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Biomedical subjects

P P Rickham

Publications and source records attributed to P P Rickham.

At least 19 recordsLinked to original sources
PubMed1992

Felix Wurtz.

Explore the source record for details and available documents.

General Surgery↗
PubMed1986

The dawn of paediatric surgery: Johannes Fatio (1649-1691)--his life, his work and his horrible end.

Johannes Fatio was probably the first surgeon who systematically studied and treated surgical condition of children. Born in Basle in 1649, he never studied medicine at the university there but became a member of the barber's guild. Later he studied medicine and became a doctor of the University of Valence. He returned to Basle to practice surgery, midwifery and paediatric surgery. He wrote a number of medical books, but only one, The Helvetic Reasonable Midwife, still exists. In it he devotes a whole section to surgical afflictions of children. He describes ingenuous operations for such conditions as hypospadias, hydrocolpos, imperforate anus and many more. He was the first surgeon successfully to separate conjoined twins. He became involved in the turbulent politics of the city of Basle and was largely responsible for the overthrow and modern ratio of the Basle parliament and government. In the following counter-revolution he was captured, imprisoned, tortured and executed. All his written works were destroyed by the authorities; The Helvetic Reasonable Midwife was published 70 years after his death.

General Surgery↗
PubMed1986

Denis Browne: surgeon.

Denis Browne was the first surgeon in England to confine his practice entirely to children. The methods of treatment devised by him were new and often revolutionary and were frequently attacked and criticized, but they worked. He regarded his research into the aetiology of congenital deformities as his most important single scientific contribution. In 1931, he published his first article on talipes equinovarus. He further enlarged his theory of the mechanical origin of congenital deformities in a study published in 1936. The mechanical theory led him to search for treatment by use of selectively applied pressures and controlled movements. He did not like open corrections. When confronted by a surgical problem he would invariably start by studying the anatomy of the region involved. He was the first to describe the superficial inguinal pouch. His anatomical studies eventually enabled him to perfect the operation for inguinal hernia in infancy and childhood and formed the basis of his operation for cleft palate and of his work on the surgical anatomy of the tonsil. He was the first pediatric surgeon to routinely employ transverse abdominal incisions. He preferred immediate anastomosis to the temporary enterostomies. He introduced the end-to-back anastomosis. He helped rationalizing and perfecting the operative technique for pyloric stenosis. Malformations of the perineum were the subject of many studies. His operation for hypospadias is also well known. His other advances in paediatric surgery, such as treatment of various infective conditions and cardiovascular surgery, were at the time original and important. His inventive genius was best seen in his development of numerous instruments and appliances.(ABSTRACT TRUNCATED AT 250 WORDS)

England↗
PubMed1984

[Ureteral replacement in newborn infants--case report].

This is a description of a ureteric replacement operation employing a modified Culp-de-Weerd method for the ileopelvic segment of the ureter combined with a Cohen ureteric reimplantation. This operation was carried out in a 2-month-old infant with a stenosis of the left ureter. 7 months postoperatively the left kidney is normal as far as its anatomy and function is concerned.

Humans↗
PubMed1984

Exstrophy of the bladder progress of management during the last 25 years.

The different methods of treatment of bladder exstrophy are described. Ureterosigmoidostomy and its various modifications are discussed and the longterm result critically reviewed. Urinary diversion by transplanting the ureters into an isolated segment of ileum or colon should, in the authors' opinion, only very rarely be necessary. Cutaneous ureterostomy is used only as a last resort in incontinent patients with severe renal damage. The greatest single advance in the management of the malformation has been the two-stage closure of the exstrophic bladder. The authors' experiences in the two-stage closure of 28 patients with ectopia vesicae are described. No selection of patients was practiced. The results obtained, both clinically and by manometry of the operated bladder, are reviewed. The results are moderately satisfactory.

Adult↗
PubMed1982

Into the limits of neonatal surgery.

After 33 years experience in neonatal surgery the considerable progress in this branch of medicine can be reviewed. The initially very high mortality was drastically reduced by the foundation of the first neonatal surgical unit in Liverpool in 1953, a unit which in the succeeding years was copied in most large paediatric surgical centres all over the world. The reasons why these units have today tended to become obsolete are discussed. Neonatal intensive therapy units for medical as well as surgical cases are now preferred in most centres. The great advances in chemotherapy, the therapy of respiratory complications, intravenous alimentation and monitoring of the patient have further decreased the operative mortality in neonates to such a degree that today only few problems remain.

Congenital Abnormalities↗
PubMed1982

[10 years of functional reconstructive surgery in exstrophy of the urinary bladder--a preliminary report (author's transl)].

