The role of endoscopic retrograde cholangiopancreatography in small children and adolescents.
Journal - Surgical laparoscopy & endoscopy (UNITED STATES )
Diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) was performed on 16 patients aged 2 months to 18 years at Jordan University Hospital in the period between May 1990 to January 1993. The adult side-viewing duodenoscope was used, and visualization of appropriate ductal system was accomplished in 100% of the cases with no complications. Intravenous sedation was used in 69% of the cases with diazepam and pethidine (meperidine). ERCP provided valuable additional information in patients with hepatobiliary and pancreatic diseases. However, it did not demonstrate significant pathology in patients with otherwise unexplained abdominal pain. Endoscopic sphincterotomy (ES) was successfully performed on four infants and small children with common bile duct stones. It is concluded that ERCP and ES are relatively easy and safe techniques when applied to infants and children with pancreatobiliary disorders.
|ISSN : ||1051-7200|
|Mesh Heading : ||Abdominal Pain Adolescent Biliary Tract Diseases Child Child, Preschool Contrast Media Diatrizoate Meglumine Diazepam Female Humans Hypnotics and Sedatives Infant Male Meperidine Narcotics Pancreatic Diseases radiography surgery instrumentation utilization diagnostic use therapeutic use therapeutic use therapeutic use therapeutic use surgery|
|Mesh Heading Relevant : ||Cholangiopancreatography, Endoscopic Retrograde radiography radiography|
Ketamine hydrochloride as sole anesthetic for open liver biopsy.
Journal - Middle East journal of anesthesiology (LEBANON )
We evaluated the use of ketamine as sole anesthetic agent for open liver biopsy, with particular reference to its effect on liver function and hepatotoxicity and its effect on cardiovascular stability and respiration. From 386 patients who underwent liver biopsy at Jordan University Hospital, 12 had open liver biopsy because of contra-indications for closed needle biopsy. The surgical procedure consisted of a small right paramedian incision allowing inspection of the liver surface and a wedge and needle biopsy. Ketamine HCl was used in a dose of 2 mg/kg I.V. with supplemental doses as necessary. No significant fluctuations in cardio-respiratory vital signs were observed. Muscle rigidity and respiratory tagging movements necessitated addition of a muscle relaxant and artificial ventilation in three patients. Six patients reported dreams, two of which were described as nightmares. There was no liver function decompensation, or significant bilirubin or transaminase elevations in the week following the biopsy. Ketamine is a safe anesthetic to use for open liver biopsy in patients with underlying liver disease, although poor muscle relaxation and nightmares may be significant side effects.
|ISSN : ||0544-0440|
|Mesh Heading : ||Adolescent Adult Child Female Humans Liver Liver Diseases Male Middle Aged|
|Mesh Heading Relevant : ||Anesthesia, Intravenous Biopsy Ketamine pathology pathology|