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Glenisson M, Bonnard A, Berrebi D, Belarbi N, Viala J, Martinez-Vinson C. Complications and Disease Recurrence After Ileocecal Resection in Pediatric Crohn's Disease: A Retrospective Study. Eur J Pediatr Surg 2024; 34:253-260. [PMID: 36882155 PMCID: PMC11076103 DOI: 10.1055/a-2048-7407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/15/2022] [Indexed: 03/09/2023]
Abstract
OBJECTIVE The aim of this retrospective study was to describe the risk of postoperative recurrence (POR) after ileocecal resection, the occurrence of surgical complications, and identify predictors of these adverse postoperative outcomes in pediatric Crohn's disease (CD). PATIENTS AND METHODS All the children less than 18 years of age with a diagnosis of CD, who underwent primary ileocecal resection for CD between January 2006 and December 2016 in our tertiary center, were considered for inclusion. Factors related to POR were investigated. RESULTS A total of 377 children were followed for CD between 2006 and 2016. During this period, 45 (12%) children needed an ileocecal resection. POR was diagnosed in 16% (n = 7) at 1 year and 35% (n = 15) at the end of the follow-up, with a median follow-up of 2.3 years (Q1-Q3 1.8-3.3). Median duration of the postoperative clinical remission was 1.5 years (range 0.5-2). Multivariate Cox regression analysis identified only young age at diagnosis as a risk factor for POR.In total, 7 of the 43 patients (16%) developed severe postoperative complications, defined as requiring surgical, endoscopic, or radiological intervention. The only risk factor was intraoperative abscess. CONCLUSION Only young age at diagnosis was associated with POR. This information could be useful to develop targeted therapeutic strategies for young CD children. At the end of follow-up with a median follow-up of 2.3 years (Q1-Q3 1.8-3.3), there was no surgical POR: endoscopic dilatation for POR should be considered in order to delay or prevent surgery.
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Affiliation(s)
- M Glenisson
- Department of Pediatric Surgery, Hôpital Universitaire Robert Debré, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - A Bonnard
- Department of Pediatric Surgery, Hôpital Universitaire Robert Debré, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - D Berrebi
- Department of Pediatric Pathology, Hôpital Universitaire Robert Debré, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - N Belarbi
- Department of Pediatric Radiology, Hôpital Universitaire Robert Debré, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - J Viala
- Department of Pediatric Gastroenterology, Hôpital Universitaire Robert Debré, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - C Martinez-Vinson
- Department of Pediatric Gastroenterology, Hôpital Universitaire Robert Debré, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
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Arthurs OJ, Rega A, Guimiot F, Belarbi N, Rosenblatt J, Biran V, Elmaleh M, Sebag G, Alison M. Diffusion-weighted magnetic resonance imaging of the fetal brain in intrauterine growth restriction. Ultrasound Obstet Gynecol 2017; 50:79-87. [PMID: 27706859 DOI: 10.1002/uog.17318] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 08/23/2016] [Accepted: 09/22/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Diffusion-weighted magnetic resonance imaging (DWI) is a sensitive method for assessing brain maturation and detecting brain lesions, providing apparent diffusion coefficient (ADC) values as a measure of water diffusion. Abnormal ADC values are seen in ischemic brain lesions, such as those associated with acute or chronic hypoxia. The aim of this study was to assess whether ADC values in the fetal brain were different in fetuses with severe intrauterine growth restriction (IUGR) compared with normal controls. METHODS Brain magnetic resonance imaging (MRI) with single-shot axial DWI (b = 0 and b = 700 s/mm2 ) was performed in 30 fetuses with severe IUGR (estimated fetal weight < 3rd centile with absent or reversed umbilical artery Doppler flow) and in 24 normal controls of similar gestational age. Brain morphology and biometry were analyzed. ADC values