William H. McAlister

Extracorporeal membrane oxygenation for circulatory support after repair of congenital heart defects

Extracorporeal membrane oxygenation was used for cardiovascular support in 13 infants and children with complex congenital heart disease and 1 premature neonate treated in preparation for pericardial patch tracheoplasty for long-segment tracheal stenosis. Nine patients were weaned from extracorporeal membrane oxygenation. There were five (36%) early deaths and four (29%) late deaths. Cannulation sites included right carotid/jugular vessels, femoral artery and vein, and right atrium and aorta. In 4 patients, the neck vessels were repaired at decannulation. Five survivors had normal growth and neurodevelopmental evaluations at follow-up. Extracorporeal membrane oxygenation can be successfully used as biventricular support in patients with intractable low cardiac output syndrome after repair of congenital heart disease. Best results are obtained in patients who have several hours of stability after operation before initiation of support. Hemorrhagic complications are reduced and long-term neurodevelopmental outcomes appear promising with right neck vessel cannulation and repair. No bleeding complications were observed in patients cannulated through the neck vessels.

Brachytelephalangic chondrodysplasia punctata with marked cervical stenosis and cord compression: report of two cases

Severe cervical spine stenosis with cord compression has not been well documented in brachytelephalangic chondrodysplasia punctata. We report two boys with phenotypic features of brachytelephalangic chondrodysplasia punctata who had severe cervical spine stenosis secondary to dysplastic cervical vertebrae, and discuss the significance of this association and its relation to the phenotypically similar Binder phenotype.

Pseudotumoral sarcoid granulomatous nephritis in a child : case presentation with sonographic and CT findings

Abstract Granulomatous nephritis with renal masses is a very uncommon complication of sarcoidosis. Renal sonography in a patient with pathologically proven granulomatous nephritis demonstrated echogenic masses. CT demonstrated low-density lesions with mottled contrast enhancement.

Fine-needle aspiration cytology of mesenchymal hamartoma of the chest wall

We report on an uncommon entity, the so‐called “chest wall chondromatous hamartoma” or “mesenchymal hamartoma of the chest wall” (MHCW), diagnosed by fine‐needle aspiration (FNA) cytology in a 6‐mo‐old boy. Radiologic features were those of an aggressive lesion with rib expansion and destruction, that contrasted with aspirate smears showing bland cartilage and spindled mesenchymal elements. The clinicoradiographic features together with the FNA yield of mixed cellular elements aided in the correct diagnosis of MHCW. Diagn. Cytopathol. 2000;22:33–38.

Umbilical artery catheter use complicated by pseudoaneurysm of the aorta.

Abstract. We report a case of a large aortic mycotic pseudoaneurysm in a premature infant, a rare but serious complication associated with sepsis and umbilical artery catheter (UAC) use. Sonography is an appropriate first-line imaging modality for detection of aortic pseudoaneurysms. Increased awareness of this rare complication may lead to earlier diagnosis in the high-risk premature infant with a history of a UAC and sepsis.

Radiographic findings after incomplete pyloromyotomy.

The gastrointestinal series of 10 patients with persistent vomiting following pyloromyotomies for pyloric stenosis were reviewed. Four patients had incomplete pyloromyotomies and required reoperation. Their studies showed persistent obstruction with elongation and narrowing of the pyloric channel similar to preoperative studies, except that the proximal muscle mass was tapered in 3 of the 4 patients. Six patients with similar histories of postpyloromyotomy vomiting but who did not require repeat surgery had irregular but much wider pyloric channels, good gastric emptying, and gastroesophageal reflux.

Prognosis for Resolution of Moderate, Primary Reflux in Girls

Detailed cystoscopic grading of ureteral orifices has proved unnecessary in our experience for determining the prognosis of moderate, primary reflux in girls. Medially placed orifices strongly predict spontaneous resolution with preventive medication, while radiographic pyelonephritic scarring and/or grade III reflux strongly predict failure to resolve. While laterally placed ureteral orifices and low volume reflux suggest a need for operation, they are prognostically less useful, particularly when those with grade III reflux are excluded. Cystitis cystica and unrelated anomalies seem to be associated with the ultimate need for operation but are of uncertain significance.

Posterior mediastinal capillary hemangioma with extradural extension resembling neuroblastoma.

Abstract We present two patients with posterior mediastinal capillary hemangiomas that were paraspinal and had intraspinal extension. Computed tomography demonstrated the strikingly hypervascular nature of these tumors, distinguishing them from neuroblastoma.

CT manifestations of ileal dysgenesis

Ileal dysgenesis is an uncommon condition of unknown etiology occurring in the distal ileum in the region of the vitelline duct. The CT appearance of this lesion, although not previously described to our knowledge, is characteristic. We report a patient with ileal dysgenesis who had an abdominal CT scan to evaluate chronic iron deficiency anemia and protein-losing enteropathy. Recognition of this lesion by pediatric radiologists is important; so that surgical treatment, which is simple and effective, can be initiated quickly.

Congenital pancreatic pseudocyst: A rare cause of abdominal mass in a neonate

Congenital pancreatic pseudocyst is a rare cause of a cystic abdominal mass in a neonate. Two cases of congenital pancreatic pseudocyst are presented, and the subject of congenital cystic lesions of the pancreas is reviewed.