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Biomedical subjects

T V Ballantine

Publications and source records attributed to T V Ballantine.

At least 55 records · Page 3Linked to original sources
PubMed1978

Hepatic mesenchymal hamartoma causing heart failure in the neonate.

This is the first report of an hepatic mesenchymal hamartoma causing congestive heart failure in an infant. These benign tumors usually present as a bulky abdominal mass but rarely can present with congestive failure when the angiomatous component is prominent.

Hamartoma↗
PubMed1978

A critical assessment of fluid requirements in gastroschisis.

This report critically evaluates the fluid requirements of 30 infants with gastroschisis. Fluid requirements were unrelated to gestational age, birth weight, or type of repair. Twenty-five percent of the fluid was colloid needed to restore intravascular volume and oncotic pressure, the balance consisting of Ringer's lactate solution. These data support the conclusion that the fluid requirements of the newborn with gastroschisis are significantly increased over those of the normal neonate. This is a reflection of antenatal peritonitis, third space fluid shifts and loss of water and electrolytes during transport to the pediatric surgical center. Recognition of these needs and appropriate replacement should reduce the perioperative morbidity and mortality in these seriously ill neonates.

Abdominal Muscles↗
PubMed1978

Experience with "second-look" operations in pediatric solid tumors.

"Second-look" operations were performed in 32 infants and children with initially unresectable or recurrent solid tumors treated with combination chemotherapy and/or irradiation. Tumors were resectable in 26 of 32 cases (81%). These procedures often yielded information affecting staging and treatment. Disease-free survival was achieved in 18 of 32 patients (56%). Mortality was related to progressive disease in seven cases and opportunistic infections due to immunosuppression in three. Four additional patients are alive with evidence of persistent tumor. Second-look procedures were beneficial in patients with Wilms' tumor previously operated upon by a flank approach and in children with bilateral tumors. These procedures were particularly useful in children with stage III localized neuroblastoma and cases of metastatic neuroblastoma that respond to chemotherapy. Second-look operations were also useful in selected cases of rhabdomyosarcoma, teratoma, and Ewing's sarcoma. These observations suggest that combination chemotherapy has increased the use of second-look operations in a variety of less favorable (e.g. initially unresectable or recurrent) pediatric solid tumors.

Antineoplastic Agents↗
PubMed1978

Cholelithiasis and Wilson disease.

We have studied three children with Wilson disease who had clinical symptoms suggestive of cholecystitis as well as radiologic evidence of gallstones, subsequently proven at the time of laparotomy. The gallstones from the patients with Wilson disease had an appreciably higher content of cholesterol than gallstones from age-matched children with hemolytic disease. Since gallstones may be present for years before they produce clinical symptoms, young patients with Wilson disease should undergo routine investigation for the presence of stones; cholelithiasis should also be considered in the differential diagnosis of abdominal pain in such patients.

Child↗
PubMed1978

Mesenteric cysts in infancy and childhood.

Of 11 infants and children with mesenteric cysts, seven patients were boys and four, girls. Clinical findings included abdominal distention, pain and vomiting in seven patients, while a movable abdominal mass was noted in four. Two patients presented with peritonitis and one patient, in a state of shock. All patients underwent laparotomy-seven as an emergency procedure. Volvulus with perforation and infarction was noted in the two patients uith peritonitis. Excision of the cyst required resection of the small intestine and end-to-end anastomosis in seven patients, while simple enucleation was possible in four. All 11 patients survived, and there have been neither subsequent complications nor recurrences. Early recognition and appropriate resection of these benign, but occasionally life-threatening, malformations is associated with an excellent long term prognosis.

Adolescent↗
PubMed1978

Esophageal atresia and tracheoesophageal fistula: Effect of delayed thoracotomy on survival.

Eighty-four infants with esophageal atresia and/or tracheosophageal (TE) fistula were treated from 1972 to 1977. Twenty-eight percent were premature and 24% weighed less than 2.0 kg. Major symptoms included excess salivation (56 patients), respiratory distress (28 patients), cyanosis (26 patients), and choking (nine patients). Pneumonia and or atelectasis occurred in 58% and associated anomalies in 68%. Seventy-three of 84 patients (87%) had proximal esophageal atresia and distal TE fistula (type C defect). Operation was carried out in 79 patients. Gastrostomy was performed in 75 patients, often under local anesthesia with subsequent delayed extrapleural thoractomy (mean, 3.9 days), when the infant's pulmonary condition was improved. Primary anastomosis was performed in 55 patients, division TE fistula and esophagostomy in ten, staged anastomosis in seven, cervical esophagostomy alone in three, division H fistual in two, ligation TE fistula alone in one, and gastrostomy alone in one. Complications were frequent, including need for ventilator support in 28 patients, atelectasis in 28, pneumonia in 18, jaundice in 13, heart failure in 11, anastomotic leak in 10, and stricture in four. Operative mortality was 5% (four of 79). Two deaths followed immediate thoracotomy and two were premature with anomalies. There were eight late deaths 4 to 39 months after operation. Seven had multiple anomalies. The overall mortality was 15%. Management of high-risk cases by preliminary gastrostomy and delayed extrapleural thoracotomy is associated with improved survival (67 to 79) (85%). Neonatal intensive care, detection of associated anomalies, and long-term follow-up are essential factors in reducing mortality.

Esophageal Atresia↗
PubMed1978

Congenital rectal stenosis: a sign of a presacral pathologic condition.

Congenital rectal stenosis may be detected in the newborn during the initial physical examination. Failure of conservative therapy (dilatation) should alert the physician to the presence of an associated pathologic condition in the presacral space. Presacral teratoma, anterior sacral meningocele, or bony anomalies may be the underlying extrinsic causes of congenital rectal stenosis. Prompt recognition and appropriate operative management directed at the presacral lesion will relieve obstructive symptoms and minimize morbidity.

Anus, Imperforate↗
PubMed1977

Splenorenal fusion: heterotopia simulating a primary renal neoplasm.

We report an instance of splenic heterotopia arising within the left kidney of an otherwise normal female infant. Embryologic considerations suggest that fusion of nephrogenic mesoderm and splenic anlage in the second month of gestation accounts for the observed findings. Although splenic-mesonephric (splenogonadal) fusion is a well-characterized, although rare, malformation, we were unable to find any previous description of splenic-metanephric fusion.

Adult↗
PubMed1977

Interstitial pneumonitis in the immunologically suppressed child: an urgent surgical condition.

Thirty-eight children were evaluated for interstitial pneumonia by open lung biopsy. In most instances the patients were immunosuppressed as a result of cancer chemotherapy and irradiation. Pneumocystis carinii infection was the most common cause of pneumonitis (60.4%), especially in children with leukemia (78.3%). The clinical triad of hypoxemia, tachypnea, and a diffuse interstitial infiltrate on chest x-ray, is an indication for early open lung biopsy. Survival was 91.7% in cases of acute pneumocystis pneumonia, a significant improvement over previous reports. These observations strongly support the concept of early open lung biopsy in the management of diffuse interstitial pneumonitis in patients who are immunosuppressed.

Acute Disease↗