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Liaqat N, Mahomed A, Nayyar SI, Akhtar N, Ali S, Haider N. Perforated Meckel’s diverticulum in neonates: a report of six cases and systematic review of the literature. Ann Pediatr Surg 2022; 18:18. [PMID: 35281619 PMCID: PMC8901267 DOI: 10.1186/s43159-021-00154-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022] Open
Abstract
Background Perforation of Meckel Diverticulum (MD) is a rare cause of pneumoperitoneum in neonates. We hereby report six cases of perforation of MD in neonates, with addition of 53 cases from systematic review of the literature. A systematic review was performed using Mesh terms “Neonate, Meckel Diverticulum, Perforation, Pneumoperitoneum.” All reports of perforated MD in the English literature were identified. Details of our 6 cases were analyzed in similar fashion. Results A total of 3027 manuscripts were screened and 59 cases including 6 of our own were identified. The vast majority (78%) were female. Fifty patients (84.7%) presented in the newborn period. Half of the cases (52.5%) had associated anomalies and 13 neonates (22%) required oxygen supplementation including CPAP or ventilatory support before surgery. In 73% of the cases, a resection of gut was undertaken. Histopathological assessment in 44 cases (74.6%) revealed no ectopic gastric mucosa. Three cases demised prior to treatment. The outcome in the vast majority was excellent with 84.7% surviving and discharged well. Conclusion Perforated MD is an unusual cause of a pneumoperitoneum in the newborns. Diagnosis is established at laparotomy and it rare to find ectopic mucosa histopathologically. The overall outcome is excellent.
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Liaqat N, Imran RM, Mahomed A. Auto-amputated ovary- rare cause of intestinal obstruction in a neonate: A case report. J Neonatal Surg 2021. [DOI: 10.47338/jns.v10.960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Congenital ovarian cysts rarely auto amputate. An unusual complication of this event is secondary intestinal obstruction. The mechanism may be consequent to a direct pressure effect or to adhesions induced by the cyst.
Case Presentation: A neonate presented with an abdominal mass and intestinal obstruction. On exploration, she had a mass hanging over the small intestine and one ovary was absent. Mass was excised and it turned out to be an auto-amputated ovary
Conclusion: Although it is a rare pathology in neonates, surgeons must suspect it, particularly if an ovary is absent.
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Thomas T, Laher AE, Mahomed A, Stacey S, Motara F, Mer M. Challenges around COVID-19 at a tertiary-level healthcare facility in South Africa and strategies implemented for improvement. S Afr Med J 2020; 110:964-967. [PMID: 33205721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 06/11/2023] Open
Abstract
SARS-CoV-2 has resulted in a global pandemic within months following its initial detection. South Africa (SA), like many other countries, was not prepared for the impact this novel infection would have on the healthcare system. In this paper, the authors discuss the challenges experienced while facing COVID-19 at a tertiary-level institution in Gauteng province, SA, and the dynamic strategies implemented to deal with the epidemic.
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Affiliation(s)
- T Thomas
- Infection Control Services Laboratory, Charlotte Maxeke Johannesburg Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Disease, University of the Witwatersrand, Johannesburg, South Africa.
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Abstract
Abstract
Background
Morgagni hernia (MH) is a rare diaphragmatic hernia with nonspecific symptoms and variable presentation. MH is managed surgically via laparotomy or a thoracotomy. Recently, laparoscopy was described for the repair of MH. The objective of this study is to report our institutional experience in laparoscopic repair of MH in infants and children.
Results
Twenty-five patients with MH were included; 17 of them were males (68%). Their median age at the time of diagnosis was 18 months. Sixteen patients (64%) presented with a recurrent chest infection. MH was on the right side in 8 patients, left side in 2, and central in 12, and 3 patients had bilateral hernias. Eleven patients (44%) had congenital heart disease, 10 (40%) had Down’s syndrome, and 2 (4%) had malrotation of the bowel. The median size of the hernia defect was 3 × 3.5 cm2, and the most common content was the colon (n = 19). One patient with Down’s syndrome developed recurrence and underwent open repair. The median operative time was 95 min. The postoperative recovery was uneventful, and the average postoperative stay was 3 days. The median follow-up was 4.5 years, and there was no reported mortality.
Conclusions
Morgagni hernia is commonly associated with other congenital anomalies. Laparoscopic repair of Morgagni hernia in children is feasible with excellent postoperative outcomes.
