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Cystectomy: A catastrophic complication of herniorrhaphy
864
16.8) yielded 6 patients with common hepatic ducts measuring greater than 4 mm. Thirty eight patients had gallstones, 51 had no gallbladder abnormalities, 5 had nonshadowing opacities, and one had biliary sludge only. Of the 6 patients with enlargement of the common hepatic duct only 2 were found to have common duct stones. The authors feel that common hepatic duct measurements do not serve as a sensitive or specific indicator of biliary disease in patients with sickle cell disease.--Randa11 W. Powell
INTERNATIONAL ABSTRACTS
closely with the wall of bladder ("bladder ears"). The authors report 2 cases of almost complete excision of the bladder during routine herniorrhaphy. In 1 patient bilateral ureteroileocecoplasty provided a course of management free of complication.--George Holcomb, