Fetal and neonatal hydronephrosis.
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Female↗
Biomedical subjects
R L Teele
Publications and source records attributed to R L Teele.
Asymptomatic scrotal masses in children.
The ultrasound scans of 16 boys with asymptomatic scrotal masses were retrospectively studied. Ultrasound localized seven of the masses as primary testicular lesions and nine as extratesticular lesions, six of which were hydroceles. Ultrasonography also characterized the scrotal masses as predominantly cystic or solid. Ultrasound could not differentiate benign from malignant disease when a solid mass was found. When a hydrocele was identified, ultrasound was able to image the underlying testis and accurately evaluate it for primary disease. These ultrasound observations can help the surgeon decide when to explore the scrotum and whether to approach the testes via an inguinal or scrotal incision. Conversely, ultrasonographic confirmation of a normal testis may prevent needless surgery and the removal of a normal testis.
Adolescent↗
Sonographic assessment of renal length in normal children.
Renal length was measured from normal real-time sonograms of 203 pediatric patients and graphed to provide a "growth chart" of normal renal size vs. age. Mean renal lengths are reported for each year of age. For children older than 1 year, the regression equation is: renal length (cm) = 6.79 + 0.22 X age (years). For babies younger than 1 year, the equation is: renal length (cm) = 4.98 + 0.155 X age (months).
Adolescent↗
Rationale for grading intracranial hemorrhage in premature infants.
There is a high incidence of hemorrhage in the germinal matrix and ventricular system in premature infants. Existing systems of grading the extent of hemorrhage into germinal matrix and ventricles of premature babies have limitations. It is necessary to consider correlations of structure (neuroanatomy by ultrasound) with function (outcome of patient). It is suggested that a standardized worksheet for evaluation of cranial ultrasound usage in premature infants be adopted. Such a worksheet allows uniformity of data collection and permits a more efficient method for evaluating correlations of structure with function.
Cerebral Hemorrhage↗
Colobronchial fistula as a late complication of coloesophageal interposition.
A 20-yr-old man developed recurrent respiratory symptoms and left lower lobe pneumonia 14 yr after long-segment colonic interposition for corrosive esophageal injury. A fistula, from a redundant supradiaphragmatic pouch of colon to a subsegmental bronchus of the lower lobe of the left lung, was discovered and treated successfully with surgical resection. This previously unreported complication, therefore, should be considered in patients who develop respiratory symptoms after coloesophageal interposition.
Adult↗
Fetal and neonatal hydronephrosis.
Maternal ultrasonography makes it possible to easily detect hydronephrosis in the fetus, and therefore fetal "screening" should be part of every obstetrical ultrasonogram. However, the mere presence of fetal hydronephrosis virtually never means that either fetal intervention or early delivery is warranted. The importance of fetal case-finding is that it enables us to promptly (and electively) evaluate and treat the asymptomatic neonate before infection or other complications occur.
Female↗
Sonography of thickened gallbladder wall: causes in children.
A review of 793 consecutive abdominal sonograms in children aged 1 day to 16 years disclosed 453 patients in whom the gallbladder was clearly visible on at least two perpendicular views. Twenty had a gallbladder wall more than 3 mm thick. The following diseases were associated with gallbladder wall thickening; hypoalbuminemia (13 cases), ascites (five, three with concomitant hypoalbuminemia), physiologic thickening because of partial wall contraction (one), and systemic venous hypertension (one). None of 26 patients with gallstones and one of 14 with sludge had a thickened gallbladder. (The latter patient had concomitant hypoalbuminemia). Five patients with surgically proven acute cholecystitis during this same interval of time had sonograms. In four, the gallbladder wall was of normal thickness. In the fifth patient, the gallbladder wall could not be visualized because of densely shadowing stones. In this population, thickening of the gallbladder wall was not associated with acute cholecystitis and thus was not an indication for cholecystectomy.
Adolescent↗
Cholelithiasis in children: recent observations.
All patients at Children's Hospital Medical Center who had ultrasonic evidence of cholelithiasis during the period from June 1979 to June 1982 were identified. Their charts and radiographs were reviewed, as were the surgical and pathologic reports of those who had cholecystectomy. Cholelithiasis was found to be less rare than expected. Sixty-five patients were identified during the three-year period. Exclusion of 13 patients more than 21 years old left 52 patients, 29 of whom were female and 23 male, ranging in age from 3 months to 21 years. Predisposing diseases or circumstances were present in 83 per cent of the cases. These included hemolytic anemia (15), cystic fibrosis (4), metabolic disease (3), liver disease (4), postpartum state (4), prior bowel resection or malabsorption (4), cardiac disease (4), prior orthopedic surgery (2), other (3). There were only nine cases in which no identifiable predisposition to cholelithiasis could be found. Although the gallstones were not subjected to chemical analysis, at least 53 per cent of them were visible on the 34 available abdominal radiographs, indicating the presence of calcium and thus stones of a mixed type.