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Fabian J, Loveland J, Maher H, Gaylard P, Etheredge H, Bouter C, Cantrell J, Sanyika C, Britz R, Strobele B, Rambarran S, van der Schyff F, Brannigan L, Demopoulos D, Campbell Lang A, Archibald-Durham L, Beretta M, Bobat B, Mahomed A, Terblanche A, Botha J. Wits Transplant Annual Data Report 2018 Adult and Paediatric Liver Transplantation. ACTA ACUST UNITED AC 2019. [DOI: 10.18772/26180197.2019.v1n3a2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Prabdial-Sing N, Blackard J, Puren A, Mahomed A, Abuelhassan W, Mahlangu J, Vermeulen M, Bowyer S. Naturally occurring resistance mutations within the core and NS5B regions in hepatitis C genotypes, particularly genotype 5a, in South Africa. Antiviral Res 2016; 127:90-8. [DOI: 10.1016/j.antiviral.2015.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/05/2015] [Accepted: 11/26/2015] [Indexed: 12/27/2022]
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Pardy C, Rajwani K, Lahiri R, Mahomed A. Laparoscopic Appendectomy for Chronic Right Iliac Fossa Pain: Correlating Histology with Outcome. J Laparoendosc Adv Surg Tech A 2016; 26:314-7. [PMID: 26849395 DOI: 10.1089/lap.2015.0431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic right iliac fossa (CRIF) pain in children is associated with repeated hospital attendance, inconclusive investigations, and missed school days. There is increasing evidence for the role of laparoscopic appendectomy for the management of CRIF pain. However, currently there is no substantial evidence to correlate histological changes identified in the appendixes removed with resolution of pain. METHOD This study collected prospective data for a single surgeon's series of laparoscopic appendectomy performed for CRIF pain between 2003 and 2014. RESULTS Forty patients with a median age of 13 years (range 5-19 years) underwent laparoscopic appendectomy for CRIF pain. Twenty-nine patients (73%) had macroscopically normal appendixes, but histological changes were identified in 28 patients (70%). Other findings at laparoscopy included gynecological pathology (ovarian/para-ovarian cysts), unfixed mobile caecum, and a well-defined peritoneal band extending from the caecum to the anterolateral abdominal wall (caeco-peritoneal band). Patients were followed up for a median of 2 months (range 1-15 months). All patients reported resolution of CRIF pain. DISCUSSION Laparoscopic appendectomy appears to be an effective treatment for CRIF pain, while also providing the opportunity to diagnose and treat potential sources of CRIF pain other than the appendix. Consistent with the literature, a small number of patients appear to have resolution of pain, despite no histological change being identified in the appendix removed and no other pathology having been identified. The same histological changes commonly seen have also been demonstrated in appendixes removed incidentally. Caution therefore should be applied when interpreting the significance of histological changes seen.
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Affiliation(s)
- Caroline Pardy
- 1 Department of Paediatric Surgery, Royal Alexandra Children's Hospital , Brighton, United Kingdom
| | - Kapil Rajwani
- 1 Department of Paediatric Surgery, Royal Alexandra Children's Hospital , Brighton, United Kingdom
| | - Rajiv Lahiri
- 1 Department of Paediatric Surgery, Royal Alexandra Children's Hospital , Brighton, United Kingdom
| | - Anies Mahomed
- 2 Department of Pediatric Surgery, King Faisal Specialist Hospital and Research Center , Jeddah, Saudi Arabia
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Abstract
BACKGROUND A caeco-peritoneal band (CPB) has been observed during diagnostic laparoscopy for chronic right iliac fossa (RIF) pain. This has a veil-like configuration and arises along a broad base from the caecum and ascending colon and attaches to the anterior abdominal wall. METHODS Retrospective analysis of a prospectively collected database of 31 patients, aged 11-16, who underwent diagnostic laparoscopy for ongoing RIF pain over a 10-year period was analysed for intra-operative presence of the CPB. The patients' symptoms, past medical history, diagnostic workup, surgical findings and outcome were evaluated. RESULTS CPB was identified in five patients. All presented with chronic RIF pain and had inconclusive preoperative investigations. Two patients underwent previous surgery. In all cases, the CPB was the sole abnormal finding on diagnostic laparoscopy. Symptoms resolved following division of the CPB with no recurrence of pain at a mean follow-up of 575 days. CONCLUSIONS CPB is a potential cause of chronic RIF pain in patients with unremarkable examination findings and negative serological and radiological investigations. Laparoscopic identification and division of the CPB has produced symptom resolution in this cohort of patients.