were measured in frontal and occipital white matter, centrum semiovale, thalami, cerebellar hemisphere and pons. Frontal-occipital and frontal-cerebellar ADC ratios were calculated, and values were compared between IUGR fetuses and controls. RESULTS There was no difference in gestational age at MRI between IUGR and control fetuses (IUGR, 30.2 ± 1.6 weeks vs controls, 30.7 ± 1.4 weeks). Fetal brain morphology and signals were normal in all fetuses. Brain dimensions (supratentorial ± infratentorial) were decreased (Z-score, < -2) in 20 (66.7%) IUGR fetuses. Compared with controls, IUGR fetuses had significantly lower ADC values in frontal white matter (1.97 ± 0.23 vs 2.17 ± 0.22 × 10-3 mm2 /s; P < 0.0001), thalami (1.04 ± 0.15 vs 1.13 ± 0.10 ×10-3 mm2 /s; P = 0.0002), centrum semiovale (1.86 ± 0.22 vs 1.97 ± 0.23 ×10-3 mm2 /s; P = 0.01) and pons (0.85 ± 0.19 vs 0.94 ± 0.12 ×10-3 mm2 /s; P = 0.043). IUGR fetuses had a lower frontal-occipital ADC ratio than did normal fetuses (1.00 ± 0.11 vs 1.08 ± 0.05; P = 0.003). CONCLUSIONS ADC values in IUGR fetuses were significantly lower than in normal controls in the frontal white matter, thalami, centrum semiovale and pons, suggesting abnormal maturation in these regions. However, the prognostic value of these ADC changes is still unknown. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- O J Arthurs
- Department of Pediatric Radiology, Robert Debré Hospital, AP-HP, Paris, France
| | - A Rega
- Department of Pediatric Radiology, Robert Debré Hospital, AP-HP, Paris, France
| | - F Guimiot
- Department of Developmental Biology, Robert Debré Hospital, AP-HP, University Paris Diderot, Paris, France
- University Paris Diderot, Paris 7, PRES Sorbonne Paris-Cité, INSERM U1141, DHU PROTECT, Paris, France
| | - N Belarbi
- Department of Pediatric Radiology, Robert Debré Hospital, AP-HP, Paris, France
| | - J Rosenblatt
- Department of Gynecology and Obstetrics, Robert Debré Hospital, AP-HP, Paris, France
| | - V Biran
- University Paris Diderot, Paris 7, PRES Sorbonne Paris-Cité, INSERM U1141, DHU PROTECT, Paris, France
- Neonatal Intensive Care Unit, Robert Debré Hospital, AP-HP, University Paris Diderot, Paris, France
| | - M Elmaleh
- Department of Pediatric Radiology, Robert Debré Hospital, AP-HP, Paris, France
| | - G Sebag
- Department of Pediatric Radiology, Robert Debré Hospital, AP-HP, Paris, France
- University Paris Diderot, Paris 7, PRES Sorbonne Paris-Cité, INSERM U1141, DHU PROTECT, Paris, France
| | - M Alison
- Department of Pediatric Radiology, Robert Debré Hospital, AP-HP, Paris, France
- University Paris Diderot, Paris 7, PRES Sorbonne Paris-Cité, INSERM U1141, DHU PROTECT, Paris, France
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Heroual N, Sidahemd L, Belarbi N, Houti L. Mortalité prématurée par cancer en milieu hospitalier à Oran, Algérie, 2014. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.06.210] [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: 11/30/2022] Open
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Spaggiari E, Vuillard E, Baumann C, Dupont C, Belarbi N, Oury JF, Delezoide AL, Guimiot F. Ultrasound detection of hyaloid artery in the third trimester of pregnancy: a pathological finding. Ultrasound Obstet Gynecol 2012; 39:478-479. [PMID: 22012788 DOI: 10.1002/uog.10123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Bach-Ségura P, Belarbi N. [Diagnostic imaging evaluation of neonatal vomiting]. ACTA ACUST UNITED AC 2011; 92:134-41. [PMID: 21352745 DOI: 10.1016/j.jradio.2010.12.007] [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] [Received: 12/07/2010] [Accepted: 12/07/2010] [Indexed: 10/18/2022]
Abstract
Vomiting during the neonatal period is frequent. The purpose is to detect neonates and infants with digestive pathology requiring urgent management such as duodenal atresia, small bowel volvulus, acute intussusception, and hypertrophic pyloris stenosis. All of these conditions may be diagnosed by ultrasound which should be performed when clinically suspected.
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Affiliation(s)
- P Bach-Ségura
- Maternité régionale de Nancy, service d'imagerie périnatale et de la femme, 10, rue du Dr-Heydenreich, 54042 Nancy cedex, France.
