- Email: [email protected]
Antral duplication with intractable duodenal ulcer
98
INTERNATIONAL
age in 5, resulting in the death of 2 premature infants. Massive atelectasis, hyperbilirubinemia, and unexplained convulsions were observed. One recurrent fistula was surgically corrected at 3 months of age. A posterior tracheal diverticulum causing periodic bronchopneumonia was successfully treated by resection. Laryngeal edema responded to tracheotomy in 5 patients. Twenty infants required dilitation of an esophageal stricture.-W. Sieber GASTRIC: RESECTION IN CHILDREN THE ZOLLINGER-ELLISON SYNDROME. S. D. Wilson and E. H. Ellison. Arch. Surg. 91:165, 1965.
ABSTRACTS
OF PEDIATRIC
SURGERY
ture. Recovery followed 75 per cent gastric resection and gastrojejunostomy. There was a muscular wall in common with the stomach, and the duplication cysts were lined with antral mucosa. It was thought that the distension of the normally innervated, non-acid containing antral duplications resulted in marked acid secretion in thz normal stomach with subsequent duodenal ulceration. Twenty-three other reported cystic antral duplications were reviewed.-R. Spencer
TOTAL WITH
More than 300 cases of Zollinger-Ellison syndrome have been reported of which eight are children ages 8 to 15 years. All of the children bled. Roentgenologic findings are large, distended, atonic stomach with prominent rugae; also distended duodenum and small bowel. Hyperperistalsis, edematous small bowel mucosa (“saw-toothed”) and ulceration in an unusual location are other findings. Twelve hour gastric secretion volumes ranged from 915 to 1800 ml. and acid values were 90 to 117 mEq./L. Seven children had metastases and one child had only islet hyperplasia. The primary tumor was not found in 5 of 8 cases. A tissue diagnosis is required before total gastrectomy is undertaken. The extent of resection had a marked influence on survival. Two children with subtotal gastrectomy lived 8 months and died of hemorrhage from recurrent ulcer adjacent to a small rim of gastric mucosa. The 5 remaining children had a total gastrectomy and are alive, presumably with residual tumor and a circulating gastric secretogogue. Follow up has been from 2 to 5 ye.lrs and although the prognosis is still uncertain, the children are doing well and are developing nearly normally.-Edward J. Berman ANTHAL DUPLICATION WITH INTRACTABLE DUODENAL ULCER. W. Garn/obti. Gastroenterology 49:419-424, 1965. A 20 year old woman with a five year history of intractable ulcer had a biloculate duplication, 3 X 5 X 8 cm., within the gastric
wall of the prepyloric
greater
curva-
CORROSIVE GASTRITIS. MANAGEMENT OF A CHILD BY GASTRECTOMY. C. Marks and B. Zilberg. Amer. J. Surg. 110:477-481, 196.5. Report of a case of ingestion of soldering fluid (zinc chloride) in an 18 month old child causing pyloric stenosis and a gastrocolic fistula. The fistula was repaired and a subtotal gastrectomy performed. Satisfactory growth and development is reported four years later.--hi. K. Connolly ABERRANT PANCREAS WITHIN A DUPLICATION OF THE STOhIAcH. W. R. Ghent, J. G. Stackhouse and R. Cebellos. Canad. J. Surg. 8:408, 1965. The authors present a case report of a 16 year old girl with acute symptoms of nausea and vomiting. There was slight tenderness in the epigastrium. Complete obstruction at the level of the pylorus was demonstrated by barium x-ray study. In addition there was a large prepyloric filling defect. After rehydration and correction of electrolyte imbalance, at laparotomy a large semi-solid mass was found filling the pyloric region of the stomach. A partial gastrectomy was performed. On pathologic examination the 5 cm. mass was found to be a duplication of the stomach containing aberrant pancreatic tissue. The patient made an uneventful recovery following her operation.-Colin C. Ferguson
JEJUNAL OBSTRUCTION FOLLOWING, A FRACTURE OF THE SPINE IN A CHILLY Ph. Masson. Ann. Chir. Infant. 6:141-144, 1965. Description of a 1 7/12 year old boy with fracture of L 2 (traffic accident) without le-
INTERNATIONAL
age in 5, resulting in the death of 2 premature infants. Massive atelectasis, hyperbilirubinemia, and unexplained convulsions were observed. One recurrent fistula was surgically corrected at 3 months of age. A posterior tracheal diverticulum causing periodic bronchopneumonia was successfully treated by resection. Laryngeal edema responded to tracheotomy in 5 patients. Twenty infants required dilitation of an esophageal stricture.-W. Sieber GASTRIC: RESECTION IN CHILDREN THE ZOLLINGER-ELLISON SYNDROME. S. D. Wilson and E. H. Ellison. Arch. Surg. 91:165, 1965.
