Congenital hepatic fibrosis in children

Twenty-seven children with congenital hepatic fibrosis were followed for three months to 12 years. Hepatosplenomegaly, normal liver function tests, and kidney abnormalities were present in most patients, indicating that a correct diagnosis of congenital hepatic fibrosis could be made using simple clinical, biologic, and radiologic criteria. Esophageal endoscopy showed varices in 21 patients. Sixteen children underwent portal-systemic shunt surgery. Follow-up examinations did not show any impairment of liver function or any sign of hepatic encephalopathy. Cholangitis was present in only three children.

Ultrasonography and percutaneous cholangiography in children with dilated bile ducts. Report of six cases

Six children had dilation of intrahepatic and extrahepatic bile ducts. The dilation was associated with or was secondary to lithiasis in two patients, spontaneous bile duct perforation in two others, and an abnormal pancreaticobiliary junction in the last two. All the children were screened by ultrasonography; five were subsequently examined by percutaneous transhepatic cholangiography. Ultrasonography permits rapid detection of bile duct dilation, while percutaneous cholangiography aids in the choice of the surgical procedure by locating the site of obstruction and sometimes disclosing the cause of obstructive jaundice.

Vascular occlusive agents

The authors have reviewed the experimental literature about the different agents used for endovascular embolization: clots, tissues, duramater, Gelfoam, oxydized cellulose, Ivalon, beads, microspheres, cyanoacrylates, silicone, barium. Each occlusive agent was studied in regard to its physical properties, injection methods, characteristics of obstruction, vascular reaction, and toxicity. The level and quality of obstruction obtained depend on many factors which are discussed.

[Ultrasound and portal hypertension in children. Demonstration of gastro-oesophageal collaterals. Preliminary report (author's transl)]

The authors studied the value of ultrasonography in demonstrating oesophageal collaterals in portal hypertension in childhood. 22 children with portal hypertension underwent successively an ultrasound examination and an endoscopy looking for submucosal oesophageal varices. Oesophageal collaterals were said to be present when ultrasound showed vascular structures in the gastro-hepatic ligament above the coeliac trunk origin. Among those 22 patient 18 had a satisfactory ultrasound examination. 12 true positive, 3 true negative, 3 false negative ultrasound examinations were obtained. 4 ultrasound studies were inconclusive. The value of ultrasound in the pre and post surgical check-up of portal hypertension in children is emphasized.

A bipolar electrode for vascular electrocoagulation with alternating current

A bipolar electrode for transcatheter electrocoagulation with alternating current is described. This electrode avoids the problem of variation of the electric impedance of the monopolar electrode/ground plate system. It allows quick, safe, and reliable endovascular occlusion of vessels.

Non-operative removal of an unusual foreign body from the duodenum after duodeno-jejunostomy

The authors report a case of peroral removal of an intraduodenal foreigh body in a 6 week old infant. The coaxial technique employed facilitates catheter manipulation and avoids traumatic lesions arising from manoeuvres during removal.

[Experimental endovascular electrocoagulation. Use of alternating current and a bipolar electrode (preliminary study) (author's transl)]

Early experimental studies have shown that it is possible to obtain vascular obliteration and clot formation using monopolar direct current electrocoagulation. There is a major risk of rupture of blood vessels if alternating current is used. Using a co-axial bipolar electrode and high frequency alternating current it was possible to obtain valid, reproducible, and safe vascular obliteration in the distal digestive tract arteries in dogs. The obliteration is due to lesions of the intima and the formation of a clot in situ.

[Intestinal obstruction with feces (meconium ileus equivalent) in the course of mucoviscidosis. Radiographic diagnosis (author's transl]

Meconium ileus equivalent is a late intestinal occlusion occurring in patients suffering from mucoviscidosis. Three cases are reported in children aged, respectively, 3 years, 6 years and 10 years. In one of the observations (three year old girl), the intestinal obstruction with feces was first manifestation of a mucoviscidosis that was previously undetected. The radiological signs are identical to those found in cases of neonatal meconium ileus: intestinal obstruction and accumulation of closely spaced matter in a distended ileum (terminal part). As in cases of meconium ileus without complications, treatment consisted of enemas with water-soluble products. The high osmotic pressure of these products made it possible to remove the obstruction.

[The temporo-maxillary joint in infants (author's transl)]

Normal phylogenetic, embryologic, and morphologic characteristics of the temporo-maxillary joint in infants are reviewed. The principal techniques for radiological examinations are outlined, followed by a classification together with illustrations of the main pathological disorders affecting this joint in infants.