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Naudin J, Katsahian S, Aizenfisz S, Vitoux C, Beydon N, Belarbi N, Nivoche Y, Dauger S, Bonnard A. CL044 - Atrésie de l’œsophage : facteurs précoces en réanimation prédictifs de complications oesophagiennes durant la 1re année post opératoire. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70260-8] [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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Levaillant JM, Moeglin D, Zouiten K, Bucourt M, Burglen L, Soupre V, Baumann C, Jaquemont ML, Touraine R, Picard A, Vuillard E, Belarbi N, Oury JF, Verloes A, Vazquez MP, Labrune P, Delezoide AL, Gérard-Blanluet M. Binder phenotype: clinical and etiological heterogeneity of the so-called Binder maxillonasal dysplasia in prenatally diagnosed cases, and review of the literature. Prenat Diagn 2009; 29:140-50. [PMID: 19156647 DOI: 10.1002/pd.2167] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Prenatal Binder profile is a well known clinical phenotype, defined by a flat profile without nasal eminence, contrasting with nasal bones of normal length. Binder profile results of a hypoplasia of the nasal pyramid (sometimes referred to as maxillonasal dysplasia). We report 8 fetuses prenatally diagnosed as Binder phenotype, and discuss their postnatal diagnoses. METHODS Ultrasonographic detailed measurements in 2D and 3D were done on the 8 fetuses with Binder profile, and were compared with postnatal phenotype. RESULTS All fetuses have an association of verticalized nasal bones, abnormal convexity of the maxilla, and some degree of chondrodysplasia punctata. The final diagnoses included fetal warfarin syndrome (one patient), infantile sialic acid storage (one patient), probable Keutel syndrome (one patient), and five unclassifiable types of chondrodysplasia punctata. CONCLUSION This series demonstrates the heterogeneity of prenatally diagnosed Binder phenotype, and the presence of chondrodysplasia punctata in all cases. An anomaly of vitamin K metabolism, possibly due to environmental factors, is suspected in these mild chondrodysplasia punctata. We recommend considering early prophylactic vitamin K supplementation in every suspected acquired vitamin K deficiency including incoercible vomiting of the pregnancy.
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Affiliation(s)
- J M Levaillant
- Prenatal Diagnosis Unit, APHP Antoine Béclère University Hospital, Clamart, France
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Bonnard A, Fouquet V, Berrebi D, Hugot JP, Belarbi N, Bruneau B, Aigrain Y, de Lagausie P. Crohn's disease in children. Preliminary experience with a laparoscopic approach. Eur J Pediatr Surg 2006; 16:90-3. [PMID: 16685613 DOI: 10.1055/s-2006-924048] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 12/29/2022]
Abstract
BACKGROUND Laparoscopic surgery in patients with Crohn's disease (CD) has been demonstrated to have advantages over a conventional approach in children. The aim of this study was to review the children treated for CD with a laparoscopic approach, to report our indications, the surgical procedure, the complications, and to compare the children with pancolitis or ileocaecal (segmental) Crohn's disease. PATIENTS AND METHOD We reviewed the files of 11 children treated for CD in a single institution between 1999 and 2004 for a retrospective study of clinical and surgical data. Mann-Whitney U-test was used for statistical analysis of nonparametric data. RESULTS Eleven children were operated. The average age when initial clinical symptoms became apparent was 12.1 years (range 6.6 - 15), and surgery was performed after an average of 3.4 years of disease (range 1 - 7.6). The surgical indications were stenosis in 6 cases, failure to thrive in 1 case (segmental CD, SCD group) and pancolitis refractory to medical treatment in 4 cases (pancolitis group, PCD group). Mean operative time was 207 minutes (range 140 - 270) for the SCD group and 285 minutes (range 260 - 300) for the PCD group (p < 0.05). Three cases needed a conversion to open surgery (2 in PCD group, one in SCD group), mainly in relation to anastomosis performed with an EEA stapler. The average length of surgical unit stay was 6.5 days (range 4 - 8) for the PCD group and 6.4 days (range 4 - 8) for the SCD group; average follow-up was 16 months (range 3 - 38). Two patients had a relapse of CD (stenosis of the anastomosis in one, skin fistula in the other). CONCLUSION A laparoscopic approach for ileocolic resection in Crohn's disease is a feasible procedure, even in cases of pancolitis. We recommend an extra-corporeal anastomosis because, in relation to the inflammatory bowel, the mechanical anastomosis is not a safe procedure in cases of pancolitis.
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Affiliation(s)
- A Bonnard
- Department of Paediatric Surgery, Hôpital Robert Debré, Paris, France.
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Abstract
An 11-month-old boy presented with an intrahepatic foreign body after ingestion of a sewing needle. Surgical management using an exclusive laparoscopic extraction was successful.
