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Biomedical subjects

P Sherman

Publications and source records attributed to P Sherman.

111 records · Page 7Linked to original sources
PubMedDate not supplied

[Ileoanal anastomosis with and without reservoir in children and adolescents with ulcerative rectocolitis and familial polyposis].

We compared the postoperative evolution of patients in whom an ileoanal anastomosis was performed, with (group 1, n:9) an without (group 2, n:7) an ileal reservoir. 3 of the 9 patients in group 1 developed intractable diarrhea, it was necessary to reoperate these children and to construct an ileal reservoir. It was not necessary to reoperate any of the group 2 patients; 2 of whom still have an ileostomy due to the presence of preanastomotic abscess. These 2 last patients where excluded from the following analysis. 2 months after surgery, children in group 1 had 16 +/- 2 bowel movements a day, compared with 8 +/- 2 in group 2, p less than 0.05. Children in group 1 did less well than those in group 2 when the following parameters were compared: fecal incontinence (7/9 vs 0/5), perianal dermatitis (6/9 vs. 1/5), treatment with antidiarrheal agents (5/9 vs 0/5), missing school (4/9 vs 0/5) and diminished social activities (4/9 vs 0/5). We conclude that in children who require colectomy, better results are obtained when an ileoanal anastomosis with ileal reservoir is performed.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

Choledochal cysts: heterogeneity of clinical presentation.

Over a 12-year period, 23 children were diagnosed as having choledochal cysts, of which 22 were type I and one was type II. The triad of right upper-quadrant abdominal pain, right upper-quadrant abdominal mass, and cholestatic jaundice was present in only four of 23 (17%). Mean time from the onset of symptoms to establishing the correct diagnosis was 20 months, and in one child the diagnosis was established only at autopsy. Six children had histologic evidence of biliary cirrhosis, and three developed portal hypertension despite surgical intervention. Both ultrasonography of the abdomen and endoscopic retrograde cholangiopancreatography (ERCP) were useful methods in establishing the diagnosis, but both tests did result in false negatives. Choledochal cysts are treatable causes of cholestatic jaundice in infants and children, but the intermittent and variable nature of their presentation renders clinical diagnosis difficult.

Adolescent↗