Pediatric radiology
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Pediatric radiology · Oct 2000
Comparative StudyInitial experience with intravenous pentobarbital sedation for children undergoing MRI at a tertiary care pediatric hospital: the learning curve.
Our purpose is to describe the initial experience with intravenous pentobarbital sedation in children undergoing MRI at a tertiary pediatric hospital to identify errors associated with inexperience. ⋯ The success rate was good, but could have been improved by restricting the use of pentobarbital to children less than 12 years of age and weighing less than 50 kg. Radiologists inexperienced with intravenous sedation should strictly observe the maximum suggested dose of pentobarbital to prevent prolonged sedation.
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Pediatric radiology · Oct 2000
Comparative StudyThe barium enema in constipation: comparison with rectal manometry and biopsy to exclude Hirschsprung's disease after the neonatal period.
The diagnosis of Hirschsprung's disease is usually made in neonates but often considered in older infants and children with constipation: these children may be referred for barium enema. Since it is widely accepted that a normal barium enema does not exclude Hirschsprung's disease, some children, after a normal enema, undergo more invasive procedures such as rectal manometry or biopsy. Our study asked how frequently a diagnosis of Hirschsprung's disease was made by biopsy or manometry in children who had normal barium enema. ⋯ The barium enema is a good initial screening test for Hirschsprung's disease in severely constipated children since it correlates well with manometry and biopsy. The enema is particularly useful in centers without easy access to pediatric gastroenterology services, and a normal enema in this setting allows the continuation of medical therapy with further evaluation only if there is a lack of response. An abnormal enema, however, requires referral to a facility equipped to perform confirmatory manometry or biopsy.
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Pediatric radiology · Oct 2000
Comparative StudyMRI in the management of scaphoid fractures in skeletally immature patients.
The scaphoid is the commonest fractured carpal bone, but excluding a scaphoid fracture with plain radiographs is difficult. Other imaging modalities are being increasingly evaluated in the management of scaphoid injuries. MRI has been shown to be of considerable value in the adult population but there have been limited studies of its use in children. ⋯ MRI of acute scaphoid injuries in children significantly alters management. Those children with normal scans are discharged earlier. Scaphoid fractures are confirmed earlier and other pathological conditions are also detected.