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Optimal timing for plastic surgical procedures for common congenital anomalies:A review

World Journal of Clinical Pediatrics 2024年第2期13卷 38-61页

作者： Aakanksha Goel Arun Goel Divine Aesthetic Surgery New Delhi 110048India Department of Plastic Surgery Lok Nayak Hospital and Associated Maulana Azad Medical CollegeNew Delhi 110002India

Apart from listening to the cry of a healthy newborn,it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to *** global incidence of children born with congenital anomalies has been reported to be 3%-6%with more than 90%of these occurring in low-and middle-income group *** exact percentages/total numbers of children requiring surgical treatment cannot be estimated for several *** children are operated under several surgical disciplines,viz,paediatric-,plastic reconstructive,neuro-,cardiothoracic-,orthopaedic surgery *** conditions may be life-threatening,e.g.,trachea-oesophageal fistula,critical pulmonary stenosis,*** require immediate surgical ***,e.g.,hydrocephalus,may need intervention as soon as the patient is fit for ***,e.g.,patent ductus arteriosus need‘wait and watch’policy up to a certain age in the hope of spontaneous *** extremely important category is that of patients where the operative intervention is done based on their *** all the congenital anomalies coming under care of a plastic surgeon are operated as elective surgery(many as multiple stages of correction)at appropriate *** are advantages and disadvantages of intervention at different *** this article,we present a review of optimal timings,along with reasoning,for surgery of many of the common congenital anomalies which are treated by plastic ***,paediatricians and general practitioners/family physicians,who most often are the first ones to come across such children,must know to guide the parents appropriately and convincingly impress upon the them as to why their child should not be operated immediately and also the consequences of too soon or too late.

关键词： Plastic surgery congenital anomalies Pediatric plastic surgery Facial cleft Microtia Vascular anomalies Syndactyly Hypospadias Optimal timing Pediatric surgery

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Diagnosis of congenital Aortic Arch anomalies in Chinese Children by Multi-Detector Computed Tomography Angiography

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2013年第3期33卷 447-451页

作者：陈鑫屈艳娟彭志远鲁锦国马小静 Department of Radiology Wuhan Asia Heart Hospital Department of Radiology Zhongnan Hospital of Wuhan University

Summary： The purpose of this study was to evaluate the value of multi-detector computed tomography （MDCT） angiography for the diagnosis of congenital aortic arch anomalies and present the radiological images of congenital aortic arch anomalies in Chinese children. MDCT angiography and transthoracic echocardiography （TTE） were applied for the diagnosis of congenital aortic arch anomalies in 362 Chi- nese children between May 2006 and December 2011 （age ranges from 5 days to 12 years; mean age, 3.3 years）. Surgery and/or catheter angiography （CA） were conducted in all patients to confirm the final diagnosis. In the 362 Chinese children with congenital heart anomalies, congenital aortic arch anomalies were definitely diagnosed in 198 children and 164 children ruled out by operation and/or （CA）. Among the 198 children with anomalies, coarctation of aorta （CoA）, interruption of aortic arch （IAA）, fight aor- tic arch, aberrant right subclavian artery and double aortic arch were diagnosed in 134, 32, 20, 10 and 2 children respectively, and there were 6 cases with uncommon congenital aortic arch anomalies： 2 had double aortic arch including 1 with five branches of the aortic arch, 2 had isolation of the right sub- clavian artery with two patent ductus arteriosus （PDA）, 1 had an isolation of the common carotid artery with a PDA, and 1 had double PDA with a single ventricle and pulmonary artery atresia. Among the 32 children with IAA, 28 were of type A, and 4 were of type B. The diagnostic sensitivity, specificity and accuracy of MDCT angiography for congenital aortic arch anomaiies were 100% （198/198）, 98% （161/164） and 99% （359/362）, respectively. The diagnostic sensitivity, specificity and accuracy of TTE were 92% （182/198）, 81% （133/164） and 87% （315/362）, respectively. In conclusion, MDCT angiogra- phy is a reliable, noninvasive imaging technique for the diagnosis of congenital aortic arch anomalies in children. Sometimes, even more information can be obtained from this

关键词： congenital anomalies multi-detector computed tomography angiography aortic arch

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Duodenal duplication cyst causing severe pancreatitis:Imaging findings and pathological correlation

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World Journal of Gastroenterology 2006年第10期12卷 1630-1633页

作者： Alessandro Guarise Niccolo' Faccioli Mauro Ferrari Luigi Romano Alice Parisi Massimo Falconi Department of Radiology Negrar VeronaItaly Department of Surgery University of Verona VeronaItaly Department of Pathology University of Verona VeronaItaly Department of Radiology University of Verona VeronaItaly

We here report a case of a 18-year-old man with a history of recurrent abdominal pain and a previous episode of severe acute pancreatitis. Abdominal ultrasonography, contrast enhanced multislice computer tomography, endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography and magnetic resonance imaging demonstrated a cystic mass lesion. Only on delayed phase magnetic resonance images after GadoliniumBOPTA injection, it was possible to demonstrate the lesion's relationship with the biliary tree, differentiating the lesion from intraluminal duodenal diverticulum, and to achieve the diagnosis of duodenal duplication cyst, a recognized rare cause of acute pancreatitis. The diagnosis was confirmed by histology.

