Subject(s)
Codon/genetics , Glucuronosyltransferase/genetics , Jaundice, Neonatal/genetics , Kernicterus/genetics , Promoter Regions, Genetic/genetics , Adult , Animals , Base Sequence , Blotting, Western , COS Cells , Crigler-Najjar Syndrome/genetics , DNA/chemistry , DNA/genetics , DNA Mutational Analysis , Female , Gilbert Disease/genetics , Glucuronosyltransferase/metabolism , Humans , Infant , Infant, Newborn , Male , Mutation , Mutation, Missense , Plasmids/geneticsABSTRACT
The authors report the successful use of laparoscopic-assisted percutaneous endoscopic gastrostomy (LAPEG) in two children. Attempts at simple percutaneous endoscopic gastrostomy in both patients had failed. Subsequently, LA-PEG was easily accomplished. This technique consisted of a combination of upper gastrointestinal endoscopy and laparoscopy. The gastrostomy was placed under direct vision in the lesser gastric curvature, hence minimizing the risk of developing gastroesophageal reflux.
Subject(s)
Gastrostomy , Laparoscopy , Adolescent , Brain Damage, Chronic , Brain Diseases , Endoscopy, Gastrointestinal , Female , Gastroesophageal Reflux/prevention & control , Gastroscopy , Gastrostomy/adverse effects , Gastrostomy/methods , Humans , Laparoscopy/methods , Male , Obesity , Transillumination , Treatment FailureABSTRACT
Steatorrhea is seen in 18-24% of patients with autoimmune polyglandular disease (APD) type 1. The etiology and pathophysiology of the steatorrhea in this disease are unknown. We present a patient with APD type 1 and steatorrhea in whom biopsies revealed intestinal lymphangiectasia. This association has not been previously described. Intestinal lymphangiectasia may explain the steatorrhea in some patients with ADP type 1. As blind intestinal biopsies may miss areas of intestinal lymphangiectasia, endoscopically directed intestinal biopsies should be included in the evaluation of steatorrhea in APD type 1.