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Affiliation(s)
- R S Wong
- Department of Paediatric Surgery, The Royal Alexandra Children's Hospital, Eastern Road, Brighton, BN2 5BE, UK
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Gane E, Kershenobich D, Seguin-Devaux C, Kristian P, Aho I, Dalgard O, Shestakova I, Nymadawa P, Blach S, Acharya S, Anand AC, Andersson MI, Arendt V, Arkkila P, Baatarkhuu O, Barclay K, Ben-Ari Z, Bergin C, Bessone F, Blokhina N, Brunton CR, Choudhuri G, Chulanov V, Cisneros L, Croes EA, Dahgwahdorj YA, Daruich JR, Dashdorj NR, Davaadorj D, de Knegt RJ, de Vree M, Gadano AC, Gower E, Halota W, Hatzakis A, Henderson C, Hoffmann P, Hornell J, Houlihan D, Hrusovsky S, Jarčuška P, Kostrzewska K, Leshno M, Lurie Y, Mahomed A, Mamonova N, Mendez-Sanchez N, Mossong J, Norris S, Nurmukhametova E, Oltman M, Oyunbileg J, Oyunsuren T, Papatheodoridis G, Pimenov N, Prins M, Puri P, Radke S, Rakhmanova A, Razavi H, Razavi-Shearer K, Reesink HW, Ridruejo E, Safadi R, Sagalova O, Sanchez Avila JF, Sanduijav R, Saraswat V, Schréter I, Shah SR, Shevaldin A, Shibolet O, Silva MO, Sokolov S, Sonderup M, Souliotis K, Spearman CW, Staub T, Stedman C, Strebkova EA, Struck D, Sypsa V, Tomasiewicz K, Undram L, van der Meer AJ, van Santen D, Veldhuijzen I, Villamil FG, Willemse S, Zuckerman E, Zuure FR, Prabdial-Sing N, Flisiak R, Estes C. Strategies to manage hepatitis C virus (HCV) infection disease burden - volume 2. J Viral Hepat 2015; 22 Suppl 1:46-73. [PMID: 25560841 DOI: 10.1111/jvh.12352] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 15 countries, and the relative impact of two scenarios was considered: (i) increased treatment efficacy while holding the treated population constant and (ii) increased treatment efficacy and increased annual treated population. Increasing levels of diagnosis and treatment, in combination with improved treatment efficacy, were critical for achieving substantial reductions in disease burden. In most countries, the annual treated population had to increase several fold to achieve the largest reductions in HCV-related morbidity and mortality. This suggests that increased capacity for screening and treatment will be critical in many countries. Birth cohort screening is a helpful tool for maximizing resources. In most of the studied countries, the majority of patients were born between 1945 and 1985.
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Affiliation(s)
- E Gane
- Auckland Hospital Clinical Studies Unit, Auckland, New Zealand
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Hatzakis A, Chulanov V, Gadano AC, Bergin C, Ben-Ari Z, Mossong J, Schréter I, Baatarkhuu O, Acharya S, Aho I, Anand AC, Andersson MI, Arendt V, Arkkila P, Barclay K, Bessone F, Blach S, Blokhina N, Brunton CR, Choudhuri G, Cisneros L, Croes EA, Dahgwahdorj YA, Dalgard O, Daruich JR, Dashdorj NR, Davaadorj D, de Knegt RJ, de Vree M, Estes C, Flisiak R, Gane E, Gower E, Halota W, Henderson C, Hoffmann P, Hornell J, Houlihan D, Hrusovsky S, Jarčuška P, Kershenobich D, Kostrzewska K, Kristian P, Leshno M, Lurie Y, Mahomed A, Mamonova N, Mendez-Sanchez N, Norris S, Nurmukhametova E, Nymadawa P, Oltman M, Oyunbileg J, Oyunsuren T, Papatheodoridis G, Pimenov N, Prabdial-Sing N, Prins M, Radke S, Rakhmanova A, Razavi-Shearer K, Reesink HW, Ridruejo E, Safadi R, Sagalova O, Sanchez Avila JF, Sanduijav R, Saraswat V, Seguin-Devaux C, Shah SR, Shestakova I, Shevaldin A, Shibolet O, Silva MO, Sokolov S, Sonderup M, Souliotis K, Spearman CW, Staub T, Stedman C, Strebkova EA, Struck D, Sypsa V, Tomasiewicz K, Undram L, van der Meer AJ, van Santen D, Veldhuijzen I, Villamil FG, Willemse S, Zuckerman E, Zuure FR, Puri P, Razavi H. The present and future disease burden of hepatitis C virus (HCV) infections with today's treatment paradigm - volume 2. J Viral Hepat 2015; 22 Suppl 1:26-45. [PMID: 25560840 DOI: 10.1111/jvh.12351] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Morbidity and mortality attributable to chronic hepatitis C virus (HCV) infection are increasing in many countries as the infected population ages. Models were developed for 15 countries to quantify and characterize the viremic population, as well as estimate the number of new infections and HCV related deaths from 2013 to 2030. Expert consensus was used to determine current treatment levels and outcomes in each country. In most countries, viremic prevalence has already peaked. In every country studied, prevalence begins to decline before 2030, when current treatment levels were held constant. In contrast, cases of advanced liver disease and liver related deaths will continue to increase through 2030 in most countries. The current treatment paradigm is inadequate if large reductions in HCV related morbidity and mortality are to be achieved.