Functional reconstructive surgery is performed in bladder exstrophy at the University Children's Hospital of Zurich since 1971. The surgical procedure is usually done in three stages--bilateral iliac osteotomy--turn-in-operation wih preliminary reconstruction of the bladder neck and antireflux surgery--closure of the epispadia, if necessary combined with continence plasty. Out of 26 patients with bladder exstrophy 23 underwent reconstruction. 3 patients died postoperatively. One was lost for follow-up. The preliminary long-term results in 19 patients are presented. The assessment was based on four criteria: last intravenous pyelography, urinary function, frequency and severity of urinary infections and degree of attained continence. The results were classified as good in 5 patients, fair in another 5 patients and insufficient in 6. 3 patients were too young to be assessed. The results are compared with other series reported in literature.

Bladder Exstrophy↗
PubMed1982

Acute intussusception: a classic clinical picture?

57 patients with acute intussusception were admitted to the Children's Hospital Zurich between 1972 and 1979. All were treated surgically. One died, 7 needed a bowel resection, 9 intussusceptions were difficult and 32 easy to reduce. The retrospectively reviewed data show that the classic symptomatology, beginning suddenly in a healthy male (60%) under 3 years of age (91%) with attacks of colicky pain (81%), vomiting (93%), a palpable abdominal mass (72%) and rectal bleeding (72%), appears during the course of illness or may not be present at all. This leads to misdiagnosis, wrong treatment and worsening of the pathology. Blood per rectum, the most typical symptom, was present in the first hours of illness in only 5%, vomiting in 44% and colicky pain in 33% of the patients. A high degree of awareness is therefore necessary to diagnose intussusception during the first hours of illness, and particular stress must be laid on the accuracy of the diagnosis because reducibility and resection rate depend directly on the duration of the symptoms.

Acute Disease↗
PubMed1981

Infants with esophageal atresia weighing under 3 pounds.

In a consecutive series of 339 infants with esophageal atresia seen since 1953 first in Liverpool and subsequently in Zurich, 12 or 4% weighed under 3 lb (1360 g) at the time of operation. Four had severe additional malformations causing death in the immediate postoperative period. Before 1957, all the infants weighing under 3 lb died, but of the six infants weighing between 2 and 3 lb (910 and 1360 g) operated upon by the author since that time, five have recovered. The only fatality was caused by the wrong choice of operation. This is discussed in detail. There appear to be no reasons why even the smallest infant with esophageal atresia should not survive, provided certain precautions in the preoperative, operative, and postoperative management are taken. These special methods are discussed in detail with special reference to transport, intensive therapy management, and operative technique. Follow-up examinations of these infants show that their subsequent development has been perfectly normal. On the basis of these figures it is suggested that today, associated malformations, especially of the heart and brain, are the only causes of postoperative mortality in esophageal atresia and that infants with even extremely low birth weights should survive.

Child↗
PubMed1980

Early differential diagnosis between neonatal hepatitis and biliary atresia.

More and more refined laboratory investigations for differential diagnosis of neonatal direct hyperbilirubinemia have been developed, but not one of them is absolutely diagnostic. All of them take time and by the time the infant is referred to the surgeon it is often too late, as the prognosis for successful surgical correction becomes rapidly worse with increasing age. Most authorities have now agreed that in cases of extrahepatic biliary atresia cirrhosis has already well developed after the second month of life. The only virtually certain methods of diagnosis are direct inspection of the gall bladder, cholangiogram, and a sizeable liver biopsy. Our clinical experience has convinced us that laparoscopy with liver biospy and simultaneous cholangiography by transhepatic puncture of the gall bladder is the simplest, fastest and most certain method for diagnosis. It allows for early differentiation of direct hyperbilirubinemia in the neonatal age and should be carried out if the hyperbilirubinemia has persisted during the first month of life and before laboratory investigations are instituted.

Bile Ducts↗
PubMed1980

Hemiparesis--an uncommon symptom of hydrocephalus or shunt dysfunction.

We describe a boy with asymmetrical hydrocephalus in whom a marked hemiparesis of recent origin resolved completely following insertion of a shunt. In 2 children with shunted obstructive hydrocephalus due to a midline tumour a newly developed hemiparesis improved markedly in one and resolved in the other case subsequent to revision of a blocked shunt. A hemiparesis should therefore not necessarily be attributed to assumed progression of an underlying disease. Other unusual symptoms of hydrocephalus or shunt dysfunction reported in childhood as well as possible causes of hemiparesis in shunted patients are listed.

Brain Neoplasms↗
PubMed1980

[Cholelithiasis as the first manifestation of cystic fibrosis of the pancreas (mucoviscidosis)].

A hitherto healthy 6-year-old girl developed cholestatic jaundice, due to multiple extra- and intrahepatic cholesterol bile calculi. Cystic fibrosis of the pancreas was established as the cause of the disease and of the biliary cirrhosis. Operative treatment and the ensuing substitution with pancreatic extracts have improved the cholestasis. Pulmonary involvement became subsequently evident and is now under treatment. The pathophysiology of bile acids in cystic fibrosis as relevant to the occurrence of gall stones in these patients is discussed.

Child↗