Browsing by Author "Ladd, Alan P."

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    Anorectal malformation and Hirschsprung disease in an otherwise healthy infant
    (Elsevier, 2022-03) Rougraff , Audra; Grayson, Britney L.; Ladd, Alan P.; Pediatrics, School of Medicine
    Hirschsprung disease and anorectal malformations are two conditions that are rarely associated with one another. Current reports of anorectal malformations with concurrent Hirschsprung disease predominantly describe children with genetic syndromes or other chromosomal anomalies. This report describes a case of imperforate anus and Hirschsprung disease in an otherwise healthy patient highlighting the importance of considering Hirschsprung disease in any patient with stooling difficulties following anorectoplasty for anorectal malformation.
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    Endovascular retrieval of difficult to remove port-a-caths
    (Elsevier, 2019-08) Rao, Raghavendra; Marshalleck, Francis E.; Ladd, Alan P.; Pediatrics, School of Medicine
    Long dwelling central venous lines develop intravenous adhesions or a calcified fibrous sheath causing difficulties in removal. Although such cases are rare, a few cases of endovascular retrieval have been reported in pediatric literature. We report our experience with 6 cases in children with port-a-caths. Transfemoral snare technique was effective in all but 1 patient. The mean age of the in dwelling port-a-caths was 5 years. One patient whose catheter could not be removed has developed no complications after a follow-up of 5 years. Review of literature suggests that while endovascular retrieval is not without risks, leaving a central line in situ has no major disadvantages. Heroic measures to remove such lines should be pursued only when absolutely necessary as in the case of an infected line.
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    Obstructive choledocholithiasis requiring intervention in a three week old neonate: A case report and review of the literature
    (Elsevier, 2016-01) Peters, Lindsay E.; Ladd, Alan P.; Markel, Troy A.; Department of Surgery, IU School of Medicine
    The discovery of cholelithiasis in neonates is often incidental, however obstructing common bile duct stones are rare. Herein we report the case of a 3 week old neonate who presented with obstructive choledocholithiasis. The patient was treated conservatively with antibiotics and ursodeoxycholic acid but did not improve. He was therefore taken to surgery for cholecystectomy and stone extraction. The operation was successful and his transaminases and bilirubin levels declined. Trials of conservative management can be attempted in asymptomatic infants with choledocholithiasis. However, failure of the stone to pass or ongoing signs of cholecystitis should be met with operative intervention to remove the obstruction.