Publications (3) View all
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Article: Facial palsy as a presenting feature of coarctation of aorta.
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ABSTRACT: We report the unusual presentation of coarctation of the aorta with facial nerve palsy in an infant and a child. The facial nerve palsy and hypertension resolved spontaneously after relief of the aortic coarctation. Our two cases are the first reports of unidentified coarctation of the aorta presenting as facial nerve palsy, with the infant being the youngest to be reported.Interactive cardiovascular and thoracic surgery 04/2003; 2(1):91-3. -
Article: Tension gastrothorax causing cardiac arrest in a child.
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ABSTRACT: Diaphragmatic herniation following blunt injuries is uncommon in children. We present a case report of a child presenting with a diaphragmatic hernia following a trivial injury leading to mediastinal shift and circulatory compromise resulting in a electromechanical dissociation cardiac arrest.Interactive cardiovascular and thoracic surgery 01/2003; 1(2):99-101. -
Article: Limitations and uses of gastrojejunal feeding tubes.
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ABSTRACT: Gastrostomy feeding is a well established alternative method to long term nasogastric tube feeding. Many such patients have gastro-oesophageal reflux (GOR) and require a fundoplication. A transgastric jejunal tube is an alternative when antireflux surgery fails, or is hazardous or inappropriate. To review experience of gastrojejunal (G-J) feeding over six years in two regional centres in the UK. Retrospective review of all children who underwent insertion of a G-J feeding tube. There were 18 children, 12 of whom were neurologically impaired. G-J tubes were inserted at a median age of 3.1 years (range 0.6-14.7) because of persistent symptoms after Nissen fundoplication (n = 8) or symptomatic GOR where fundoplication was inappropriate. Four underwent primary endoscopic insertion of the G-J tube; the remainder had the tube inserted via a previous gastrostomy track. Seventeen showed good weight gain. There was one insertion related complication. During a median follow up of 10 months (range 1-60), four experienced recurrent aspiration, bilious aspirates, and/or diarrhoea. There were 65 tube related complications in 14 patients, necessitating change of the tube at a median of 74 days. Jejunal tube migration was the commonest problem. Five died from complications of their underlying disease. Although G-J feeding tubes were inserted safely and improved nutritional status, their use was associated with a high rate of morbidity. Surgical alternatives such as an Roux-en-Y jejunostomy may be preferable.Archives of Disease in Childhood 03/2002; 86(2):134-7. · 2.88 Impact Factor