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Affiliation(s)
- A Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece
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Saraswat V, Norris S, de Knegt RJ, Sanchez Avila JF, Sonderup M, Zuckerman E, Arkkila P, Stedman C, Acharya S, Aho I, Anand AC, Andersson MI, Arendt V, Baatarkhuu O, Barclay K, Ben-Ari Z, Bergin C, Bessone F, Blach S, Blokhina N, Brunton CR, Choudhuri G, Chulanov V, Cisneros L, Croes EA, Dahgwahdorj YA, Dalgard O, Daruich JR, Dashdorj NR, Davaadorj D, de Vree M, Estes C, Flisiak R, Gadano AC, Gane E, Halota W, Hatzakis A, Henderson C, Hoffmann P, Hornell J, Houlihan D, Hrusovsky S, Jarčuška P, Kershenobich D, Kostrzewska K, Kristian P, Leshno M, Lurie Y, Mahomed A, Mamonova N, Mendez-Sanchez N, Mossong J, Nurmukhametova E, Nymadawa P, Oltman M, Oyunbileg J, Oyunsuren T, Papatheodoridis G, Pimenov N, Prabdial-Sing N, Prins M, Puri P, Radke S, Rakhmanova A, Razavi H, Razavi-Shearer K, Reesink HW, Ridruejo E, Safadi R, Sagalova O, Sanduijav R, Schréter I, Seguin-Devaux C, Shah SR, Shestakova I, Shevaldin A, Shibolet O, Sokolov S, Souliotis K, Spearman CW, Staub T, Strebkova EA, Struck D, Tomasiewicz K, Undram L, van der Meer AJ, van Santen D, Veldhuijzen I, Villamil FG, Willemse S, Zuure FR, Silva MO, Sypsa V, Gower E. Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 2. J Viral Hepat 2015; 22 Suppl 1:6-25. [PMID: 25560839 DOI: 10.1111/jvh.12350] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chronic hepatitis C virus (HCV) infection is a leading cause of liver related morbidity and mortality. In many countries, there is a lack of comprehensive epidemiological data that are crucial in implementing disease control measures as new treatment options become available. Published literature, unpublished data and expert consensus were used to determine key parameters, including prevalence, viremia, genotype and the number of patients diagnosed and treated. In this study of 15 countries, viremic prevalence ranged from 0.13% in the Netherlands to 2.91% in Russia. The largest viremic populations were in India (8 666 000 cases) and Russia (4 162 000 cases). In most countries, males had a higher rate of infections, likely due to higher rates of injection drug use (IDU). Estimates characterizing the infected population are critical to focus screening and treatment efforts as new therapeutic options become available.
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Affiliation(s)
- V Saraswat
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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Rajwani KM, Butler S, Mahomed A. In children undergoing umbilical hernia repair is rectus sheath block effective at reducing post-operative pain? Best evidence topic (bet). Int J Surg 2014; 12:1452-5. [DOI: 10.1016/j.ijsu.2014.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 10/30/2014] [Accepted: 11/04/2014] [Indexed: 11/15/2022]
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Abstract
Pediatric ovarian torsion is an infrequent diagnosis and it often mimics acute appendicitis. Most cases are due to underlying ovarian pathology and if left untreated, ovarian torsion may eventually cause peritonitis. Emergency exploratory laparoscopy represents a valuable diagnostic and therapeutic tool in suspected ovarian torsion.
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Affiliation(s)
- Kapil M Rajwani
- Royal Alexandra Children's Hospital Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom
| | - Anies Mahomed
- Royal Alexandra Children's Hospital Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom
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Ellis R, Lahiri R, Mahomed A. Mapping testicular blood supply in gubernaculum-sparing second-stage Fowler–Stephens procedure. Surg Endosc 2014; 28:3158-61. [DOI: 10.1007/s00464-014-3574-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 04/18/2014] [Indexed: 10/25/2022]
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Mahomed A, Dunckley MG. Spontaneous peritoneal closure after orchidopexy in children : comment to: orchidopexy without ligation of the processus vaginalis is not associated with an increased risk of inguinal hernia. Ceccanti S, Zani A, Mele E and Cozzi DA (2013). Hernia 2013; 18:343-4. [PMID: 24100928 DOI: 10.1007/s10029-013-1160-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 09/13/2013] [Indexed: 11/25/2022]
Affiliation(s)
- A Mahomed
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Eastern Road, Brighton, BN2 5BE, UK,
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Dunckley M, Mahomed A. Re: Choi et al. (2012) Ped Surg Int 28:1165-1169: outcomes following laparoscopic inguinal hernia repair in infants compared with older children. Pediatr Surg Int 2013; 29:761. [PMID: 23539336 DOI: 10.1007/s00383-013-3300-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2013] [Indexed: 11/29/2022]
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Adams S, Mahomed A. Regarding: "Pediatrics varicocele surgery: 10 years of experience in two pediatric surgical centers". J Laparoendosc Adv Surg Tech A 2012; 23:84. [PMID: 23259575 DOI: 10.1089/lap.2012.0299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mahomed A, Adams S, Islam S. Initial Success with Gubernacular-Sparing Laparoscopic-Assisted Fowler-Stephens Orchidopexy for Intra-abdominal Testes. J Laparoendosc Adv Surg Tech A 2012; 22:192-4. [DOI: 10.1089/lap.2011.0130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anies Mahomed
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Brighton, United Kingdom
| | - Stephen Adams
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Brighton, United Kingdom
| | - Saidul Islam
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Brighton, United Kingdom
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Blackburn S, Chow V, Kalidasan V, Mahomed A. Single port paediatric heminephrouretectomy. Surg Tech Dev 2011. [DOI: 10.4081/std.2011.e18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We present a 4-year-old girl who underwent a single incision laparoscopic surgery (SILS) heminephrouretectomy. The procedure was completed without intra-operative complications or conversion. The operative time was 162 min. At 3 month follow up there is no evident scar and the patient is asymptomatic. SILS upper moiety heminephrouretectomy for duplex kidney is safe and technically feasible in children.
