RESUMO
A 14-year-old boy after a Mustard procedure for transposition of the great arteries developed pulmonary hypertension secondary to baffle obstruction. This occurred over several years without apparent significant symptomatology. Systemic-level pressure prevailed in the left (pulmonary) ventricle and provided an opportunity to perform a successful one-stage arterial switch.
Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Hipertensão Pulmonar/etiologia , Artéria Pulmonar/cirurgia , Pneumopatia Veno-Oclusiva/etiologia , Pneumopatia Veno-Oclusiva/cirurgia , Transposição dos Grandes Vasos/cirurgia , Adolescente , Cateterismo Cardíaco , Procedimentos Cirúrgicos Cardíacos/métodos , Constrição Patológica/diagnóstico , Constrição Patológica/cirurgia , Seguimentos , Humanos , Hipertensão Pulmonar/cirurgia , Masculino , Reoperação , Resultado do TratamentoRESUMO
A total of 17 radiographs from seven babies with clinical evidence of necrotizing enterocolitis were examined by six pediatric radiologist and four neonatologists from the Southern California area. The participants were asked to interpret each radiograph as to the presence or absence of necrotizing enterocolitis and to indicate whether pneumoperitoneum was present. A substantial degree of interobserver variability was observed, with only one of the 17 films yielding universal agreement. We propose that this interobserver variability in interpreting abdominal films of neonates with clinically suspected necrotizing enterocolitis may in fact contribute to the reported difference in incidence of this disease among centers.
Assuntos
Enterocolite Pseudomembranosa/diagnóstico por imagem , Doenças do Recém-Nascido/diagnóstico por imagem , Erros de Diagnóstico , Humanos , Lactente , Recém-Nascido , RadiografiaRESUMO
In 46 preterm infants with RDS the patency of the ductus arteriosus was established by single film aortography or by clinical diagnosis and confirmation at surgery. The estimated left-to-right shunt through the PDA by aortogram correlated well with the heart size and the clinical diagnosis of heart failure. In 14 infants massive cardiomegaly and heart failure with a PDA occurred before the appearance of a heart murmur. Twelve infants had severe RDS and 34 had mild or moderate RDS. Massive cardiomegaly occurred significantly earlier in infants with severe RDS. It is suggested that ductal ligation is indicated when an infant with massive cardiomegaly requires IPPV and whose aortagram shows that all of the contrast material is in the pulmonary arteries and none in the aortic arch. A heart murmur may or may not be present.