Objective: To determine the risk factors, clinical features,and outcome of infants diagnosed with portal vein thrombosis(PVT). Study design: A retrospective chart review was conducted of all consecutive infants admitt...Objective: To determine the risk factors, clinical features,and outcome of infants diagnosed with portal vein thrombosis(PVT). Study design: A retrospective chart review was conducted of all consecutive infants admitted to the Hospital for Sick Children, Toronto, between January 1999 and December 2003 diagnosed with PVT. Results: PVT was diagnosed in 133 infants, all but 5 of whom were neonates, with a median age at time of diagnosis of 7 days. An umbilical venous catheter(UVC) was inserted in 73%of the infants and was in an appropriate position in 46%of them. Poor outcome, defined as portal hypertension or lobar atrophy, was diagnosed in 27%of the infants and was significantly more common in those with an initial diagnosis of grade 3 PVT and in those with a low or intrahepatically placed UVC. Anticoagulation treatment did not appear to have a significant effect on outcome. Conclusions:PVT occurs early in life; major risk factors in addition to the neonatal period are placement of UVC and severe neonatal sickness. Poor outcome is associated with an improper lyplaced UVC and with grade 3 thrombus.展开更多
Aim of Study: The aim of this study was to determine if the presence of an appendicolith is associated with an increased risk for recurrent appendicitis after nonoperative treatment of pediatric ruptured appendix with...Aim of Study: The aim of this study was to determine if the presence of an appendicolith is associated with an increased risk for recurrent appendicitis after nonoperative treatment of pediatric ruptured appendix with inflammatory mass or abscess. Methods: Ninety-six pediatric patients (52 girls, 44 boys), aged 16 months to 17 years (average, 7 years), were managed between 1980 and 2003. All were treated nonoperatively with intravenous triple antibiotics for 5 to 21 days. All children had at least a 2- year follow-up. This study was approved by the hospital research ethics board. Main Results: Six children (6% ) who became worse and 41 (46% ) who had an interval appendectomy were eliminated from the study. The other 49 patients comprised the study group and received no further treatment. Twenty-eight (57% ) had no recurrence, and 21 (43% ) had a recurrence within 1 month to 2 years (average, 3 months). In the study group, 31 (63% ) children had no appendicolith on radiological imaging and 18 (37% ) had. Presence of an appendicolith was associated with a 72% rate of recurrent appendicitis compared with a recurrence rate of 26% in those with no appendicolith (χ 2 test, P < .004). Conclusion: We conclude that the patients with appendicolith should have an interval appendectomy.展开更多
The authors present a case of a 2-year-old boy with an abdominal mass, which was later found to be a yolk sac tumor arising from the diaphragm. To the authors’ knowledge there has been only 1 previous report of a ger...The authors present a case of a 2-year-old boy with an abdominal mass, which was later found to be a yolk sac tumor arising from the diaphragm. To the authors’ knowledge there has been only 1 previous report of a germ cell tumor arising from the diaphragm. This case illustrates the imaging findings in this rare tumor and how it could be confused with a primary liver neoplasm.展开更多
文摘Objective: To determine the risk factors, clinical features,and outcome of infants diagnosed with portal vein thrombosis(PVT). Study design: A retrospective chart review was conducted of all consecutive infants admitted to the Hospital for Sick Children, Toronto, between January 1999 and December 2003 diagnosed with PVT. Results: PVT was diagnosed in 133 infants, all but 5 of whom were neonates, with a median age at time of diagnosis of 7 days. An umbilical venous catheter(UVC) was inserted in 73%of the infants and was in an appropriate position in 46%of them. Poor outcome, defined as portal hypertension or lobar atrophy, was diagnosed in 27%of the infants and was significantly more common in those with an initial diagnosis of grade 3 PVT and in those with a low or intrahepatically placed UVC. Anticoagulation treatment did not appear to have a significant effect on outcome. Conclusions:PVT occurs early in life; major risk factors in addition to the neonatal period are placement of UVC and severe neonatal sickness. Poor outcome is associated with an improper lyplaced UVC and with grade 3 thrombus.
文摘Aim of Study: The aim of this study was to determine if the presence of an appendicolith is associated with an increased risk for recurrent appendicitis after nonoperative treatment of pediatric ruptured appendix with inflammatory mass or abscess. Methods: Ninety-six pediatric patients (52 girls, 44 boys), aged 16 months to 17 years (average, 7 years), were managed between 1980 and 2003. All were treated nonoperatively with intravenous triple antibiotics for 5 to 21 days. All children had at least a 2- year follow-up. This study was approved by the hospital research ethics board. Main Results: Six children (6% ) who became worse and 41 (46% ) who had an interval appendectomy were eliminated from the study. The other 49 patients comprised the study group and received no further treatment. Twenty-eight (57% ) had no recurrence, and 21 (43% ) had a recurrence within 1 month to 2 years (average, 3 months). In the study group, 31 (63% ) children had no appendicolith on radiological imaging and 18 (37% ) had. Presence of an appendicolith was associated with a 72% rate of recurrent appendicitis compared with a recurrence rate of 26% in those with no appendicolith (χ 2 test, P < .004). Conclusion: We conclude that the patients with appendicolith should have an interval appendectomy.
文摘The authors present a case of a 2-year-old boy with an abdominal mass, which was later found to be a yolk sac tumor arising from the diaphragm. To the authors’ knowledge there has been only 1 previous report of a germ cell tumor arising from the diaphragm. This case illustrates the imaging findings in this rare tumor and how it could be confused with a primary liver neoplasm.
