A 6(1/2)-year-old girl developed recurrent cholangitis following hepatic portoenterostomy for biliary atresia. Computed tomogram showed an ovoid cyst (4.5 x 4.0 cm in size) in the left hepatic lobe and another tubular dilatation (2.0 x 0.8 cm in size) in the right hepatic lobe. Percutaneous transhepatic cholangio-drainage (PTCD) with cystogram showed an ovoid cyst in the left hepatic lobe (Tsuchida type A), measuring 6.6 x 5.0 cmin size. She became afebrile and anicteric with aid of PTCD and parenteral antibiotics. However she continued to drain 45-150 cc of bile per day via the tube for over 2 weeks. Then she successfully underwent intrahepatic cystojejunostomy with guidance of intraoperative ultrasonography. This case illustrates relapsing cholangitis caused by Tsuchida type A intrahepatic cyst, which was successfully managed with PTCD followed by internal drainage procedure.
Anti-Bacterial Agents ; Bile ; Biliary Atresia* ; Cholangitis ; Dilatation ; Drainage ; Female ; Humans ; Portoenterostomy, Hepatic ; Ultrasonography

No abstract available.
Humans ; Pyloric Stenosis, Hypertrophic* ; Siblings*

This paper includes our 9-year experience of 34 infants with biliary atresia with introduction of a new non-invasive diagnostic method, that is, ultrasonographic "triangular cord" (TC) sign. TC sign was defined as visualization of a triangular or a band-like echogenicity just cranial to the portal vein. Ultrasonographic TC sign seemed to be a simple, non-invasive, time-saving and useful tool in the diagnosis of biliary atresia, representing 84% sensitivity. Active bile excretion was restored in 90% of the patients who were treated between 31-60days, 78% of those between 61-90 days, and 33% of those being 91days or older. The incidence of postoperative cholangitis was 36%, and construction of antireflux valve in the Roux-en -Y loop did not affect the incidence of postoperative cholangitis (P=0.18). As for the surgical outcome, of 34 infants with biliary atresia, 23 (68%) are alive for 2-102 months period, and 12 of them are alive for more than 5 years . Five-year estimate survival by Kaplan-Meier method was 66 %.
Bile ; Biliary Atresia* ; Cholangitis ; Diagnosis* ; Humans ; Incidence ; Infant ; Portal Vein ; Ultrasonography

No abstract available.
Catheters* ; Drainage* ; Pancreatic Pseudocyst*

No abstract available.
Anus, Imperforate* ; Perineum* ; Ultrasonography*

Reflex sympathetic dystrophy(RSD) defines as a chronic pain syndrome with sympathetic manifestations that afflicts individuals who haute suffered a trauma to the hand. Persistent pain and dysfunctions of the hand are frequently overlooked by the surgeons. The exact pathophysiology of RSD is not known but severity of injury and prolonged immobilization of the joints are considered as resonable causes on the retrospective studies. The diagnosis of reflex sympathetic dystrophy is based on clinical manifestations, simple X-ray and three-phase bone scan. Confirmative diagnosis absolutely depends on the presence of a diffusely abnormal pattern of uptake in phase III in a patient haying pain with underlying cause and strong clinical signs of sympathetic overactivities. As with most disease processes, early diagnosis and treatment is a goal of management of RSD. Surgical restoration of anatomical structures such as tendon, nerve and joint goes ahead of any kind of procedures and it made the VAS pain score decrease from 7.8 to 3.4 in 16 patients. Also, decrease of pain could be achievable with sympathetic or stellate ganglion block with steroid medication. Active physical therapy after surgery is also verb helpful to functional recovery of the hands. Once the appropriate diagnosis is made, combined therapy composed of surgical restoration of anatomical structure, physiotherapy and steroid medication with sympathetic block will be free from pain and produce early functional recovery.
Chronic Pain ; Diagnosis ; Early Diagnosis ; Hand Injuries* ; Hand* ; Humans ; Immobilization ; Joints ; Reflex Sympathetic Dystrophy* ; Reflex* ; Retrospective Studies ; Stellate Ganglion ; Tendons

No abstract available.
Humans

No abstract available.
Lymphadenitis*

Pathological laughing and crying(PLC) is a condition that is characterized by episodic, brief, contextually inappropriate, uncontrollable outbursts of laughing and/or crying. It can be observed in patients with various neurological disorders. PLC often causes distress in interpersonal functioning and activities for patients and their families. PLC can be recognized easily with proper understanding of the condition and its nature. Also it generally shows good response to various pharmacological treatments. This review aims to encourage the diagnosis and treatment of PLC by providing definition and clinical presentation of PLC, analysis of its pathophysiology and various current treatment options.
Crying* ; Diagnosis ; Humans ; Nervous System Diseases

No abstract available.
Barium* ; Enema* ; Intussusception* ; Ultrasonography* ; Water*