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Adams SD, Lisle R, Coelho T, Chouhan A, Butt A, Mahomed A. Use of Laparoscope as Rigid Enteroscope in Blue Rubber Bleb Naevus Syndrome. Surgical Techniques Development 2011. [DOI: 10.4081/std.2011.e12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Management of bleeding multiple haemangiomata within the gastrointestinal tract is a surgical challenge in this case of Blue Rubber Bleb Naevus Syndrome (BRBNS). Described is a novel use of the laparoscope as a rigid enteroscope in order to provide intraluminal imaging for successful lesional resection from small bowel.
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Abstract
Circumcisions are among the most frequently performed operations in children and numerous techniques are employed often with varying results. Use of the Plastibell (Hollister Incorporated, Illinois, USA), under local anesthetic, is popular for cultural and religious circumcisions but is not without its problems. Complications of Plastibell (slippage, migration, bleeding and serious infection) have been reported. Described is a prospective series of cases in which modifications to the standard Plastibell technique were utilized to improve outcomes, in particular, the risk of bleeding.
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Affiliation(s)
- Anies Mahomed
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Brighton, United Kingdom.
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Nataraja R, Mahomed A. Video demonstration of the technique of laparoscopic gastrophrenopexy for the treatment of symptomatic primary organoaxial gastric volvulus. J Laparoendosc Adv Surg Tech A 2010; 20:507. [PMID: 20518692 DOI: 10.1089/lap.2009.0448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIM The aim of this work was to demonstrate the technique of laparoscopic gastrophrenopexy performed for intermittent partial organoaxial volvulus. METHODS Two pediatric patients, with an initial presentation of postprandial epigastric discomfort, were investigated by upper gastrointestinal contrast meal. These investigations revealed the presence of a rare variant of primary organoaxial gastric volvulus. Both patients underwent a laparoscopy, which confirmed gastromegaly with redundant gastrophrenic and gastrolienal ligaments. A gastrophrenopexy was performed with initial pexy of, principally, the fundus to the left hemidiaphragm, using interrupted nonabsorbable sutures. The gastrophrenopexy was performed without an esophagocardiopexy or an anterior gastropexy. A video demonstrates the technical aspects of the procedure, and the associated pre- and postoperative imaging for both patients will be presented. RESULTS Both procedures were accomplished laparoscopically in less than 60 minutes, with no immediate postoperative complications. The patients were discharged the following day after a period of observation. Symptom resolution occurred with both patients. One patient underwent a repeat upper gastrointestinal contrast study 4 years post intervention, which demonstrated an intact gastropexy. CONCLUSIONS Laparoscopic gastrophrenopexy may be utilized for this rare variant of gastric organoaxial volvulus. This technique is durable over the medium term and is, therefore, recommended as the primary intervention in symptomatic pediatric patients.
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Affiliation(s)
- Ramesh Nataraja
- Department of Pediatric Surgery, Royal Alexandra Children's Hospital, Brighton, UK
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Moghadas P, Hukins D, Shepherd D, Mahomed A. S-30 Friction in Ball-and-Socket Total Disc Arthroplasty. J Biomech 2010. [DOI: 10.1016/s0021-9290(10)70083-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Affiliation(s)
- Costa Healey
- Department of Pediatric Surgery, Royal Alexandra Children's Hospital, Brighton, United Kingdom
| | - Rebecca Lisle
- Department of Pediatric Surgery, Royal Alexandra Children's Hospital, Brighton, United Kingdom
| | - Anies Mahomed
- Department of Pediatric Surgery, Royal Alexandra Children's Hospital, Brighton, United Kingdom
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Mahomed A, Chidi NM, Hukins DWL, Kukureka SN, Shepherd DET. Frequency dependence of viscoelastic properties of medical grade silicones. J Biomed Mater Res B Appl Biomater 2009; 89:210-6. [PMID: 18823017 DOI: 10.1002/jbm.b.31208] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Cylinders of medical grade silicone elastomers, (29 mm in diameter and 13 mm thick), immersed in physiological saline solution at 37 degrees C, were investigated by dynamic mechanical analysis (DMA). A sinusoidal cyclic compression of 40 +/- 5 N was applied over a frequency range, f, of 0.02-100 Hz. Values of the storage, E', and loss, E'', moduli for the cylinders were found to depend on f; the dependence of E' or E'' on the logarithm (base 10) of f was represented by a third-order polynomial. Above about 0.3 Hz, the cylindrical specimens appeared to be undergoing the onset of a transition from the rubbery to the glassy state. There was no significant difference between results obtained at 37 and 23 degrees C; pretreatment of specimens in physiological saline at 37 degrees C for 24 h and 29 days had no appreciable effect on the results.
