Ewell A. Clarke

Right pneumonectomy syndrome in infancy treated with an expandable prosthesis

Severe respiratory distress developed in a 5-month-old infant approximately ten days after pneumonectomy for complete sequestration of the right lung. Right pneumonectomy syndrome was diagnosed by bronchography, which revealed thinning and obstruction of the left main bronchus during expiration. A right thoracotomy was then performed, and an inflatable tissue expander with a subcutaneous injection port was inserted into the right chest cavity to prevent recurrence of the mediastinal shift and to allow for future growth. The patient has done well, requiring reinjection of the prosthesis with additional volume on one occasion in a 20-month period of follow-up.

Cerebro-costo-mandibular syndrome with consanguinity

The cerebro-costo-mandibular syndrome is a rare disorder characterized by unique posterior rib defects, micrognathia, and mental deficiency. The mode of transmission is undetermined. This report describes the first case with documented parental consanguinity as well as hitherto undescribed CT and skeletal findings.

First Rib Fractures in Abused Infants A Report of Three Cases

The authors describe 4 first rib fractures in 3 infants, highlighting the difficulty in detecting first rib fractures on skeletal survey. All 4 fractures were the result of physical abuse. A literature search does not find a case of first rib fracture in a healthy infant that is not the result of child abuse. The diagnosis of first rib fracture in an infant should prompt a thorough medical and social evaluation for child abuse.

Effect of oral metrizamide on hematocrit and serum osmolality in the neonate

Sixteen newborns and young infants, weighing between 800 and 5200 grams, received orally administered metrizamide for evaluation of suspected gastrointestinal pathology. Images were judged good to excellent in 14 cases. No effect of metrizamide on hematocrit and serum osmolality was noted. Metrizamide appears to be a relatively safe and effective agent for examination of the neonatal gastrointestinal tract.