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1.
Eur J Pediatr Surg ; 14(4): 274-8, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15343469

ABSTRACT

Ingestion of a disc battery can lead to hazardous complications including tracheoesophageal fistula (TEF), especially when the battery is impacted in the esophagus. Urgent esophagoscopic removal of the battery is essential in all cases. Persisting respiratory symptoms and/or feeding difficulty after removal should alert the surgeon to evaluate for TEF. Esophagography and/or esophagoscopy should be performed. Once the TEF is identified, conservative management is the initial treatment of choice. Delayed primary repair can be tried if spontaneous closure does not occur. The authors present a case of TEF secondary to disc-battery ingestion with review of the current literature and discuss the management of this rare but potentially life-threatening complication.


Subject(s)
Foreign Bodies/complications , Tracheoesophageal Fistula/etiology , Esophagoscopy , Esophagus/diagnostic imaging , Esophagus/pathology , Esophagus/surgery , Female , Humans , Infant , Radiography , Tracheoesophageal Fistula/surgery , Treatment Outcome
2.
J Pediatr Surg ; 39(4): 582-6, 2004 Apr.
Article in English | MEDLINE | ID: mdl-15065032

ABSTRACT

BACKGROUND/PURPOSE: Whole-bowel irrigation (WBI) has been used for different purposes. It has been the preferred method of bowel cleansing before large bowel surgery and colonoscopy. There are some studies about histopathologic alterations in the gastrointestinal system caused by WBI. It was reported that large quantities of bile-stained intraluminal fluid were seen after WBI with lactated Ringer's solution. In light of all these studies, the authors have decided to inspect whether WBI is choleretic and whether the histopathologic findings in the gastrointestinal system are caused by this choleretic effect. METHODS: During the experimental procedures, animals at first were divided into 2 major groups of A and B; A consisted of the animals whose bile was not collected, and B consisted of animals whose bile was collected. Later, these 2 groups were divided into 4 subgroups consisting of 6 animals each. Sham operations were performed on the animals in group SH-A and SH-B. The animals in group saline-A and saline-B were given 0.9% of sodium chloride (isotonic sodium chloride). The animals in group LR-A and LR-B received lactated Ringer's solution. The last group (PEG-A and PEG-B) underwent WBI by using polyethylene glycol solution (PEG). After completing WBI, animals were rested for 4 hours, and at the end of resting time, laparotomy was performed to take biopsy specimens from stomach, small bowel, and large bowel. All of the specimens were evaluated and graded for congestion, edema, and inflammation by the individual blinded pathologist. RESULTS: According to the results, WBI has been shown to affect biliary secretion and to have a choleretic effect (P <.05, Tuckey-Kramer). The choleretic effect has also been shown to be responsible for histopathologic alterations in some groups (P <.05, Tuckey-Kramer). The most severe changes of congestion, edema, and inflammation have been detected in isotonic sodium chloride solutions in all groups. The least alterations have been seen in lactated Ringer's and PEG solutions. CONCLUSIONS: In light of these findings, it might be concluded that the use of WBI can cause different degrees of histopathologic changes in gastrointestinal system depending on the type of solutions. WBI has been shown to have choleretic effect, and it was found that there is a connection between histopathologic changes in gastrointestinal system and choleretic effect of WBI.


Subject(s)
Bile/metabolism , Colon , Digestive System/drug effects , Liver/metabolism , Solutions/pharmacology , Animals , Cholagogues and Choleretics/pharmacology , Cholagogues and Choleretics/toxicity , Colon/drug effects , Digestive System/pathology , Edema/chemically induced , Female , Gastric Mucosa/drug effects , Gastric Mucosa/pathology , Gastroenteritis/chemically induced , Intestinal Mucosa/drug effects , Intestinal Mucosa/pathology , Isotonic Solutions/pharmacology , Isotonic Solutions/toxicity , Polyethylene Glycols/pharmacology , Polyethylene Glycols/toxicity , Rats , Rats, Sprague-Dawley , Ringer's Lactate , Single-Blind Method , Sodium Chloride/pharmacology , Sodium Chloride/toxicity , Solutions/toxicity , Therapeutic Irrigation/adverse effects
3.
Eur J Pediatr Surg ; 13(6): 421-4, 2003 Dec.
Article in English | MEDLINE | ID: mdl-14743334

ABSTRACT

Inflammatory myofibroblastic tumour is a rare entity in children with few reported series. The extrahepatic bile duct is an unusual location for this tumour. The authors report here the case of an 8-year-old girl presenting with obstructive jaundice due to inflammatory myofibroblastic tumour of the extrahepatic bile ducts with differential diagnosis of obstructive jaundice in children.


Subject(s)
Bile Duct Neoplasms/complications , Bile Ducts, Extrahepatic , Granuloma, Plasma Cell/complications , Jaundice, Obstructive/etiology , Bile Duct Neoplasms/pathology , Bile Duct Neoplasms/surgery , Bile Ducts, Extrahepatic/diagnostic imaging , Bile Ducts, Extrahepatic/pathology , Child , Dilatation, Pathologic , Granuloma, Plasma Cell/pathology , Granuloma, Plasma Cell/surgery , Humans , Lymphatic Metastasis , Ultrasonography
4.
Eur J Pediatr Surg ; 12(5): 327-9, 2002 Oct.
Article in English | MEDLINE | ID: mdl-12469260

ABSTRACT

A 16-year-old girl with intrathyroidal ectopic thymic tissue, which was diagnosed incidentally after surgery for thyroid nodule, is reported to emphasise the possible clinical and surgical presentations of this rare entity.


Subject(s)
Choristoma/pathology , Thymus Gland , Thyroid Diseases/pathology , Thyroid Nodule/pathology , Adolescent , Choristoma/surgery , Female , Humans , Thyroid Diseases/surgery , Thyroid Nodule/surgery
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