Clinical pediatrics
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Clinical pediatrics · Mar 1988
Determination of the time of closure of the ductus arteriosus in severely ill premature infants.
In order to investigate the time of ductal closure in the premature infant, we performed multiple echocardiographic examination in each of 42 premature infants. Twenty eight of these infants had spontaneous closure of the ductus arteriosus (median date of closure--3 days). Twelve required medical or surgical closure of the ductus arteriosus and two died of severe lung disease. There was a significant relationship of decreasing birth weight to prolonged patency of the ductus arteriosus.
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Clinical pediatrics · Mar 1988
Case ReportsAn unusual presentation of an infected urachal cyst. Review of urachal anomalies.
An infected urachal cyst classically presents with a tender lower midline abdominal mass and systemic signs of infection, including fever, malaise, and leukocytosis. At times, the findings may be clinically confused with those of acute appendicitis, Meckel's diverticulitis, or peritonitis. Sonography aids in differentiating these entities by identifying the localized cystic mass containing debris, located anteriorly in the low mid-abdomen, extending from the region of the bladder to the umbilicus. We present an unusual case of an infected urachal cyst in a 6-year-old boy who presented with lower abdominal pain, fever, intermittent diarrhea, polyuria and dysuria, a firm, fixed left lower quadrant tender mass, and an elevated white blood cell count.
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Clinical pediatrics · Mar 1988
Case ReportsLate closure of the ductus arteriosus using indomethacin in the preterm infant.
Several studies have shown a lack of effect of indomethacin therapy for the closure of a patent ductus arteriosus (PDA) in premature infants over 14 days of postnatal age. In this report we describe two cases in which a hemodynamically significant PDA was closed with indomethacin in preterm infants over 20 days of age. The response to indomethacin may be more related to postconceptual age than to actual postnatal age. We suggest that intravenous indomethacin therapy should be attempted before surgical ligation is performed in those premature infants under 34 weeks postconceptual age who have a hemodynamically significant patent ductus arteriosus.