Alexander K. C. Leung, MD

June 01, 2004

7-year-old boy presented with an asymptomatic cystic lesion on the lateral aspect of the left ankle of 4 months’ duration. There was no history of trauma. The mass fluctuated in size; it was smaller when the child was recumbent and larger when the child was upright.

June 01, 2002

Affected infants present shortly afterbirth with a large bowel obstructionsecondary to transient dysmotility inthe descending colon. Although thecause is unknown, immaturity of thecolonic myenteric plexuses has beendemonstrated in some cases. Morethan 50% of affected infants are bornto mothers with diabetes. Other predisposingfactors include hypoglycemiaand sepsis.

June 01, 2002

The extent of mucosal or transmural intestinal necrosis varies. Pneumatosis progresses from the submucosa through the muscular layer to the subserosa. The distal ileum and proximal colon are most frequently involved.

June 01, 2002

This condition, which accounts forabout 30% of cases of intestinal obstructionamong neonates, is characterizedby the inspissation of thick,tenacious meconium in the bowel.The most common cause is cystic fibrosis;approximately 6% to 20% of infantswith cystic fibrosis have meconiumileus. Hyperviscous mucus secretedby abnormal intestinal glands,an abnormal concentrating processin the proximal small intestine, and adeficiency of pancreatic enzymeshave been implicated in the pathogenesis.The histologic hallmark is distention of the gobletcells in the intestinal mucosa.

June 01, 2002

Inspissated, sticky, immobile meconiumcauses this transient form of distalcolonic or rectal obstruction in newborns.The incidence has been estimatedat 1 in 500 to 1000 live births.The condition is thought to resultfrom dehydration of the meconium.

April 15, 2002

A boy was born to a gravida 2, para 1, 26-year-old woman at 37 weeks’ gestation. The pregnancy had been complicated by gestational diabetes. The infant was delivered vaginally; Apgar scores were 6 at 1 minute and 9 at 5 minutes.

April 01, 2002

This condition is characterized bya localized narrowing of the jejunumwithout a disruption of continuityor defect in the mesentery. At thestenotic site, there is often a short,narrow segment with a minute lumenwhere the muscularis is irregularand the submucosa is thickened.The resultant intestinal obstructionis incomplete.

April 01, 2002

This condition involves the invagination of a proximalsegment of bowel (the intussusceptum) into a more distalsegment (the intussuscipiens) (A). It occurs mostfrequently in infants between the ages of 5 and 12months and is a leading cause of intestinal obstructionin children aged 2 months to 5 years. Intrauterine intussusceptionis associated with the development of intestinalatresia. The male to female ratio is approximately3:2. Intussusception is slightly more common in whitethan in black children and is often seen in childrenwith cystic fibrosis.

April 01, 2002

This obstruction is caused by a failure of intestinal peristalsis;there is no evidence of mechanical obstruction.Paralytic ileus is common after abdominal surgery, especiallyif anticholinergic drugs are given preoperativelyand/or narcotics are used postoperatively. It usually lasts2 to 3 days. Paralytic ileus may also be caused by peritonitis;ischemia or surgical manipulation of the bowel; retroperitonealhemorrhage; spinal fracture; systemic sepsis;shock; hypokalemia; uremia; pharmacologic agents (eg,vincristine, loperamide, and calcium channel blockers);diabetic ketoacidosis; and myxedema.

March 01, 2002

This obstruction results from hypertrophyof the circular and longitudinalmuscularis of the pylorus and the distalantrum of the stomach. It occursin approximately 3 of every 1000 livebirths and is 4 times more commonin boys. Pyloric stenosis (PS) is relativelyuncommon in African Americanand Asian infants. The observationthat it occurs primarily in first-borninfants has been disputed.