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Affiliation(s)
- A Le Mandat-Schultz
- Department of Visceral Surgery, Hôpital Robert Debré, 48 Boulevard Serrurier, 75019 Paris, France
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Carricaburu E, Enezian G, Bonnard A, Berrebi D, Belarbi N, Huot O, Aigrain Y, de Lagausie P. Laparoscopic distal pancreatectomy for Frantz's tumor in a child. Surg Endosc 2003; 17:2028-31. [PMID: 14598158 DOI: 10.1007/s00464-003-4222-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2003] [Accepted: 04/21/2003] [Indexed: 12/17/2022]
Abstract
Solid pseudopapillary tumor of the pancreas is a rare pathologic entity. Although the role of laparoscopy in surgery of the pancreas is still controversial, laparoscopic distal pancreatectomy has been reported with good results in adults. We report a laparoscopic spleen-preserving distal pancreatectomy in a 9-year-old boy who presented with a low-grade malignant tumor. Needle biopsy was impossible. A laparoscopic spleen-preserving distal pancreatectomy was performed. We used four trocars, and the operative time was 240 min. Conversion to open surgery was not necessary. The boy's postoperative recovery was uneventful, and he was discharged on the 6th day. CT-scan control at 6 months was normal. This case shows that even in advanced surgical cases, such as spleen-preserving distal pancreatectomy, laparoscopic procedures can be done safely, within a reasonable operative time, in children.
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Affiliation(s)
- E Carricaburu
- Department of Pediatric Surgery, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, 48, Boulevard Sérurier, 75019 Paris, France.
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Tubiana-Rufi N, Belarbi N, Du Pasquier-Fediaevsky L, Polak M, Kakou B, Leridon L, Hassan M, Czernichow P. Short needles (8 mm) reduce the risk of intramuscular injections in children with type 1 diabetes. Diabetes Care 1999; 22:1621-5. [PMID: 10526725 DOI: 10.2337/diacare.22.10.1621] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [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: 02/03/2023]
Abstract
OBJECTIVE To study whether 8-mm needles can reduce the frequency of intramuscular injections in diabetic children. RESEARCH DESIGN AND METHODS We conducted a prospective crossover study in 50 children whose BMI was < or = 60th percentile to compare two lengths of needles (12.7 and 8 mm) regarding the occurrence of intramuscular injections as assessed by ultrasonography. RESULTS The frequency of intramuscular injections was 86% with the 12.7-mm needles and 38% with the 8-mm needles. The frequency of intramuscular injections was significantly reduced when using the 8-mm needles in the arms (P < 0.01) and thighs (P < 0.001). The efficiency of 8-mm needles, as defined by an intramuscular injection with a 12.7-mm needle and a subcutaneous injection with an 8-mm needle, was found for half of the children who injected in the arm and for two-thirds of the children who injected in the thigh. The subcutaneous tissue (SQT) thickness measured by ultrasonography with a skinfold was significantly higher (9.8 +/- 2.2 mm) in the group in which the 8-mm needles were efficient than in the group in which they were not efficient (6.8 +/- 2.1 mm, P < 0.0001). The efficiency of the 8-mm needle was not related to age, sex, BMI, percentile of BMI, injection device, or injection site. The sensibility and specificity of SQT thickness in predicting the efficiency of the 8-mm needles were both 79%. CONCLUSIONS Needles that are 8 mm long significantly reduce the risk of intramuscular insulin injection in slim or normal-weight (BMI < or = 60th percentile) diabetic children and adolescents.
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Affiliation(s)
- N Tubiana-Rufi
- Department of Pediatric Endocrinology and Diabetology, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, France.
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Traxer O, de Lagausie P, Kron C, Belarbi N, Aigrain Y. [Left aortic arch--right descending aorta--right ductus arteriosus (encircling aortic arch). A rare malformation of the aortic arches]. Arch Pediatr 1998; 5:409-13. [PMID: 9759162 DOI: 10.1016/s0929-693x(98)80029-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
UNLABELLED Abnormalities of the aortic arch which are responsible for tracheobronchial compression are well known. This case demonstrates the value of magnetic resonance imaging (MRI) for diagnosis and suggests that recurrent respiratory symptoms should evoke these abnormalities in infancy. CASE REPORT The authors report a very rare malformation of the aortic arch formed by encircling aortic arch, with left aortic arch, right descending aorta and right ligamentum arteriosum. It was revealed by airway disorders due to the compression of tracheobronchial axis by the ligamentum arteriosum. Section of the ligamentum permitted suppression of obstruction. The diagnosis of these abnormalities is usually established by means of oesophagogram, tracheobronchial endoscopy, angiography and MRI. CONCLUSION In this case, MRI gave a better picture than angiography. Sections of the ligamentum arteriosum are sometimes ineffective when compression is due to the aorta itself. Aortic uncrossing, a more complex operation, is then necessary.