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Affiliation(s)
- A Mahomed
- School of Mechanical Engineering, University of Birmingham, Edgbaston, Birmingham, United Kingdom.
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Mahomed A, D'hondt B, Khan K, Butt A. Technical Aspects of the Laparoscopic Management of a Late Presenting Duodenal Web. J Laparoendosc Adv Surg Tech A 2009; 19 Suppl 1:S175-7. [DOI: 10.1089/lap.2008.0173.supp] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Anies Mahomed
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Brighton, UK
| | - Beelke D'hondt
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Brighton, UK
| | - Khalid Khan
- Department of Radiology, Royal Alexandra Children's Hospital, Brighton, UK
| | - Assad Butt
- Department of Gastroenterology, Royal Alexandra Children's Hospital, Brighton, UK
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Abstract
BACKGROUND Laparoscopic transperitoneal nephrectomy is technically feasible in most cases of benign renal disease. To date, there have been isolated reports of laparoscopic transperitoneal heminephroureterectomy of principally the upper moiety of a duplex system. Rarely reported are lower moiety nephroureterectomies. AIM The aim of this IPEG submission is to present a 3-minute video demonstrating the technical details of a transperitoneal laparoscopic, right, lower moiety, heminephroureterectomy in a 3-year-old. METHODS/TECHNIQUES: A child with marginally functioning (<5%) lower moiety of a right duplex system was subjected to a transperitoneal heminephroureterectomy. The patient was placed in a left lateral position and an umbilical camera and two working ports (right iliac fossa, epigastric), all 5 mm, were utilized. The ascending colon was reflected to the left and the underlying lower moiety ureter identified and isolated. With traction on the ureter, the pelvis was brought into view and control of blood supply to the lower moiety was achieved by using a combination of ultrasonic scalpel and hook diathermy. A critical step at this stage was definition of the superior limit of the pelvis, which corresponded to the level of vascular demarcation. The renal parenchyma was transected at this point by using the ultrasonic scalpel, which ensured reasonable hemostasis. Complete hemostasis was assured by approximating the divided kidney with a series of three interrupted intracorporeal sutures. The subtending ureter was dissected close to the bladder base, where it was ligated and divided. A drain was placed percutaneously in the renal bed and the specimen retrieved via an extended umbilical incision. RESULTS The patient was started on fluids on recovery with oral feeds introduced the next morning. The drain was removed prior to discharge on day 2. At 6 months post-resection, the patient remains well. CONCLUSION Laparoscopic transperitoneal lower pole heminephroureterectomy is technically feasible for benign renal disease in children. The combination of ultrasonic scalpel and intracorporeal suturing is adequate to control bleeding of the transected kidney. Dissection of the ureter distally to bladder neck is easily achieved without change in port position. Recovery is robust with minimal requirement for analgesia. The wider space, better view, and ability to access all of the urinary tract make this a tenable alternative to other laparoscopic approaches.
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Affiliation(s)
- Anies Mahomed
- Department of Pediatric Surgery, Royal Alexandra Children's Hospital, Brighton, UK.
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Abstract
Long gap oesophageal atresia is a clinically and technically challenging condition to manage. Documentation of the gap between the upper and lower pouches is critical to deciding the timing and feasibility of a primary anastamosis. Integral to this process is the role of radiology. We present a case of long gap oesophageal atresia accompanied by chronological radiography demonstrating its' staged management and highlighting some common complications.
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Affiliation(s)
- Paul Charlesworth
- Department of Pediatric Surgery, Royal Alexandra Children's Hospital, Brighton, UK
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Politylo P, Zaparackaite I, Khan K, Mahomed A. Ovarian reconstitution following laparoscopic decapsulation of congenital cyst. J Laparoendosc Adv Surg Tech A 2008; 18:895-7. [PMID: 19105677 DOI: 10.1089/lap.2007.0232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Laparoscopic management of congenital ovarian cysts is widely practiced but there is a dearth of information on the performance of the gonad where organ-preserving surgery is undertaken. Presented is a radiological diary documenting the progress of a complex congenital ovarian cyst from the antenatal period to a year post-laparoscopic decapsulation.
