Alan D. Hoffman

Problems in the Clinical and Roentgenographic Diagnosis of Pneumonia in Young Children

The difficulty of diagnosing pneumonia by chest x-ray in children less than 4 years of age was studied by comparing the chest roentgenograms of 34 healthy children with the chest roentgen ograms of 34 children previously diagnosed as having pneumonia. Review of these films without knowledge of the previous interpretation and without clinical information disclosed variations regarding the roentgenographic confirmation of pneumonia in 24 percent of the cases and variations regarding the location of the lesion in about 50 percent of the cases.

Simple Renal Cysts in Children

Simple renal cysts in childhood are uncommon and often are confused with duplication anomalies or renal malignancy. A review of 20 children with simple renal cysts at our institution has documented the spectrum of clinical presentations and radiographic findings of this unusual renal mass. Surgical exploration and marsupialization of the cyst wall were done in 12 patients, 4 underwent nephrectomy earlier in our series and 4 have been followed conservatively by ultrasonography or computerized tomography scanning. Although equivocal cases necessitate surgical intervention, we advocate conservative therapy with diagnostic ultrasonography with or without cyst puncture in asymptomatic and normotensive children with simple renal cysts.

Imaging diagnosis and follow-up of infantile hepatic haemangioendothelioma: a case report.

A 4-week-old male infant was admitted to the hospital with acute gastrointestinal bleeding and marked coagulopathy secondary to vitamin K malabsorption in the presence of cholestasis. Physical examination revealed hepatomegaly and cutaneous haemangiomas. Ultrasonography, CT, and MRI demonstrated a multifocal vascular process and allowed the diagnosis of infantile hepatic haemangioendothelioma to be made without the use of more invasive diagnostic procedures. To avoid high-output congestive heart failure, the patient was treated with oral corticosteroids. After 5 months, rapid involution of the vascular malformations ensued. At age 2 years, a magnetic resonance scan confirmed complete resolution of the hepatic haemangioendothelioma.

Fiddler's neck in a child

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Renal Growth in Small Kidneys after Ureteroneocystostomy

Postoperative renal growth was determined in 22 patients with unilateral atrophic kidney and vesicoureteral reflux. Atrophic kidney growth was compared to the contralateral kidney and growth tables. Significant growth of the atrophic kidney was observed in 68 per cent of the patients after reimplantation. Ureteroneocystostomy enhances growth in atrophic kidneys and is important in salvaging renal function.