Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027819 (neuroblastoma)
 27,800 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of our 174 neuroblastoma patients, 11 were classified as Stage IV-S. The primary tumor is usually small and there is widespread disease in the liver, skin, bone marrow, or any combination of these. The prognosis is favorable and radiation and chemotherapy should be avoided if possible. In some of these children the rapidly enlarging liver may cause respiratory distress and vena caval compression. The creation of a ventral hernia by means of a Silastic patch is a useful, temporary procedure during the life-threatening period of rapid growth and increased intra-abdominal pressure. Closure is simple once the liver has returned to normal.
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PMID:Silastic abdominal patch for temporary hepatomegaly in Stage IV-S neuroblastoma. 12 71

Intestinal obstruction is a common postoperative complication and is usually related to peritoneal adhesion formation. A less well-recognized cause is postoperative intussusception (POI). Thirty-six instances of POI in children (aged 1 month to 18 years) were treated between 1970 and 1987. POI followed Nissen fundoplication in 9 patients, neuroblastoma resection in 5, small-bowel procedures in 4, inguinal herniorrhaphy in 3, pull-through procedures in 3, ureterostomy in 2, thoracic procedures in 2, ventral hernia in 1, nephrectomy in 1, hepatic resection in 1, Heller myotomy in 1, ventriculo-atrial shunt in 1, and gastrocystoplasty in 1. Initial symptoms included bilious vomiting or increased nasogastric drainage (after initial return of gut function) in 26 patients, abdominal distension in 24, irritability in 10, intermittent pain in 7, palpable abdominal mass in 2, rectal bleeding in 2, and lethargy in 1. The symptoms occurred 1 to 24 days (mean, 8 days) after the initial surgery. Plain abdominal radiographs revealed multiple air-fluid levels in 31 and an "adynamic ileus" in five patients. Barium contrast techniques could successfully reduce two ileocolic and one distal ileo-ileal lesions. The remainder necessitated operative management. Manual reduction was possible in 29 cases, and four children with diagnostic delay required bowel resection and an anastomosis for intestinal necrosis. The site of intussusception was ileo-ileal in 23 patients, jejunojejunal in 6, ileocolic in 5, and jejuno-ileal in 2. The diagnosis of POI should be considered in children with signs of bowel dysfunction in the early postoperative period. Contrast studies are of limited value, since most cases are confined to the small bowel. A high index of suspicion and prompt laparotomy will usually allow manual reduction of the lesion. Diagnostic delay may result in bowel necrosis.
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PMID:Postoperative intussusception: experience with 36 cases in children. 317 73

Acute renal failure developed in an infant aged 30 days during chemotherapy and irradiation for hepatic neuroblastoma (IV-S). Acute hemodialysis via a profunda femoris - long saphenous vein shunt was accomplished on 9 occasions in this 4 kg infant. The complications of septicemia and acute respiratory embarrassment caused by hepatomegaly were treated by appropriate antibiotic treatment, creation of a temporary ventral hernia and assisted ventilation. Careful attention to correct pediatric hemodialysis technique, as described, can permit long-term survival if the underlying disorder is also amenable to treatment.
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PMID:Acute renal failure in an infant with congenital neuroblastoma - successful treatment by hemodialysis. 714 95

We herein report three pediatric cases of spigelian hernia involving a 6-month-old girl, an 8-month-old girl, and a 3-year-old boy. This is a rare condition with only 20 children (12 boys and 8 girls) younger than 15 years of age previously reported in the literature. Their ages ranged from 6 days to 15 years. The hernia was situated on the right side in six cases, on the left side in nine, and was bilateral in four (with one case unreported). Among these, four cases were caused by trauma and one case by a postoperative complication. Our first and third cases were spontaneous, while the second case was a postoperative lateral ventral hernia. The first and second cases were associated with ipsilateral mediastinal neuroblastoma. No previous report of spigelian hernia has been associated with mediastinal neuroblastoma. We suspected that muscle atrophy caused by the neuropathy of the ninth to twelfth intercostal nerves may have been the cause of the hernia. These two cases are thus believed to be the first such cases to be reported.
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PMID:Pediatric spigelian hernia: reports of three cases. 778 Feb 31

Stage IV-S neuroblastoma has a relatively favorable outcome. However, urgent surgical treatment may be necessary for management of life-threatening complications related to massive hepatomegaly caused by metastatic tumor infiltration. The enlarged liver often becomes of primary concern because diaphragmatic elevation results in life-threatening respiratory embarrassment. An external SILAS-TIC dome has been used as a temporizing procedure to decrease the intraabdominal pressure. The authors developed a modification of this approach using an internal polytetrafluoroethylene patch to create a ventral hernia. This technique decreases the potential complications of prosthetic material use, namely, risk of infection. The graft may be left in place for an extended period and removed in staged operations as the bulk of the metastatic tumor regresses.
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PMID:Abdominal expansion as a bridging technique in stage IV-S neuroblastoma with massive hepatomegaly. 784 23