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Affiliation(s)
- Pawel Politylo
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Brighton, United Kingdom
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Mahomed A, D'hondt B, Khan K, Butt A. Technical aspects of the laparoscopic management of a late presenting duodenal web. J Laparoendosc Adv Surg Tech A 2008. [PMID: 19021465 DOI: 10.1089/lap.2008.0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The value of laparoscopy in repair of congenital duodenal webs is yet to be established and techniques are evolving. Described are technical details of a successful laparoscopic web ablation without duodenoplasty.
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Affiliation(s)
- Anies Mahomed
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Brighton, UK.
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Healy C, Hobeldin M, Mahomed A. Conservative management of grade 1V renal injury with complete transection: a case report. Cases J 2008; 1:129. [PMID: 18752672 PMCID: PMC2531172 DOI: 10.1186/1757-1626-1-129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Accepted: 08/27/2008] [Indexed: 11/13/2022]
Abstract
The expectant management of high grade renal injuries in hemodynamically stable children has gained increasing acceptance amongst paediatric surgeons. However, patients with grade 1V injury with complete renal transection have been identified as a subgroup with a poor outcome that may benefit from early operative intervention. Interestingly, both internal and external drainage have been independently utilised as part of the expectant approach. The former is more widely practiced and was first suggested by Haas et al who used it successfully in 5 patients with grade 1V renal trauma. Yet to be clearly established in this context is the value and timing of external drainage, particularly, when used in combination with internal stenting. Described is a child with complete renal transaction who was successfully managed with a combination of internal and external drainage.
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Affiliation(s)
- Costa Healy
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Brighton, UK.
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Hukins DWL, Mahomed A, Kukureka SN. Accelerated aging for testing polymeric biomaterials and medical devices. Med Eng Phys 2008; 30:1270-4. [PMID: 18692425 DOI: 10.1016/j.medengphy.2008.06.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Revised: 05/28/2008] [Accepted: 06/01/2008] [Indexed: 11/24/2022]
Abstract
Elevated temperature is frequently used to accelerate the aging process in polymers that are associated with medical devices and other applications. A common approach is to assume that the rate of aging is increased by a factor of 2(DeltaT/10), where DeltaT is the temperature increase. This result is a mathematical expression of the empirical observation that increasing the temperature by about 10 degrees C roughly doubles the rate of many polymer reactions. It is equivalent to assuming that the aging process is a first order chemical reaction with an activation energy of 10R/log(e)2, where R is the universal gas constant. A better approach would be to determine the activation energy for the process being considered but this is not always practicable. The simple approach does not depend on the temperature increase, provided that it is not so great that it initiates any physical or chemical process that is unlikely to be involved in normal aging. If a temperature increment theta were to increase a given polymer reaction rate n times, then an elevated temperature would increase the rate of aging by a factor of n(DeltaT/theta).
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Affiliation(s)
- D W L Hukins
- School of Mechanical Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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Panagidis A, El Salam S, Al Marzauqi A, Hobeldin M, Mahomed A. The emerging role of laparoscopy in diagnosis and treatment of primary omental torsion in children. J Laparoendosc Adv Surg Tech A 2008; 18:324-6. [PMID: 18373469 DOI: 10.1089/lap.2007.0122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Antonios Panagidis
- Department of Pediatric Surgery, Royal Alexandra Children's Hospital, Brighton, UK
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Wells J, Mahomed A. Delayed presentation of profunda femoris pseudoaneurysm following an intertrochanteric neck of femur fracture. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.injury.2007.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mahomed A. Re: Watson fundoplication in children: a comparative study with Nissen fundoplication. Wagener S, Sudhakaran N, Cusick E. J Pediatr Surg 2007;42:1098-1102. J Pediatr Surg 2007; 42:2140-1. [PMID: 18082727 DOI: 10.1016/j.jpedsurg.2007.08.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2007] [Accepted: 08/22/2007] [Indexed: 11/30/2022]
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Abstract
There are many methods for analysing wear volume in failed polyethylene acetabular components. We compared a radiological technique with three recognised ex vivo methods of measurement. We tested 18 ultra-high-molecular-weight polyethylene acetabular components revised for wear and aseptic loosening, of which 13 had pre-revision radiographs, from which the wear volume was calculated based upon the linear wear. We used a shadowgraph technique on silicone casts of all of the retrievals and a coordinate measuring method on the components directly. For these techniques, the wear vector was calculated for each component and the wear volume extrapolated using mathematical equations. The volumetric wear was also measured directly using a fluid-displacement method. The results of each technique were compared. The series had high wear volumes (mean 1385 mm(3); 730 to 1850) and high wear rates (mean 205 mm(3)/year; 92 to 363). There were wide variations in the measurements of wear volume between the radiological and the other techniques. Radiograph-derived wear volume correlated poorly with that of the fluid-displacement method, co-ordinate measuring method and shadowgraph methods, becoming less accurate as the wear increased. The mean overestimation in radiological wear volume was 47.7% of the fluid-displacement method wear volume. Fluid-displacement method, coordinate measuring method and shadowgraph determinations of wear volume were all better than that of the radiograph-derived linear measurements since they took into account the direction of wear. However, only radiological techniques can be used in vivo and remain useful for monitoring linear wear in the clinical setting. Interpretation of radiological measurements of acetabular wear must be done judiciously in the clinical setting. In vitro laboratory techniques, in particular the fluid-displacement method, remain the most accurate and reliable methods of assessing the wear of acetabular polyethylene.
