Subject(s)
Humans , Infant, Newborn , Brain Neoplasms/diagnosis , Nose Neoplasms/diagnosis , Agenesis of Corpus Callosum/diagnosis , Lipoma/diagnosis , Brain Neoplasms/complications , Infant, Premature , Magnetic Resonance Imaging , Nose Neoplasms/complications , Agenesis of Corpus Callosum/complications , Lipoma/complications , Neoplasms, Multiple Primary/complications , Neoplasms, Multiple Primary/diagnosisABSTRACT
Spontaneous oesophageal rupture (Boerhaave's syndrome) is extremely rare in children. Presentation is usually in middle aged men as a result of vomiting following heavy food or alcohol consumption. We describe an unusual case of a 12-year old boy without significant past medical history presenting with acute chest pain following gastroenteritis.
La ruptura esofágica espontánea (síndrome de Boerhaave) es extremadamente rara en niños. Por lo general se presenta en hombres de mediana edad como resultado vómitos tras la ingestión de alcohol o alimentos pesados. Describimos un caso inusual de un niño de 12 años de edad sin antecedentes clínicos significativos, que acudió con dolor torácico agudo tras una gastroenteritis.
Subject(s)
Humans , Male , Child, Preschool , Child , Pneumopericardium/diagnostic imaging , Rupture, Spontaneous/diagnosis , Esophageal Perforation/diagnosis , Mediastinal Emphysema/diagnostic imaging , Mediastinal Diseases/diagnosis , Pneumopericardium/etiology , Rupture, Spontaneous/etiology , Vomiting/etiology , Chest Pain/etiology , Radiography , Diagnosis, Differential , Esophageal Perforation/etiology , Gastroenteritis/complications , Mediastinal Emphysema/etiology , Mediastinal Diseases/etiologyABSTRACT
Spontaneous oesophageal rupture (Boerhaave's syndrome) is extremely rare in children. Presentation is usually in middle aged men as a result of vomiting following heavy food or alcohol consumption. We describe an unusual case of a 12-year old boy without significant past medical history presenting with acute chest pain following gastroenteritis.
Subject(s)
Esophageal Perforation/diagnosis , Mediastinal Diseases/diagnosis , Mediastinal Emphysema/diagnostic imaging , Pneumopericardium/diagnostic imaging , Rupture, Spontaneous/diagnosis , Chest Pain/etiology , Child , Diagnosis, Differential , Esophageal Perforation/etiology , Gastroenteritis/complications , Humans , Male , Mediastinal Diseases/etiology , Mediastinal Emphysema/etiology , Pneumopericardium/etiology , Radiography , Rupture, Spontaneous/etiology , Vomiting/complicationsSubject(s)
Agenesis of Corpus Callosum/diagnosis , Brain Neoplasms/diagnosis , Lipoma/diagnosis , Neoplasms, Multiple Primary/diagnosis , Nose Neoplasms/diagnosis , Agenesis of Corpus Callosum/complications , Brain Neoplasms/complications , Humans , Infant , Lipoma/complications , Magnetic Resonance Imaging , Neoplasms, Multiple Primary/complications , Nose Neoplasms/complicationsABSTRACT
INTRODUCTION: Children with inflammatory bowel disease (IBD) frequently present with small bowel involvement at some stage of their disease. Hence, reliable assessment of the entire small bowel is required in order to adjust treatment accordingly. Recently, magnetic resonance imaging (MRI) of the small bowel in combination with luminal contrast agent delivered via a naso-jejunal tube (MR enteroclysis) is an emerging technique demonstrating good results in adult patients. However, data on its use and benefits in children is limited. AIMS: In this study we report our experience on performing small bowel MR enteroclysis (MRE) in children with IBD. Specifically, we reviewed indications, MR findings, advantages and disadvantages of the technique in a tertiary unit. METHODS: A total of 34 MRE studies (29 paediatric IBD patients) were retrospectively analysed. All patients underwent upper and lower endoscopy under general anaesthetic (GA) the day before MR imaging was performed. Nasojejunal (NJ)-tube was placed during endoscopy. RESULTS: Frequently detected findings included small and large bowel wall thickening, small bowel strictures and intestinal lymph node enlargement. Importantly, in all our clinical cases, MRE results were key to making a clinical decision in the given scenario regardless of whether MRE findings were positive or negative. CONCLUSIONS: Within our setup, MR enteroclysis is a well-tolerated, sensitive technique for small bowel imaging, providing detailed information at crucial clinical decision points. Moreover, accurate information then allows appropriate clinical decisions to be made.
Subject(s)
Contrast Media/administration & dosage , Endoscopy, Gastrointestinal/methods , Inflammatory Bowel Diseases/diagnosis , Intestine, Small/pathology , Intubation, Gastrointestinal , Magnetic Resonance Imaging/methods , Adolescent , Child , Diagnosis, Differential , Female , Humans , Inflammatory Bowel Diseases/therapy , Male , Reproducibility of Results , Retrospective StudiesABSTRACT
Microvascular endothelial cells involved in angiogenesis are exposed to an acidic environment that is not conducive for growth and survival. These cells must exhibit a dynamic intracellular (cytosolic) pH (pHcyt) regulatory mechanism to cope with acidosis, in addition to the ubiquitous Na+/H+ exchanger and HCO3--based H+-transporting systems. We hypothesize that the presence of plasmalemmal vacuolar-type proton ATPases (pmV-ATPases) allows microvascular endothelial cells to better cope with this acidic environment and that pmV-ATPases are required for cell migration. This study indicates that microvascular endothelial cells, which are more migratory than macrovascular endothelial cells, express pmV-ATPases. Spectral imaging microscopy indicates a more alkaline pHcyt at the leading than at the lagging edge of microvascular endothelial cells. Treatment of microvascular endothelial cells with V-ATPase inhibitors decreases the proton fluxes via pmV-ATPases and cell migration. These data suggest that pmV-ATPases are essential for pHcyt regulation and cell migration in microvascular endothelial cells.
