Browsing by Author "Larraín, Francisco"

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    Evaluación prospectiva de la seguridad y tolerancia de los procedimientos colonoscópicos en pacientes pediátricos
    (2006) Gana, Juan Cristobal; Glenz, Constanza; Marchant, Pamela; Vaca, Carina; García, Ximena; Larraín, Francisco; Harris, Paul R.
    Background: Colonoscopy is a well established diagnostic and therapeutic procedure in pediatrics. Aim: To evaluate colon preparation alternatives for colonoscopy or sigmoidoscopy, type of sedation, clinical indications and findings. Patients and methods: Prospective study of 123 children referred for colonoscopy. Demographic data, type of colon preparation, sedation, type of endoscope and endoscopic results were obtained. The following day, a phone interview was carried out inquiring about duration, quality and adverse effects of the sedation and procedure. Results: Seventy one boys (58%) and 52 girls (42%) with a mean age of 6.7±4.4 years, were recruited. The main indication was lower gastrointestinal bleeding (71%). The different colon preparations produced elimination of clear liquid stools in 50%, non transparent liquid in 23%, semi liquid in 22% and solid in 6% of the patients. Most common side effects were abdominal distension (20%) and nausea (16.8%). The most commonly used drugs were midazolam (76%) and demerol (43%). The average duration of the procedure was 18.3 minutes (range: 4-50). The most common findings were rectal polyps (18.7%) and hemorrhagic colitis (14.6%). In 77% of cases, the sedation was considered very good or good. Colon visualization was described as very good (51%) or good (36%). Seventy three percent of children had complete amnesia. The most common adverse effect was vomiting (7.5%). Conclusion: Lower endoscopies are feasible procedures to carry out in children, in an ambulatory basis, with intravenous sedation and minimum adverse effects.
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    Litiasis biliar en niños: un estudio clínico-morfológico
    (2003) Harris Diez, Paul Richard; Chateau, Bernardita; Miquel, Juan Francisco; Zavala, Alejandro; Montes, Patricio; Herrera, José Miguel; Zúñiga, Sergio; Larraín, Francisco; Santos, Marcela; Contador, Mónica
    Background: The use of ultrasonography increased the frequency of diagnosis of cholelithiasis in childhood. Aim: To determine the clinical and laboratory features and follow up of children with biliary stones. Patients and methods: Twenty six children (13 male, aged 1 month to 14 years) were prospectively enrolled. Results: Nine children had a past medical history of factors potentially predisposing to stones. A clinical presentation with vomiting (50%), abdominal pain (46%) and jaundice (23%) was the most common indication for surgery. The diagnosis was based on abdominal ultrasound in all children. Cholecystectomy was performed in 15 children (laparoscopy in 13 and open surgery in 2). Children who underwent surgery were older than those who did not undeago surgery (p < 0.001), but they did not have differences in liver function tests. Eight children had pigmented stones and seven had cholesterol stones. Conclusions: In our patients, neither family history nor laboratory tests were useful in the diagnosis as well as hi the clinical decision of surgery, which was based on symptoms. The presence of cholesterol stones in a high proportion of these children may be a unique situation in Chile considering the high prevalence of this disease in the adult population.