Search PubMed⌕ Search

Biomedical subjects

S J Crankson

Publications and source records attributed to S J Crankson.

13 recordsLinked to original sources
PubMed2001

Pediatric thoracic trauma.

OBJECTIVE: A retrospective analysis of the medical records of children up to 12 years of age inclusive, who sustained thoracic injuries during a 6-year period. METHODS: Ninety-one children were treated at King Fahad National Guard Hospital, Riyadh from January 1993 through December 1998. The clinical data included age, sex, mechanism of injury, associated injuries, pediatric trauma score, treatment and mortality. RESULTS: Eighty-seven children (96%) had injuries from blunt trauma and 4 from penetrating injuries. Of the blunt trauma cases, 82 children sustained motor vehicle accident related injuries, 62 as pedestrians and 20 as passengers. Penetrating thoracic injuries occurred in 4 children: 1 stab wound and 3 gunshots. The most frequent thoracic injuries were pulmonary contusion (70), pneumothorax (32), fractured rib (20) and fractured clavicle (18). Extrathoracic injuries included head (45), abdominal (41) and skeletal (26). Thoracotomy was required in only 1 child, laparotomy being necessary in 9 children for intraabdominal injuries. Tube thoracostomy was required in 33 children. Nine children died from motor vehicle accident related fatal head and neck injuries, 8 as pedestrians all with a pediatric trauma score < or = 6. CONCLUSION: Thoracic injuries in children below 12 years of age are usually from motor vehicle accident related blunt trauma. Pulmonary contusion and pneumothorax are the most common thoracic injuries. Most thoracic injuries can be managed either conservatively or by tube thoracostomy. Thoracic trauma in children is an indicator of multisystem injury with head injury being the most common cause of mortality.

Accidents, Traffic↗
PubMed2000

Intussusception. A cause of postoperative intestinal obstruction in children.

Intestinal obstruction is a common postoperative complication and usually related to intra-abdominal adhesions. Postoperative intussusception, however, is a rare cause and may be confused with postoperative ileus. With more children undergoing abdominal operations, the incidence of postoperative intussusception should rise but reports indicate that this complication may be either not suspected or overlooked. We report 2 children who developed postoperative intussusception following repair of ruptured urinary bladder in one and appendicectomy in the other. Both had successful manual reduction at laparotomy.

Appendectomy↗
PubMed1998

Patent omphalomesenteric duct of the vermiform appendix in a neonate: congenital appendicoumbilical fistula.

Umbilical anomalies arise from fetal structures such as the omphalomesenteric duct (OMD) or urachus or from failure of closure of the umbilical fascial ring. Persistence of the OMD may lead to several anomalies including umbilical sinus, umbilical cyst, Meckel's diverticulum, or patent OMD (POMD). A POMD is usually associated with the ileum, but rarely may be with the caecum or appendix. We describe a POMD of the vermiform appendix and discuss the possible pathogenesis and management.

Appendix↗
PubMed1998

Congenital diaphragmatic hernia: experience with preoperative stabilization and delayed surgery without ECMO and inhaled nitric oxide.

Despite many advances in the management of congenital diaphragmatic hernia (CDH), the condition carries a mortality rate of 40-50% usually consequent to pulmonary hypoplasia and/or persistent pulmonary hypertension. Several centers have reported improved survival with preoperative stabilization and delayed surgery, which is now an accepted method of management. This is a retrospective analysis of all neonates with respiratory distress at birth due to CDH who were treated at our institution with neither extracorporeal membrane oxygenation nor nitric oxide being used. The medical records of all neonates with CDH and respiratory distress at birth who were treated at this institution from August 1, 1992 through March 1, 1997 were reviewed. There were 21 patients, 11 male and 10 female. There were 17 full-term and 4 premature infants; two premature infants at 30 and 34 weeks' gestation were not resuscitated because of severe associated congenital anomalies. Surgery was performed from 5 to 144 hr (mean 45 hr) in 18 infants. One infant died during preoperative stabilization from severe pulmonary hypoplasia and pulmonary hypertension and one infant died postoperatively from the same conditions. Seventeen of 19 infants (89.5%) survived and were discharged home. Three infants (17.6%) who failed to thrive due to severe gastroesophageal reflux (GER) required fundoplication. Eleven infants (64.7%) who had sepsis proven by blood culture responded satisfactorily to appropriate antibiotics. Preoperative stabilization and delayed surgery has been a satisfactory form of management in our series. The significant complication was sepsis, which must be addressed.

Bronchodilator Agents↗
PubMed1997

Hepatic foreign body in a child.

The majority of foreign bodies (FBs) swallowed by children are passed spontaneously without event. Perforation of the intestine with migration to the liver is rare. A child with a needle in the right lobe of the liver is reported.

Child, Preschool↗
PubMed1997

Female bladder exstrophy.

Bladder exstrophy is one of the most challenging congenital urinary tract abnormalities. Apart from the open bladder the patient also has various other abnormalities, including urogenital, musculoskeletal and anorectal defects. The size of the exstrophic bladder varies from patient to patient. In the female the clitoris to bifid and the vagina is anteriorly placed. In this paper various aspects of female bladder exstrophy are reviewed in detail, including incidence, etiology, anatomy and clinical features, together with early, medium-term and long-term surgical management. The aim is to achieve a functional bladder closure, although some patients are better off with a urinary diversion. Considering the complexity of the urogenital problems and the surgical management thereof, all patients require lifelong follow-up.

Abnormalities, Multiple↗
PubMed1992

Haemangiomatous polyp of the posterior urethra in a boy.

Urethral haemangiomas are rare and usually involve the entire urethra or are localized to the anterior urethra. Posterior urethral polyps are uncommon. A posterior urethral polyp was removed from a 3-year-old boy which proved to be haemangioma. In the histological classification of posterior urethral polyps, haemangioma should therefore be included.

Child, Preschool↗
PubMedDate not supplied

Extrahepatic biliary atresia in Saudi Arabia: the importance of early diagnosis and referral.

OBJECTIVE: A retrospective analysis of the medical records of children who were managed for extrahepatic biliary atresia (EHBA) over a 6-year period. MATERIALS AND METHODS: Twelve children were managed at King Fahad National Guard Hospital with a diagnosis of extrahepatic biliary atresia from January 1993 through December 1998. The data obtained included age, sex, clinical presentation, age at referral, investigations, management, complications and follow-up. RESULTS: There were 7 males and 5 females with age of onset of jaundice ranging from 3 days to 42 days (mean 10 days). The mean age at referral was 17 weeks (range 6-49 weeks). Kasai Portoenterostomy (PE) was performed in 7 infants and the mean age at surgery was 8 weeks (range 7 to 10.5 weeks). Four children could not undergo Kasai PE because they were more than 20 weeks old and 1 child although 10 weeks old had extensive liver cirrhosis and was considered not suitable for the procedure. One child who had primary liver transplant outside the Kingdom and 4 children who had Kasai PE are still alive. Seven children are lost to follow-up and are probably dead. CONCLUSION: The incidence of EHBA in Saudi Arabia is unknown and the disease is probably rare based on our review. Although jaundice, pale stools and dark urine were observed in early infancy, referral was always late. Public and health professional's awareness of the clinical features of EHBA is important in early identification of infants and early referral. Starting paediatric hepatobiliary centers in Saudi Arabia will improve the management of these cases.

Biliary Atresia↗