ABSTRACTS
OF PEDIATRIC
SURGERY
ture. Recovery followed 75 per cent gastric resection and gastrojejunostomy. There was a muscular wall in common with the stomach, and the duplication cysts were lined with antral mucosa. It was thought that the distension of the normally innervated, non-acid containing antral duplications resulted in marked acid secretion in thz normal stomach with subsequent duodenal ulceration. Twenty-three other reported cystic antral duplications were reviewed.-R. Spencer
TOTAL WITH
More than 300 cases of Zollinger-Ellison syndrome have been reported of which eight are children ages 8 to 15 years. All of the children bled. Roentgenologic findings are large, distended, atonic stomach with prominent rugae; also distended duodenum and small bowel. Hyperperistalsis, edematous small bowel mucosa (“saw-toothed”) and ulceration in an unusual location are other findings. Twelve hour gastric secretion volumes ranged from 915 to 1800 ml. and acid values were 90 to 117 mEq./L. Seven children had metastases and one child had only islet hyperplasia. The primary tumor was not found in 5 of 8 cases. A tissue diagnosis is required before total gastrectomy is undertaken. The extent of resection had a marked influence on survival. Two children with subtotal gastrectomy lived 8 months and died of hemorrhage from recurrent ulcer adjacent to a small rim of gastric mucosa. The 5 remaining children had a total gastrectomy and are alive, presumably with residual tumor and a circulating gastric secretogogue. Follow up has been from 2 to 5 ye.lrs and although the prognosis is still uncertain, the children are doing well and are developing nearly normally.-Edward J. Berman ANTHAL DUPLICATION WITH INTRACTABLE DUODENAL ULCER. W. Garn/obti. Gastroenterology 49:419-424, 1965. A 20 year old woman with a five year history of intractable ulcer had a biloculate duplication, 3 X 5 X 8 cm., within the gastric
wall of the prepyloric
greater
curva-
CORROSIVE GASTRITIS. MANAGEMENT OF A CHILD BY GASTRECTOMY. C. Marks and B. Zilberg. Amer. J. Surg. 110:477-481, 196.5. Report of a case of ingestion of soldering fluid (zinc chloride) in an 18 month old child causing pyloric stenosis and a gastrocolic fistula. The fistula was repaired and a subtotal gastrectomy performed. Satisfactory growth and development is reported four years later.--hi. K. Connolly ABERRANT PANCREAS WITHIN A DUPLICATION OF THE STOhIAcH. W. R. Ghent, J. G. Stackhouse and R. Cebellos. Canad. J. Surg. 8:408, 1965. The authors present a case report of a 16 year old girl with acute symptoms of nausea and vomiting. There was slight tenderness in the epigastrium. Complete obstruction at the level of the pylorus was demonstrated by barium x-ray study. In addition there was a large prepyloric filling defect. After rehydration and correction of electrolyte imbalance, at laparotomy a large semi-solid mass was found filling the pyloric region of the stomach. A partial gastrectomy was performed. On pathologic examination the 5 cm. mass was found to be a duplication of the stomach containing aberrant pancreatic tissue. The patient made an uneventful recovery following her operation.-Colin C. Ferguson
JEJUNAL OBSTRUCTION FOLLOWING, A FRACTURE OF THE SPINE IN A CHILLY Ph. Masson. Ann. Chir. Infant. 6:141-144, 1965. Description of a 1 7/12 year old boy with fracture of L 2 (traffic accident) without le-