerized tomography (CT) in all five children with Bartter's syndrome followed at our institution. In three of these five patients, nephrocalcinosis was also noted on ultrasound examination. Hypercalciuria was present in only one case. The mechanism leading to renal calcification remains unclear in this disease. It is noteworthy, however, that Bartter's syndrome is associated with such a high incidence of nephrocalcinosis.

Adolescent↗
PubMed1987

Renal metastases from neuroblastoma. Report of two cases.

Neuroblastoma is one of the pediatric cancers that has the most unpredictable evolution. It can metastasize to almost any organ, but intrarenal metastases have never been reported. We report 2 such cases: the first patient had a left adrenal neuroblastoma completely resected 10 months before routine follow up ultrasound and CT scan demonstrated 3 right intrarenal metastases. The second patient was being investigated for a left abdominal mass when one left intrarenal metastasis was found during the same CT scan. An intrarenal mass found during investigation for staging or follow up of neuroblastoma should then be considered as a metastase until proven otherwise.

Adrenal Gland Neoplasms↗
PubMed1987

Surgical portosystemic shunts in children: assessment with duplex Doppler US. Work in progress.

The patency of 12 surgical portosystemic shunts in 11 children with portal hypertension was assessed with duplex Doppler ultrasonography. Results were compared with surgical, angiographic, and clinical findings. Seven of nine patent shunts were directly seen, and flow in them was assessed. One proximal splenorenal and one mesentericocaval shunt were not directly seen because of intestinal meteorism. The obstructed shunts were not seen, and no flow could be detected at their site. The presence and direction of flow in the splanchnic venous system were determined in all children, obviating the need for further angiographic studies.

Adolescent↗
PubMed1987

Myeloperoxidase deficiency with extensive candidal osteomyelitis of the base of the skull.

A 6-year-old girl had a 7-month history of headaches and painful torticollis. A CT scan of the mastoids showed extensive bone destruction of the base of the skull and C-1. Biopsies of the retropharyngeal area and of the anterior aspect of C-1 were performed: histopathologic findings were suggestive of mycotic infection and cultures were positive for Candida albicans. The child was treated successfully with amphotericin B. The immunologic evaluation demonstrated the absence of myeloperoxidase in the neutrophils.

Candidiasis↗
PubMed1987

Primary sclerosing cholangitis in children: study of five cases and review of the literature.

Primary sclerosing cholangitis in five children is described and 78 cases in the pediatric age group are reviewed. In 24% of the cases, primary sclerosing cholangitis is not associated with an underlying disease and may appear to be prolonged cholestasis of infancy. When an associated condition is present, chronic inflammatory bowel disease, in particular ulcerative colitis, is most common (47%). Histiocytosis X and a variety of immune disorders account for 15% and 10% of cases, respectively. Primary sclerosing cholangitis should be considered in the differential diagnosis of chronic liver disease in the pediatric age group, even in young infants. Results of this survey demonstrate that neither clinical features nor liver function tests are reliable diagnostic predictors, that histologic changes are often nonspecific, and that cholangiography is essential to establish the correct diagnosis.

Adolescent↗