Adolescent↗
A self teaching file for radiology residents.
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Internship and Residency↗
Causes of increased renal echogenicity in pediatric patients.
Review of 2,700 abdominal ultrasonic examinations revealed 56 patients whose kidneys showed increased echogenicity. Echogenic kidneys were associated with medical renal disease in 94% of cases (30% glomerular, 48% tubulointerstitial, 16% end-stage) and with no detectable renal disease in 6% (three patients). Patterns of increased echogenicity and renal size were evaluated. Specific patterns occurred in end-stage renal disease and polycystic kidney disease. Other medical renal diseases had overlapping ultrasonographic features. Some generalizations could be made although increased echogenicity was often nonspecific.
Child↗
The infant with possible biliary atresia: evaluation by ultrasound and nuclear medicine.
Twenty-eight infants with jaundice were evaluated with ultrasound and radionuclide scans. Comparison of these studies with pathologic, surgical and clinical examinations demonstrated good correlation between ultrasonic and radionuclide studies. Ultrasound is an important preliminary study in the workup of such patients. Combined imaging provides the most information in a patient with suspected biliary atresia.
Bile Ducts↗
Benign vascular tumors of the liver in infants: sonographic appearance.
The distinctive sonographic appearance of benign vascular tumors of the liver (one hemangioendothelioma and two mesenchymal hamartomas) in three infants is presented. Each child had hepatomegaly and congestive heart failure, and all had confirmatory arteriography. The sonographic pattern of a complex mass, dilated proximal aorta, and enlarged nutritive and draining vascular structures should alert the radiologist and clinician to this diagnosis.
Angiography↗
The hyperechogenic liver in children: cause and sonographic appearance.
The clinical records of 28 patients seen in one institution during a recent 2 year period who, on sonography, had been identified as having a hyperechogenic (bright) liver were reviewed. Seven children were diagnosed as having metabolic diseases, four were malnourished, four were receiving hyperalimentation, 10 were receiving chemotherapy, and three were undiagnosed. The sonograms of all the patients and the histologic sections on those who had biopsies, were reevaluated in order to assess the sonographic pattern in greater detail, and these findings were correlated with fatty infiltration and fibrosis of the liver. The bright liver corresponded to the pathologic finding of fatty change. This sonographic finding in children is important, as further evaluation (hepatic biopsy with fat stain, enzymatic analyses, amino acid screens) can be suggested to identify underlying metabolic disorders in those not on therapy. Often the complications of metabolic diseases can be prevented or delayed by early diagnosis and appropriate therapy.
Adolescent↗
Acute torsion of normal uterine adnexa in children: sonographic demonstration.
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Adnexa Uteri↗
Hydronephrosis in children: narrowing the differential diagnosis with ultrasound.
Twenty patients with hydronephrosis in whom examination with ultrasound was helpful in defining the extent of dilation of the collecting system are presented. Thirteen patients had hydronephrosis due to obstruction at the ureteropelvic junction, six had obstruction of the ureterovesical junction from various causes, and one had massive bilateral vesicoureteral reflux. The diagnosis of high ureteral obstruction as opposed to obstruction or reflux at the ureterovesical junction was based on visualizing a dilated ureter in the later two groups.
Child↗
The radiographic and ultrasonographic evaluation of enteric duplication cysts.
The pattern of diagnostic evaluation of seven children with duplication cysts of the gastrointestinal tract (two with bronchopulmonary foregut malformations and five with mid or hindgut duplications) is presented. Each child had plain radiographs followed by ultrasonic scans and appropriate confirmatory radiographic studies with contrast. Scans showed a well defined cystic mass in each case. Radiographs were able to identify more precisely the site of origin of the duplication cyst.
Adolescent↗
Cystic fibrosis: its characteristic appearance on abdominal sonography.
The abdominal sonograms of 24 patients with cystic fibrosis aged 8-30 years were reviewed. Most patients had abnormal scans; the number and severity of organs involved tended to increase with age. When the pancreas was identified, it was usually echogenic and small. Cholelithiasis, microgallbladder, and obstruction of the common bile duct were observed. Textural changes in the liver reflected underlying parenchymal disease; splenomegaly and portal hypertension occurred in responses to severe hepatic involvement. A few patients had thick gastric or duodenal wall.
Abdomen↗
Delayed diagnosis of duodenal obstruction in Down syndrome.
Four children with Down syndrome (trisomy 21) came to medical attention in late childhood with symptoms of obstruction of the upper gastrointestinal tract. Each patient had radiographic evaluation. The combination of Down syndrome, retained foreign material in the stomach or proximal duodenum, and obstruction resulted in the diagnosis of congenital duodenal stenosis in each patient.
Child↗