scholarly journals Clinical Presentations, Diagnosis, and Management for Pediatric Antral Web—A 20-Year Experience of a Referral Center

2021 ◽  
Vol 9 ◽  
Author(s):  
Pai-Jui Yeh ◽  
Hsun-Chin Chao ◽  
Chien-Chang Chen ◽  
Jin-Yao Lai ◽  
Ming-Wei Lai
Keyword(s):  
Outlet Obstruction ◽  
Gastric Ulcers ◽  
Interventional Treatment ◽  
Web Based ◽  
Referral Center ◽  
Growth Faltering ◽  
Clinical Presentations ◽  
Age Of Diagnosis ◽  
Antral Web ◽  
Surgical Treatments

Background: Antral web is a rare cause of gastric outlet obstruction in children. The presentation is diverse, depending on the degree of obstruction. Unfortunately, the guidance of management is still lacking.Methods: This study retrospectively evaluated the presentations, management, and outcomes of the pediatric antral web based on a 20-year experience in a referral center.Results: A total of 23 cases were included. The median age of diagnosis was 10 months (interquartile range, IQR, 0.8–23 months). Main presentations comprised vomiting (83%) and upper gastrointestinal (UGI) bleeding (48%). Concurrent gastric ulcers were common (68%). A total of 13 cases (57%) underwent interventional treatment. The median duration from diagnosis to intervention (DtI) was 10 days, but five with longer DtI, ranged from 30 to 755 days. Among the 15 cases with concurrent gastric ulcers, 10 patients received intervention, immediately in six but delayed in four. Surgical treatments (N = 12) achieved a cure in 11, with one rescued by endoscopic treatment.Conclusions: Children who suffer from early gastric ulcers with outlet obstruction shall raise the suspicion of the antral web. Complete obstruction madates early intervention. Around half of the cases with adequate feeding and growth need no intervention. Recurrent obstructive symptoms or adjacent ulcers justify a switch from observation to intervention to avoid complications or growth faltering.

Paediatric ophthalmology

2014 ◽  
pp. 761-824
Author(s):  
Alastair K.O. Denniston ◽  
Philip I. Murray
Keyword(s):  
Retinopathy Of Prematurity ◽  
Congenital Cataract ◽  
Metabolic Diseases ◽  
Orbital Cellulitis ◽  
Developmental Abnormalities ◽  
Clinical Presentations ◽  
Key Issues ◽  
Paediatric Ophthalmology ◽  
Surgical Treatments ◽  
Ophthalmic Disease

‘Paediatric ophthalmology’ provides the reader with a practical approach to the assessment and management of ophthalmic disease in children. After outlining the relevant embryology of the eye, the chapter addresses the key issues and clinical presentations arising in children, before going on to discuss specific diseases such as ophthalmia neonatorum, orbital cellulitis, congenital cataract, uveitis in children, glaucoma in children, retinopathy of prematurity, metabolic diseases and developmental abnormalities. Using a patient-centred approach the key clinical features, investigations and management (including medical and surgical treatments) are described for each condition.

scholarly journals Surgical Treatment of Adult Moyamoya Disease In Saudi Arabia: A Review Article

2021 ◽  
pp. 145-153
Author(s):  
Bedour Eid H. Alatawi ◽  
Faisal Saeed A. Al-Ghamdi ◽  
Muath Sulaiman G. Alhamdi ◽  
Raghad Dhafer E. ALamri ◽  
Lena Defallah G. Alzahrani ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Hemorrhagic Stroke ◽  
Sudden Increase ◽  
Hemodynamic Changes ◽  
Clinical Presentations ◽  
Indirect Revascularization ◽  
Undetermined Etiology ◽  
Adult Moyamoya Disease ◽  
Surgical Treatments ◽  
Prevention Of Recurrence

Moyamoya disease (MMD) is an isolated chronic, usually bilateral, vasculopathy disease of undetermined etiology. The clinical presentations of MMD include TIA, ischemic stroke, hemorrhagic stroke, seizures, headache, and cognitive impairment. Intra- and extra-cranial revascularization for the prevention of recurrence of bleeding in patients with hemorrhagic MMD is controversial. Surgical revascularization of MMD includes 3 types: Direct revascularization, indirect revascularization and combined revascularization. The surgical goal of cerebral revascularization is to prevent progression of symptomology, alleviate intracranial hemodynamic stress, and reduce the incidence of subsequent ischemic or hemorrhagic stroke. However, surgical treatments pose various complications due to the sudden increase in cerebral blood flow or hemodynamic changes caused by perioperative risk factors and anesthesia, such as HS, cerebral hemorrhage and cerebral infarction, bypass occlusion caused by distal vascular resistance, bypass occlusion caused by compression of the temporalis, and anastomotic aneurysm.

