Through the looking-glass what you found there.

نویسندگان

Giampiero Soccorso

George K Ninan

چکیده

C liical im ge A term-newborn baby developed respiratory distress after his first feed. An orogastric tube failed to reach the stomach. Chest and abdominal radiography showed a coiled tube in the proximal oesophageal pouch, and a gas-containing abdomen. These findings were consistent with oesophageal atresia (OA) and distal tracheo-esophageal fistula (TOF) (Fig.). Dextrocardia, right-sided gastric bubble and leftsided liver were also noted. The findings suggested combined OA, TOF and situs inversus totalis (SIT). Echocardiography confirmed dextrocardia, right-sided aortic arch and a small atrial septal defect with normal pulmonary venous connections. Left thoracotomy was performed by extra-pleural approach via the 5th intercostal space to repair the OA and ligate the TOF. At the 12-month postoperative follow-up, the baby was doing well. SIT is a rare anomaly with complete right-to-left transposition of the thoraco-abdominal organs. The incidence of SIT is 0.01%. Associated intra-abdominal anomalies are polysplenia, malrotation and duodenal obstruction. Situs inversus may also occur in patients with primary ciliary dyskinesia (PCD). Kartagener syndrome is the combination of situs inversus, chronic sinusitis, and bronchiectasis. Although rare, the preoperative recognition of SIT and right-sided aortic arch is essential in infants with OA to enable the surgeon to plan the side of thoracotomy, be aware of other gastrointestinal anomalies, and thereby avoid complications that may jeopardize the OA repair. Finally, to assess the longterm prognosis, surgeons should be aware that situs inversus occurs randomly in half the patients with PCD. Late complications of OA such as gastro-esophageal reflux, respiratory tract infection and tracheomalacia can be potential factors aggravating PCD and Kartagener syndrome.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

1 Quantification in Child Language

Quantification in Child Language Jeffrey Lidz University of Maryland "Who did you pass on the road?" the King went on, holding out his hand to the Messenger for some more hay. "Nobody" said the Messenger. "Quite right," said the King:"this young lady saw him too. So of course Nobody walks slower than you." "I do my best," the Messenger said in a sullen tone. "I'm sure that nobody walks much fas...

متن کامل

Virtual reality - through the new looking glass

Find the secret to improve the quality of life by reading this virtual reality through the new looking glass. This is a kind of book that you need now. Besides, it can be your favorite book to read after having this book. Do you ask why? Well, this is a book that has different characteristic with others. You may not need to know who the author is, how well-known the work is. As wise word, never...

متن کامل

"Why, sometimes I've believed as many as six impossible things before breakfast." Lewis Carroll, In "Through the looking-glass, and what Alice found there".

متن کامل

Through the looking glass--or, look before you leap.

متن کامل

The Abstractness of Artworks and its Implications for Aesthetics

What would it be like to belong to a profession whose members routinely believe many more than six impossible things before breakfast? Well, just look in the looking glass: the chances are that if you're reading this, you are already associated with the profession in question. Such are the implications of the argument to follow. We aestheticians, and our theories, are currently embroiled in all...

متن کامل