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Biomedical subjects

M Iuchtman

Publications and source records attributed to M Iuchtman.

At least 37 records · Page 2Linked to original sources
PubMed1993

Management of urachal anomalies in children and adults.

During a period of fifteen years, 9 children and 5 adults with a variety of urachal anomalies were treated. Infected urachal cysts were more common in children whereas adults more frequently had infected urachal sinuses. After careful physical examination, a preoperative diagnosis could be made in most patients, with ultrasound examination decisive in doubtful cases. Whenever feasible, complete excision of the umbilicovesical tract is performed, but in very ill patients, a staged treatment becomes necessary. The preoperative injection of methylene blue is helpful in the identification of communicating tracts, all of which should be removed. All affected children should undergo investigation for associated genitourinary anomalies.

Adolescent↗
PubMed1993

Situs inversus abdominis in association with duodenal obstruction and internal hernia.

Persistent bile-stained vomiting in a neonate led to a radiologic workup that revealed the existence of a situs inversus and a partial duodenal obstruction. A duodenal diaphragm with a central aperture was diagnosed. Surgery confirmed the preoperative diagnosis. In addition, an annular pancreas with an anterior gap and a right parietocolic internal hernia containing all the small bowel were discovered. Embryologic aspects, therapeutic options, and the literature were discussed.

Abnormalities, Multiple↗
PubMed1993

Malignant duodenocolic fistula. The role of extended surgery.

Malignant duodenocolic fistula is a seldom-seen complication of advanced right colon carcinoma. We describe four patients who illustrate the sometimes rewarding results of aggressive treatment. Because duodenocolic fistula is always associated with severe nutritional impairment, operation should be deferred until total parenteral nutrition (TPN) and blood transfusions have improved the clinical state. Whenever feasible, resection offers the best treatment; lesser techniques such as bypass and exclusion result only in minimal palliation. A direct approach and fistula disconnection are contraindicated. The benefit of exploration should almost always be offered, even in such secondary fistulas, as a better quality of life and long-term survival are realistic goals.

Aged↗
PubMed1992

Morbidity and mortality in 46 patients with the VACTERL association.

During a 10-year period, 313 infants were treated at the Hospital for Sick Children for esophageal atresia, of whom 46 had features of the VACTERL association. These 46 patients had a mortality rate of 24%, most deaths being caused by cardiovascular abnormalities. Infants weighing less than 2,050 g had a mortality rate of 26%, double that of heavier infants. During the first year of life there was considerable morbidity resulting from the tracheoesophageal abnormalities. Whenever possible primary repair of the esophagus should be performed; however, many patients with VACTERL association had an unusually long gap between the two ends of the esophagus, and repair under tension was associated with a high incidence of complications. Of the 35 survivors, 25 are in a satisfactory, stable condition, but 10 still require treatment necessitating repeated admission to hospital. Anorectal, renal or skeletal anomalies rarely caused death, but, when severe, were associated with a poor quality of life.

Abnormalities, Multiple↗
PubMed1991

[Heterotopic pancreas and pyloric atresia].

A 2.5 kg female neonate, born after a normal 39-week pregnancy to Arab parents (1st degree cousins), developed unremitting vomiting of gastric contents, not bile-stained. Barium study demonstrated a grossly distended stomach with complete obstruction of the outlet. At laparotomy, pyloric atresia and a heterotopic pancreas located subserosally on the antrum of the stomach were diagnosed. A 3-cm gap was measured between the occluded antrum and the duodenum. Transmesocolic gastrojejunostomy was performed, and oral feeding was started 5 days later. Pyloric atresia and heterotopic pancreas are both rare congenital malformations. To the best of our knowledge, the combination of pyloric atresia and heterotopic pancreas has not previously been reported.

Choristoma↗
PubMed1991

Perforated nonspecific ulcer of the colon in children.

Nonspecific ulceration of the colon is rarely seen in children. The most common location is the cecum, but the left colon is the involved segment in 15% of patients. We describe two affected children, who presented acutely with free colonic perforation. In the first patient, treatment consisted of exteriorization followed by delayed closure, and in the second child of localized excision followed by primary two-layer suture. Both patients recovered uneventfully.

Child↗
PubMed1987

Acute abdomen in ruptured interstitial pregnancy following unilateral salpingectomy.

Interstitial pregnancy is an infrequent type of ectopic pregnancy. Two cases of acute abdomen due to ruptured interstitial pregnancy following salpingectomy, a rare event, are presented. Both patients were young women who had had a previous salpingo-oophorectomy due to ovarian cyst. The presenting symptoms were in the first case abdominal pain followed by hemorrhagic shock, and in the second a right iliac fossa syndrome simulating acute appendicitis. Surgical intervention consisted of wedge resection of the uterine segment involved. A review of the literature and practical considerations are presented.

Abdomen, Acute↗
PubMed1986

Importance of small bowel involvement in bleeding angiodysplasia.

Lower intestinal bleeding related to enterocolic angiodysplasia is now accepted as a common clinical situation in the elderly. A planned approach is mandatory to allow early localization and appropriate therapy. Colonoscopy, scintigraphy and angiography used judiciously have almost entirely replaced exploratory laparotomy as a diagnostic tool. Nonoperative treatment comprising arteriographic selective vasopressin infusion and endoscopic coagulation has been followed in some cases by hemorrhage control. Such techniques, if easily obtainable, have their place; however, surgery remains the ultimate method for definitive treatment. A previous knowledge of the nature of ileal involvement is essential if surgical hemostasis is to be achieved. The recent successful management of three patients exemplifies the problems found in dealing with iliocecal bleeding angiodysplasia.

Aged↗