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Biomedical subjects

L Graivier

Publications and source records attributed to L Graivier.

At least 19 recordsLinked to original sources

Pediatric lateral ventral (spigelian) hernias.

Lateral ventral (spigelian) hernias may not be recognized if the physician is unaware that they can occur in pediatric patients. Diagnosis depends on finding a protrusion in the spigelian fascia lateral to the rectus sheath at the junction of the arcuate and semilunar lines, below the umbilicus. We report nine such cases, to bring the total number of recorded pediatric cases to 18. Surgical repair involves a layered overlapping closure using interrupted nonabsorbable sutures. Since the rim of the defect is extremely difficult to outline once the child is asleep and relaxed, it must be outlined in indelible ink while the child is awake and straining.

Child

Ileal stenosis due to arteriovenous malformation in a newborn infant.

This is the first reported case of bowel obstruction in a newborn infant secondary to arteriovenous malformation of the alimentary tract. Although all reported cases of congenital vascular malformations of the intestinal tract presented with bleeding, this infant was seen because of symptoms of ileal stenosis. Symptomatic arteriovenous anomalies in infants under 6 mo of age are extremely rare and present as central nervous system, hepatic or lung lesions.

Arteriovenous Malformations

Blunt trauma to the pancreas in children.

Sixteen children below the age of 12 were operated on for blunt injury to the pancreas during a ten-year period. Unless there was an associated injury, signs and symptoms did not immediately develop. Common to the delayed manifestation of an injury to the pancreas was history of an impaling force to the upper abdomen, abdominal tenderness, and an elevated serum amylase level. The postoperative morbidity for contusion of the pancreas was unpredictable, and a prolonged period without oral alimentation should be anticipated.

Child

Lateral ventral (spigelian) hernias in infants and children.

Lateral ventral hernias are found in the spigelian fascia lateral to the junction of the arcuate and semilunar lines and below the level of the umbilicus. Three cases are reported in infants and children. Diagnosis depends on finding an unusual mass on the anterior abdominal wall and palpation of the rim of the hernia defect upon reduction of the mass. A spigelian hernia may be misdiagnosed easily if the examiner is unaware that it can occur in childhood. The edge of the defect must be outlined while the child is straining, prior to induction of anesthesia, as the rim may be difficult to find when the patient is asleep.

Abdominal Muscles

Hydrocolpos, vaginal atresia, and urethrovaginal fistula in a neonate: abdomino-perineal-vaginal pull-through.

The combination of high maternal estrogenic stimulation of the secretory glands of the reproductive tract of the newborn female and vaginal obstruction results in an abdominal mass due to vaginal distention (hydrocolpos). Prior experience with two infants with hydrocolpos (LG) led us to perform abdomino-perineal-vaginal pull-through, as advocated by Ramenofsky and Raffensperger, in the newborn period. So far as we can ascertain this is only the second infant so reported in the literature.

Abdomen

The localization of multiple intra-abdominal abscesses by gallium scanning.

A septic course suggestive of intra-abdominal abscess followed surgery in a small child with a perforated appendix. Usual diagnostic studies, fluoroscopy, and rectal and wound exploration failed to localized an abscess. The use of gallium 67 scanning accurately localized multiple abscesses which were successfully drained.

Appendectomy