[Intussusception in children. A 17-year study].
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Biomedical subjects
Publications and source records attributed to T Swensen.
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A material of 108 patients with 125 intussusceptions was evaluated retrospectively. Barium enema is recommended as an excellent diagnostic tool. Reduction should be tried in all cases except those with signs of peritonitis, because the enema causes fewer complications and leads to a considerably decreased hospital stay.
Endoscopic retrograde brush cytology (ERBC) was performed in 29 patients with primary pancreatic malignancies verified later by histology. Results were positive in 21 patients, suspicious in five, and negative in three. ERBC performed in seven patients with uncertain findings at endoscopic retrograde cholangiopancreatography (ERCP) was positive for malignancy in six and suspicious in one. Endoscopic aspiration cytology (EAC) performed in 10 patients with primary tumours was positive for malignancy in three, suspicious in two, and negative in five cases. ERBC and/or EAC performed in five cases with secondary tumours were positive for malignancy in one and negative in four. It is concluded that ERBC gives a high rate of positive or suspicious (90%) diagnosis of malignancy in patients with primary pancreatic lesions. In secondary tumours cytology seems to be negative in most cases. The study further shows that many of the malignant tumours found by ERP are secondary lesions. Cytology is often able to detect malignancy when ERP has proved inconclusive.
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In a consecutive series of 174 patients the biliary and pancreatic ducts were demonstrated by endoscopic retrograde cholangio-pancreatography (ERCP). In 84 patients with normal duct systems, juxtapapillary diverticula were found in 5 patients (6%). In 90 cases with ductal abnormalities due to biliary concrements, dilated common bile duct and pancreatitis, diverticula were found in 35 patients (39%). In patients with abnormalities in both duct systems, diverticula were found in 52%, and in patients with changes in one duct system diverticula were found in 33%. The difference in occurrence of diverticula in patients with normal duct systems and pathological duct systems was statistically significant (p less than 0.02). The findings indicate a correlation between juxtapapillary diverticula and pathological changes due to biliary concrements, dilated common bile duct without concrements and pancreatitis.