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Affiliation(s)
- O Traxer
- Service de Chirurgie Infantile, Hôpital Robert-Debré, Paris, France
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Belarbi N, Sebag G, Holvoet L, Delagausie P, Lupoglazoff JM, Hassan M. [Left aortic arch with right descending aorta and right ligamentum arteriosum in an infant]. J Radiol 1998; 79:61-3. [PMID: 9757224] [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] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A rare form of vascular ring, consisting of a left aortic arch, a right descending aorta and a right ligamentum arteriosum is reported in a symptomatic infant. The role of MRI in the surgical planning is emphasized.
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Affiliation(s)
- N Belarbi
- Département d'Imagerie Pédiatrique, Hôpital Robert-Debré, Paris
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Faure C, Belarbi N, Mougenot JF, Besnard M, Hugot JP, Cézard JP, Hassan M, Navarro J. Ultrasonographic assessment of inflammatory bowel disease in children: comparison with ileocolonoscopy. J Pediatr 1997; 130:147-51. [PMID: 9003865 DOI: 10.1016/s0022-3476(97)70325-1] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.4] [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: 02/03/2023]
Abstract
OBJECTIVES To determine the feasibility and value of transabdominal ultrasonography of the terminal ileum and colon of children with inflammatory bowel disease (IBD) and to compare the findings with those of ileocolonoscopy. STUDY DESIGN Thirty-eight patients ranging in age from 4 to 18 years who underwent ileocolonoscopy for management of IBD or for diagnosis were studied prospectively. Twenty-one patients had Crohn disease, nine had ulcerative colitis, and eight served as control subjects. Transabdominal ultrasonography was performed on the day before ileocolonoscopy. Ultrasonographic findings were compared with the results of ileocolonoscopy, used as the reference method. RESULTS Peristalsis was recorded in all segments of the control subjects; the thickness of the terminal ileum was always less than 2.5 mm, and that of the large bowel, 2 mm or less. In the two patient subgroups, the thickness range of affected ileal and colonic segments was similar, but values were significantly different from those of the control subjects (chi-square test, p <0.0001). The overall sensitivity of the method was 88%, and the specificity, 93%. CONCLUSION Transabdominal ultrasonography should prove to be a useful clinical and investigational technique, although further studies are needed to assess its value in the treatment of children with IBD.
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Affiliation(s)
- C Faure
- Pediatric Gastroenterology Unit, Hôpital Robert Debré, Paris, France
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Polak M, Beregszaszi M, Belarbi N, Benali K, Hassan M, Czernichow P, Tubiana-Rufi N. Subcutaneous or intramuscular injections of insulin in children. Are we injecting where we think we are? Diabetes Care 1996; 19:1434-6. [PMID: 8941479 DOI: 10.2337/diacare.19.12.1434] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [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: 02/03/2023]
Abstract
OBJECTIVE This study was designed to assess the insulin injection location in a group of children who had their injection according to their daily practice, thought to lead to subcutaneous injections. RESEARCH DESIGN AND METHODS The location of the insulin deposit at the injection site was visualized using an ultrasound device. RESULTS The exact insulin injection location could be localized, and 18 of 59 injections (30.5%) (one injection for each child) were in the intramuscular tissue. Of the children who had intramuscular injection, 15 of 18 were boys. The children who had an intramuscular injection had a significantly lower percentile of BMI (mean +/- SE: 47 +/- 8 vs. 72 +/- 4, P = 0.004), lower distance from skin surface to muscle fascia without a skinfold (5.6 +/- 0.6 vs. 11 +/- 0.7 mm, P < 0.0001), and a lower distance from skin surface to muscle fascia with a skinfold (8.1 +/- 0.9 vs. 15.9 +/- 0.8 mm, P < 0.0001) than children who had a subcutaneous insulin injection. CONCLUSIONS We identified a group of children at risk for intramuscular insulin injections and that may deserve specific injection technique and advice.
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Affiliation(s)
- M Polak
- Department of Pediatric Endocrinology and Diabetology, Robert Debré University Hospital, Paris, France
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