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Bandyopadhyay D, Haque AR, Mahomed A. Massive recurrent hemorrhage due to duodenal diverticulum--role of tattooing and suture plication. Indian J Gastroenterol 2007; 26:43-4. [PMID: 17401242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We report a 79-year-old lady with massive recurrent GI bleeding from a duodenal diverticulum arising at the mesenteric border. We used tattooing during endoscopy as a method for identifying the bleeding source at surgery. The diverticulum was treated with suture plication.
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Affiliation(s)
- D Bandyopadhyay
- Department of Surgery, Calderdale Royal Hospital, West Yorkshire, United Kingdom.
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Tousek M, Hughes-Thomas A, Mahomed A. Calcific parasite or surgical miscellany? J Pediatr Surg 2007; 42:267-9. [PMID: 17208581 DOI: 10.1016/j.jpedsurg.2006.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This article highlights the difficulties posed by initial radiological investigations that misleadingly interpreted a linear opacity in the ascending colon of a 2-year-old to be a complicating calcified Ascaris. Final surgical management revealed an unusual cause for the tram tracking effect so pathognomonic of Ascaris infestation. Of interest are the images of the abdominal x-ray, ultrasound scan, and barium study.
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Affiliation(s)
- Martin Tousek
- Department of Paediatric Surgery, Royal Alexandra Children's Hospital, BN1 3JN Brighton, UK
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Mahomed A. Operative Endoscopy and Endoscopic Surgery in Infants and Children. Ann R Coll Surg Engl 2006. [DOI: 10.1308/rcsann.2006.88.6.601b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
We describe a child with the rare clinical entity of female pseudohermaphroditism, accessory phallic urethra, and posterior cloaca who was successfully treated with posterior sagittal anorectovaginourethroplasty. Masculinization was limited to the external genitalia, and no chromosomal, metabolic, or adrenal abnormalities were detected. Associated pathology included bilateral vesicoureteric reflux, a non functioning dysplastic kidney, and bicornuate uterus. The investigation and surgical management of this particularly challenging combination of anomalies is detailed.
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Affiliation(s)
- Mairi Macarthur
- Department of Paediatric Surgery, Royal Aberdeen Children's Hospital, Aberdeen AB25 2ZG, UK
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Mahomed A, Shenoy KN. Present and future management of deep venous thrombosis (Br J Surg 2001; 88: 1427-8). Letter 2. Br J Surg 2002; 89:808. [PMID: 12028000 DOI: 10.1046/j.1365-2168.2002.02127_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mahomed A, Ogston K. Gomco circumcision. J Pediatr Surg 2002; 37:683; author reply 683. [PMID: 11912537 DOI: 10.1053/jpsu.2002.31649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mahomed A. Vein graft surveillance. Eur J Vasc Endovasc Surg 1999; 17:273-4. [PMID: 10092909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Abstract
Laparotomy has become the preferred approach to the excision of large, complex abdominal cysts in the neonate. We describe a laparoscopic-assisted decapsulation of an antenatally diagnosed abdominal cyst that was noted on postnatal ultrasound scan to have a complex echo pattern. This limited procedure allows for accurate verification of the diagnosis, institution of appropriate therapy, and organ salvage. It represents a superior management option that obviates the significant complications associated with conservative management.
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Affiliation(s)
- A Mahomed
- Department of Paediatric Surgery, Royal Aberdeen Children's Hospital, Aberdeen, AB9 2ZG, Scotland
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Abstract
The etiology of lateral cervical cysts in infancy is complex. The cysts are congenital in origin and are derived from the third or fourth branchial apparatus. The authors describe two cases of congenital lateral cervical cysts with an internal opening in the pyriform sinus and possible origin in the third branchial arch. The embryology, clinical presentation, and operative management of this condition is reviewed.
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Affiliation(s)
- A Mahomed
- Royal Aberdeen Children's Hospital, Scotland
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Mahomed A, Merry C, Guiney EJ. Splenic cysts--aspiration or partial splenic decapsulation? S AFR J SURG 1998; 36:84-6. [PMID: 9810217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
We report on 2 children who had partial splenic decapsulation for splenic cysts--a pseudocyst and a congenital epidermoid cyst. Ultrasound-guided percutaneous needle aspiration with drainage was attempted in both patients but resulted in rapid cyst reaccumulation. Used on its own in the management of splenic cysts, percutaneous drainage has limited therapeutic value and delays definitive surgery. Partial splenic decapsulation is a simple and safe procedure.
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Affiliation(s)
- A Mahomed
- Royal Aberdeen Children's Hospital, UK
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