Zoran Marjanovic
Boston Children's Hospital
Network
Latest external collaboration on country level. Dive into details by clicking on the dots.
Publication
Featured researches published by Zoran Marjanovic.
Vojnosanitetski Pregled | 2010
Ana Kostic; Andjelka Slavkovic; Zoran Marjanovic; Jelica Madic; Marijana Krstic; Dragoljub Zivanovic; Danijela Djeric
BACKGROUND/AIMS Acute appendicitis (AA) remains a diagnostic challenge in children, despite ongoing researches. With an aim to facilitate making diagnosis of AA many scoring systems have been created; among them Alvarado score is the most popular. C-reactive protein (CRP) has proven significance for diagnosing AA in adults, but not in children. The aim of this study was to evaluate significance of Alvarado score, as well as CRP values, in making diagnosis of AA in children. METHODS This prospective six-month study was performed on 257 patients under the age of 15, admitted for acute abdominal pain in the Clinic of Pediatric Surgery and Orthopedics in the Clinical Centre of Nis. Alvarado score and CRP values were determined on admission and compared with final diagnosis on discharge. The patients were divided into two groups: group I--non operated patients with abdominal pain (n=184) and group II--operated on patients for appendectomy (n=73). RESULTS Values of Alvardo score were statistically significantly different between groups (group I: 4.9 +/- 1.21, group II: 8.55 +/- 1.32). Also, our results showed significantly high values of CRP measured in operated children (group I: 8.17 +/- 4.7 mg/L, group II: 38 +/- 26 mg/L). Values of validity parameters for Alvarado score were: sensitivity 90%, specifity 80%, positive predictive values 87%; for CRP 95%, 70% and 80%, respectively. CONCLUSION Alvarado score and CRP are very useful adjuvant diagnostic tool for AA to a less experienced surgeon. High values of Alvarado score and CRP cannot be ignored neither at the same time, used as the sole diagnostic method for discriminating children with AA.
International Urology and Nephrology | 2007
Zoran Marjanovic; Sava V. Perovic; Andjelka Slavkovic; Dragoljub Živanović; Ivona Đorđević
Transverse testicular ectopia (TTE) in an extremely rare entity in which both testes migrate along the same inguinal canal towards the same hemiscrotum, while the opposite inguinal canal and hemiscrotum are empty [1–3]. The clinical findings are usually symptomatic inguinal hernia on one side to which the ectopic gonad has migrated, and an impalpable testis on the other side. TTE is usually associated with abnormalities such as persistent Müllerian duct syndrome (PMDS). PMDS is a rare form of male pseudohermafroditism characterized by the persistence of Müllerian duct structures (uterus, fallopian tubes) in phenotypically normal boys [4–6]. Majority of patients were of a very young age, around 1–2 years old. In 65% cases the exact diagnosis is not determined prior to surgical intervention [3]. Patient often undergoes unsuccessful inguinal exploration and the ectopic testis is usually discovered during the repair of an inguinal hernia [7, 8]. In this paper, with an aim to raise awareness of this uncommon condition, we report two cases of TTE, one of which is associated with PMDS.
Central European Journal of Medicine | 2011
Miroslava M. Stojanovic; Andjelka Slavkovic; Miroslav Stojanović; Zoran Marjanovic; Milan Lj. Bojanovic
Ascariasis is a helminthic infection of global distribution, and intestinal obstruction is its most common gastrointestinal complication. This is a case of a 7-year-old boy admitted to Pediatric Surgery because of intestinal obstruction caused by ascariasis. On admission, the patient presented with colicky abdominal pain, bile-stained vomiting and meteorism. On physical examination, the patient was thin, pale, and dehydrated. An abdominal examination showed distention and diffuse tenderness. After admission, the patient had fecal vomiting and expulsion of worms through the mouth. Laboratory-test results showed leucocytosis, eosinophilia, hypoalbuminaemia, and hypochloremia. Abdominal radiographs and ultrasound studies were indicative of small-bowel obstruction due to roundworms, which led to the performance of an exploratory laparotomy. On bowel exploration, an intraluminal mass, 10 by 6 cm in diameter, consisting of roundworms in the middle third of the ileum was found. A longitudinal enterotomy was performed, and the worms were meticulously extracted manually. Postoperatively, broad-spectrum antibiotics and antihelminthic drugs were administered. Our case of intestinal obstruction caused by ascariasis is the first to be reported in Serbia, according to the Serbian literature.