关键词： Pancreatitis congenital anomalies Duodenal duplication cyst Ultrasonography Computed Tomography Cholangiopancreatography Magnetic Resonance Imaging

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Unilateral hypoplastic kidney in adults:An experience of a tertiarylevel urology center

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World Journal of Nephrology 2022年第1期11卷 30-38页

作者： Rabea Ahmed Gadelkareem Nasreldin Mohammed Department of Urology Assiut Urology and Nephrology HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt

BACKGROUND Unilateral small-sized kidney is a radiological term referring to both the congenital and acquired causes of reduced kidney ***,the hypoplastic kidney may have peculiar clinical and radiological *** To evaluate the clinical presentations,complications,and management approaches of the radiologically diagnosed unilateral hypoplastic *** A retrospective review of the records of patients with a radiological diagnosis of unilateral hypoplastic kidney between July 2015 and June 2020 was done at Assiut Urology and Nephrology Hospital,Assiut University,*** A total of 33 cases were diagnosed to have unilateral hypoplastic kidney with a mean(range)age of 39.5±11.2(19-73)*** main clinical presentation was loin pain(51.5%),stone passer(9.1%),anuria(12.1%),accidental discovery(15.2%),or manifestations of urinary tract infections(12.1%).Computed tomography was the most useful tool for radiological ***,radioisotope scanning could be requested for verification of surgical interventions and nephrectomy *** occurred in 23(69.7%)cases and pyuria was detected in 22(66.7%)cases where the infection was documented by culture and sensitivity test in 19 *** the non-complicated cases were managed by assurance only(12.1%),nephrectomy(15.2%)was performed for persistent ***,symptomatic(27.3%)and endoscopic(45.6%)approaches were used for the management of correctable *** Unilateral hypoplastic kidney in adults has various complications that range from urinary tract infections to death from *** is mainly radiological and management is usually conservative or minimally invasive.

关键词： congenital anomalies Hypoplastic kidney Kidney size Small sized kidney Solitary kidney Urolithiasis

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Our experience with management of congenital urological pathologies in adulthood:What pediatric urologists should know and adult urologists adopt in pediatric practice experience

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Current Urology 2024年第1期18卷 7-11页

作者： Leon Chertin Binyamin B.Neeman Jawdat Jaber Guy Verhovsky Amnon Zisman Ariel Mamber Ilan Kafka Ala Eddin Natsheh Dmitry Koulikov Ofer Z.Shenfeld Boris Chertin Stanislav Koucherov Amos Neheman Department of Urology Shamir Medical CenterZerifinIsrael(Affiliated with the Sackler School of MedicineTel-Aviv UniversityTel-AvivIsrael) Department of Pediatric Urology Shaare Zedek Medical CenterJerusalemIsrael(Affiliated with the Faculty of MedicineThe Hebrew UniversityJerusalemIsrael)

Purpose:To summarize our experience in the management of congenital anomalies in the kidney and urinary tract(CAKUT)in *** and methods:We conducted a retrospective chart review of all adult patients who underwent primary surgical intervention for CAKUT between 1998 and ***:The study included 102 patients with a median age of 25(interquartile range,23-36.5).Of these,85(83.3%)patients reported normal prenatal ultrasound,and the remaining 17(16.7%)patients were diagnosed with antenatal *** patients were followed-up conservatively postnatally and were discharged from follow-up because of the absence of indications for surgical intervention or because they decided to leave medical *** studied adult patients presented with the following pathologies:67 ureteropelvic junction obstructions,14 ectopic ureters,9 ureteroceles,and 6 primary obstructive megaureters,and the remaining 6 patients were diagnosed with vesicoureteral ***-three percent of the patients had poorly functioning moieties associated with ectopic ureters or ***,67%of patients underwent pyeloplasty,9%underwent endoscopic puncture of ureterocele,3%underwent ureteral reimplantation,6%underwent endoscopic correction of reflux,7%underwent partial nephrectomy of non-functioning moiety,and the remaining 9%underwent robotic-assisted laparoscopic *** median follow-up period after surgery was 33 months(interquartile range,12-54).Post-operative complications occurred in 5 patients(Clavien-Dindo 1-2).Conclusions:Patients with CAKUT present clinical symptoms later in *** of patients diagnosed during fetal screening and treated conservatively should be aware of this possibility,and children should be appropriately counseled when they enter *** surgical skills and operative techniques used in the pediatric population may be applied to adults.