scholarly journals A Histomorphological Pattern Analysis of Pulmonary Tuberculosis in Lung Autopsy and Surgically Resected Specimens

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Mamta Gupta ◽  
Flora D. Lobo ◽  
Deepa Sowkur Anandarama Adiga ◽  
Abhishek Gupta
Keyword(s):  
Pulmonary Tuberculosis ◽  
Pattern Analysis ◽  
Surgical Intervention ◽  
Miliary Tuberculosis ◽  
Frequent Pattern ◽  
Male Predominance ◽  
Clinical Presentations ◽  
Age Of Diagnosis ◽  
The Mean ◽  
Necrotizing Granulomas

Background. Tuberculosis (TB) is a major cause of morbidity and mortality globally. Many cases are diagnosed on autopsy and a subset of patients may require surgical intervention either due to the complication or sequelae of TB. Materials and Methods. 40 cases of resected lung specimens following surgery or autopsy in which a diagnosis of pulmonary tuberculosis was made were included. Histopathological pattern analysis of pulmonary tuberculosis along with associated nonneoplastic changes and identification of Mycobacterium tuberculosis bacilli was done. Results. The mean age of diagnosis was 41 years with male predominance (92.5%). Tuberculosis was suspected in only 12.1% of cases before death. Seven cases were operated upon due to associated complications or suspicion of malignancy. Tubercular consolidation was the most frequent pattern followed by miliary tuberculosis. The presence of necrotizing granulomas was seen in 33 cases (82.5%). Acid fast bacilli were seen in 57.5% cases on Ziehl-Neelsen stain. Conclusion. Histopathology remains one of the most important methods for diagnosing tuberculosis, especially in TB prevalent areas. It should be considered in the differential diagnosis of all respiratory diseases because of its varied clinical presentations and manifestations.

scholarly journals An asymptomatic presentation of gastric outlet obstruction secondary to congenital antral web in an extremely preterm infant

2009 ◽  
Vol 2009 (dec14 1) ◽  
pp. bcr1020092327-bcr1020092327
Author(s):  
S. V Godambe ◽  
P. Boriana ◽  
S. H Ein ◽  
V. Shah
Keyword(s):  
Preterm Infant ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Extremely Preterm ◽  
Antral Web

scholarly journals A Questionnaire Survey of Management of Patients with Aneurysmal Subarachnoid Haemorrhage in Poland

2020 ◽  
Vol 17 (11) ◽  
pp. 4161
Author(s):  
Mariusz Hofman ◽  
Norbert Hajder ◽  
Izabela Duda ◽  
Łukasz J. Krzych
Keyword(s):  
Clinical Practice ◽  
Subarachnoid Haemorrhage ◽  
Treatment Plan ◽  
Anaesthetic Management ◽  
Interventional Treatment ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Web Based ◽  
Mortality And Morbidity ◽  
Microsurgical Clipping ◽  
First Choice

Background: Aneurysmal subarachnoid haemorrhage (aSAH) remains a potentially devastating threat to the brain with a serious impact on mortality and morbidity. We attempted to investigate correspondence between the current guidelines for aSAH management and real clinical practice in Poland. Methods: A web-based questionnaire was performed between 03.2019 and 06.2019. Centres performing neuro-interventional radiology procedures and neuro-critical care were included (n = 29). One response from each hospital was recorded. Results: In three (10.4%) centres, there was no clear protocol for an interventional treatment plan. Endovascular embolisation was predominantly used in 11 (37.9%) hospitals, and microsurgical clipping, in 10 (34.5%). A written protocol for standard anaesthetic management was established only in six (20.7%) centres for coiling and in five (17.2%) for microsurgical clipping. The diagnosis of cerebral vasospasm was based on transcranial Doppler as the first-choice method in seven (24.1%) units. “3-H therapy” was applied by 15 (51.8%) respondents, and “2-H therapy”, by four (13.8%) respondents. In only eight (27.6%) centres were all patients with aSAH being admitted to the ICU. Conclusion: Many discrepancies exist between the available guidelines and clinical practice in aSAH treatment in Poland. Peri-procedural management is poorly standardised. Means must be undertaken to improve patient-oriented treatment and care.

scholarly journals Interesting and unusual clinical presentations in leprosy at a referral center

2013 ◽  
Vol 4 (4) ◽  
pp. 273
Author(s):  
VivekV Pai ◽  
Vikram Rathod ◽  
PritamU Tayshetye ◽  
Ramaswamy Ganapati ◽  
SubhashA Khanolkar
Keyword(s):  
Referral Center ◽  
Clinical Presentations
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