Central European Journal of Medicine | 2011
Zoran Marjanovic; Andjelka Slavkovic; Marijana Krstic; Ivona Djodjevic; Dragan Dimov
Gastrointestinal autonomic nerve tumors form an uncommon subcategory of stromal tumors of the intestinal tract although their histologic appearance is similar to other gastrointestinal stromal tumors. Our aim was to evaluate our experience in the diagnosis and therapy of these kinds of tumors. Two patients were admitted to the Pediatric Surgery Clinic in Niš with abdominal pain and a palpable mass in the abdomen. After excision, the tumor tissue was sampled, sent for histopathological diagnosis, and examined by light microscopy, immunohistochemistry, and electron microscopy. Postoperatively, both patients recovered without complications. The patient with the tumor bulk in the mesentery of the small bowel had no evidence of tumor progression 6 years after surgery. In the second case, a giant tumor was present along the greater curvature of gaster. Even with a tumor of this size, there were no signs of progression 10 years after surgery. Radical surgical resection of gastrointestinal autonomic nerve tumors seems to be the curative approach to date, and long-term survival is possible even with large tumors.
Central European Journal of Medicine | 2012
Zoran Marjanovic; Ivona Djordjevic; Andjelka Slavkovic; Marijana Krstic
Digestive tract duplications are uncommon congenital anomalies, encountered mostly in the first 3 months of life. Overall the rectum is the least common site of alimentary duplications. We represent a case of large cystic non-communicating duplication that manifested with constipation and profuse rectal bleeding. When diagnosis was established, surgery was planned and the cyst was enucleated completely. Histopathology examination confirmed the diagnosis.
Facta Universitatis, Series: Medicine and Biology | 2018
Ivona Đorđević; Anđelka Slavković; Zoran Marjanovic; Dragoljub Živanović; Milan Petrović
We present an extremely rare case of gastroschisis associated with colonic atresia, anomaly seen in only 1.5-5% of all gastroschisis patients. Surgery for this anomaly can be very difficult due to the concomitant inflammation or other anomalies (mesenterium communae, volvulus, etc). Although prolonged intestinal dismotility is expected in these patients, mechanical obstruction must not be excluded in postoperative course, as it is explained in this case. Our case report demonstrates that primary colonic anastomosis is safe and well tolerated surgical procedure for these patients and that obstructive ileus is possible days after primary surgery and must not be overlooked.
Vojnosanitetski Pregled | 2017
Zoran Radovanovic; Andjelka Slavkovic; Zoran Marjanovic; Dragoljub Zivanovic; Ivona Djordjevic
Introduction. Burkitt lymphoma (BL) is a high-grade, highrisk type of non-Hodgkin lymphoma characterized by a very rapid cell progression. Although BL is a rare cause of intussusceptions, it must arouse suspicion if the intussusception occurs outside the characteristic peak. Case report. A previously healthy 7-year-old boy was hospitalized for recurrent abdominal pain, loss of appetite and body weight, a fever of up to 38°C, persistent vomiting and with soft tumefaction ileocecally. Nuclear magnetic resonance (NMR) revealed intussusceptions due to a tumor mass, which was followed by a surgical procedure (right hemicolectomy and terminoterminal anastomosis). Histopathological examination confirmed the diagnosis of primary abdominal Burkitt lymphoma. In spite of the subsequent oncologic treatment lasting for four months, an undifferentiated mass was detected in the retroperitoneal space below the lower pole of the right kidney. Positron emission tomography (PET) scan was performed in order to detect the metabolic activity of the deposit in the retroperitoneal space. A high metabolic activity of Burkitt lymphoma confirmed its presence, as well as the need for additional surgical intervention for tumor extirpation. PET scan undoubtedly contributed to distinguishing the visibility of tumor cells and to the detection of the subcentimeter tumor mass. Conclusion. The timely diagnosis, high tumor sensitivity to chemotherapy as well as the great importance of PET scan in the early detection of tumor recurrence, significantly increase the survival rate in patients with BL.
