Metastatic pulmonary calcifications in children. Three cases.
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Biomedical subjects
Publications and source records attributed to L Garel.
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Ultrasonography has made the study of the biliary tract easier. This may account for an apparent increase in the incidence of cholelithiasis in children. Twenty-nine cases of biliary stones, mostly gallstones, were seen in a 3 year period. More than half of the cases were secondary to a definite cause, among which the interruption of the enterohepatic circulation of bile salts should be emphasized. The etiological factors of biliary stones and biliary sludge appeared identical in our material.
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A case of iatrogenic bilio-bronchial fistula due to a retained surgical sponge is reported. The diagnosis was delayed because of the absence of opaque marker within the retained swab.
A girl with chronic hereditary tyrosinemia is described in whom the diet caused an immediate resolution of tubular defect and rapid healing of the rickets. However cirrhosis was not prevented and at the age of 8 she developed a hepatoma. Complete surgical excision was possible and she remained well 15 months later. The value of blood alpha-fetoprotein levels and liver echotomography to monitor the course of the disease is emphasized. The apparent ineffectiveness of the low phenylalanine and tyrosine diet in preventing hepatic complications is discussed.
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The authors report a case of peroral removal of an intraduodenal foreigh body in a 6 week old infant. The coaxial technique employed facilitates catheter manipulation and avoids traumatic lesions arising from manoeuvres during removal.
The authors report some unusual pediatric conditions where grey scale ultrasound was the most useful diagnostic tool. Cases of pericardial cyst, polycystic kidney disease of the adult type, hepatic hamartoma and hepatocarcinoma, gallstones, renal pseudo tumors, calcified inferior vena caval thrombus, acute pancreatitis, multicystic kidney and retroperitoneal lymphangioma are briefly described and compared to the literature. In a patient presenting with hereditary tyrosinemia, ultrasound not only disclosed evidence of hepatocarcinoma but was shown to be the procedure of choice for following the course of the disease.
Forty-one children with subdiaphragmatic rhabdomyosarcoma underwent bipedal lymphography. Twenty-two (53.5%) of the lymphograms were interpreted as being positive. In our series, the lower limbs were the most common primary site of involvement, were more frequently involved by the alveolar histologic subtype which carries a poor prognosis, and were associated with a higher incidence of lymph node metastases. Positive lymphographic findings in this group of children were similar to those seen in both adults and children with other solid tumors, i.e., the presence of discrete lymph node filling defects. However, in 3 cases, abnormalities more characteristic of lymphoma were identified. Evaluation of lymph node metastases as demonstrated by lymphography has prognostic significance.
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High dose selective renal arteriography was performed in 62 cases of renal cell carcinoma to study the patency of the renal vein trunk. Arteriographic findings were correlated with histopathology in all cases. In 35 cases of angiographic patency of the renal vein surgery always confirmed the findings. 11 false positive results were observed (the arteriographic diagnosis of venous involvement was not found at surgery). The authors believe that this method is easy and reliable; inferior cavagraphy is not necessary when arteriography shows the patency of the vein.