关键词： Antenatal diagnosis congenital anomalies Adults Minimal invasive surgery

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Assessment of fetus during second trimester ultrasonography using HDlive software:What is its real application in the obstetrics clinical practice?

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World Journal of Radiology 2016年第12期8卷 922-927页

作者： Gabriele Tonni Gianpaolo Grisolia Eduardo Félix Santana Edward Araujo Júnior Department of Obstetrics and Gynecology Guastalla Civil Hospital AUSL Reggio Emilia Department of Obstetrics and Gynecology "Carlo Poma"Hospital Department of Obstetrics Paulista School of Medicine-Federal University of S?o Paulo(EPM-UNIFESP) Department of Perinatology Albert Einstein Hospital

AIM To show imaging results from application of fourdimensional(4D) ultrasound lightening technique(HDlive^(TM)) in clinical obstetrics practice. METHODS Normal and abnormal fetuses at second and third trimester of pregnancy undergoing routine scan with 4D HDlive^(TM)(5DUS) in the rendering mode are described. Realistic features of fetal structures were provided by 5DUS in the rendering mode. Normal anatomy as well as pathology like cleft lip, hypoplastic face, micrognathia, low-set ears, corpus callosum, arthrogryposis, aortic arch, left congenital diaphragmatic hernia are highlighted in this study. Anatomical details of the fetuses were provided by 5DUS with higher quality imaging modality compared to those obtained using conventional 2D/3D ultrasound. RESULTS Realistic views of fetal anatomy details were displayed by means of 5DUS in the rendering mode, with high image quality obtained either in low-risk or in high-risk obstetrics population. Corpus callosum, esophagus, and aortic arch were obtained in normal fetuses. Cleft lip, cleft lip and palate, micrognathia, hypoplastic face, lowset ears, arthrogryposis, left congenital diaphragmatic hernia, exomphalos, and clitoris hypertrophy were clearly rendered by 5DUS *** The use of 5DUS in the rendering mode, when clinical available, was diagnostic in a variety of congenital anomalies, aided understanding of the parents-tobe and improved prenatal counseling and perinatal management.

关键词： Three-dimensional ultrasound Four-dimensional ultrasound HDlive Second trimester scan congenital anomalies

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An Ongoing Epidemic of Birth Defects

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Pharmacology & Pharmacy 2013年第3期4卷 312-317页

作者： Gladys Cossio Alberto Bissot Mireya de Rivas Luis Morales Paul Gallardo David Ellis Judith Hall Neonatology Ward and Genetics Department Hospital del Nino de Panama(Panama’s Children’s Hospital)Panama CityRepublic of Panama Department of Pediatrics University of British ColumbiaVancouverCanada

In the 1990s, misoprostol (synthetic prostaglandin E1 analogue) was found to be an effective abortive agent when taken orally and became widely used in Latin America as a means to terminate unwanted pregnancies. A variety of congenital anomalies have been observed among the children of women who ingested misoprostol, but failed to terminate their pregnancy. We report here eight years of experience in Panama with the detection and follow-up of the malformations seen in infants associated with the use of misoprostol prostaglandin during the first trimester of pregnancy. During the period between April 1995 and March 2003, we identified 63 infants at the Panama’s Children’s Hospital who were exposed to misoprostol while in the womb and who were born with malformations. These infants were evaluated by a team of neonatologists, geneticists, cardiologists, ophthalmologists, and radiologists.

关键词： congenital anomalies Teratogenic Agent Misoprostol Pregnancy

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Isolated sporadic bilateral split hand malformation: a case report and review of the literature

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Plastic and Aesthetic Research 2014年第1期1卷 114-117页

作者： Manjit Singh Sukhminder Jit Singh Bajwa Harsimarjit Kaur Ravinder Singh Department of Orthopaedics Gian Sagar Medical College and HospitalBanur 140601PunjabIndia Department of Anaesthesiology and Intensive Care Gian Sagar Medical College and HospitalBanur 147001PunjabIndia Department of Anatomy Govt.Medical CollegePatiala 147001PunjabIndia

Typical cleft hand is a rare disorder usually inherited in an autosomal-dominant *** report a case of bilateral typical cleft hand in a 6-year-old *** was no positive family history of such presentation,and no systemic manifestations were associated with this *** evaluation revealed no systemic or airway challenges and parents were counseled for routine surgical and anesthetic *** hands underwent successful surgical reconstruction with no peri-operative *** the best of our knowledge,this is theﬁrst report of an operated case of an isolated,bilateral,and sporadic typical split hand malformation.

关键词： Cleft hand congenital anomalies split hand malformation syndactyly

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