Acta Facultatis Medicae Naissensis | 2017
Dragoljub Živanović; Andjelka Slavkovic; Zoran Marjanovic; Ivona Djordjevic; Nikola Bojović; Milan Petrović
Summary Congenital posteromedial bowing of the tibia (CPMBT) is a rare congenital anomaly of the lower limbs. The aim of the present study was to analyze our experience in the treatment of CPMBT. A retrospective study of patients treated for CPMBT in the period January 2000 – June 2016 was performed. In the observed period, six patients were treated (five girls and one boy), with predominance of the right tibia involvement (5:1). The initial treatment included a series of corrective casts (4-9) applied in all patients, followed by removable splints and physiotherapy. Four children with residual angulation of tibia after walking age were prescribed ankle-foot orthosis (AFO) as a prevention of pathological fractures. Both posterior and medial angulation correct over time. Mean initial shortening was 11 mm. At the last follow-up visit, mean shortening was 23.33mm. Three patients had lower limb shortening of more than 2 cm. In two of them, with shortening of 27 mm and 35 mm, Ilizarov lengthening was performed. In one girl, we performed lengthening over titanium elastic nails. In the other girl, after lengthening, circular frame was exchanged with a locking plate to reduce fixator wearing time. There were no major complications of treatment. Patients were followed up for 2-12 years (mean 6.83 years). None of them reached skeletal maturity yet. Primary manifestation of CPMBT – angulation of tibia and fibula as well as calcaneovalgus deformity usually correct spontaneously or with conservative measures. However, limb length inequality, as a consequence of CPMBT, progresses with growth and may require surgical correction in some children. Therefore, all children with CPMBT should be followed up until skeletal maturity.
Central European Journal of Medicine | 2012
Zoran Marjanovic; Nikola Vacic; Dusanka Dobanovacki; Andjelka Slavkovic
Omental cysts are the least common cystic lesions of the abdomen. Large intraabdominal cysts can mimic ascites. The incidence of 1 in 20000 pediatric hospital admissions makes them hard to diagnose. We report a three year-old boy with accidentally discovered intraperitoneal fluid collection on ultrasonography. The patient was scheduled for operative treatment with working diagnosis of ascites, but finding of no fluid in Morison’s pouch brought to massive cystic intraabdominal lesion as differential diagnosis. The cyst was emptied; altered parts of the greater omentum were completely excised. Final pathology confirmed lymphangioma. Explorative laparotomy led to correct diagnosis and proper surgical treatment.
Central European Journal of Medicine | 2010
Miroslava M. Stojanovic; Andjelka Slavkovic; Zoran Marjanovic; Miroslav Stojanović; Dragoljub Zivanovic
Bezoars are collections of indigestible materials found in the gastrointestinal tract. Rapunzel syndrome is a rare complication of a gastric trichobezoar in which the mass of hair extends through the pylorus into the small bowel and can even reach the colon. A 12-year-old girl with severe pain and a feeling of “fullness” in the upper abdomen was admitted to Pediatric Surgery. Two days before admission, the patient presented with vague abdominal pain, vomiting with a little blood, and black stool. On physical examination she was pale and listless with patchy alopecia. Abdominal examination showed a mobile, palpable mass in the epigastrium. The initial hematocrit was 7,1%, and the erythrocyte count was 1,12×1012 cells per liter. Abdominal ultrasound and computed tomographic (CT) examinations confirmed the presence of a tumor-like formation in stomach. A giant bezoar with ulceration on the back wall of the stomach was verified by upper gastrointestinal endoscopy. Endoscopic extraction was not possible because of the size of the bezoar. Gastrotomy was performed to remove the bezoar that occupied most of the stomach, with a long tail that extended deeply into the duodenum (Rapunzel syndrome). The bezoar, 35 by 10 cm in diameter, was black and consisted of hair and synthetic fibers. Prompt diagnosis and treatment of trichobezoars are important to avoid a possible fatal outcome.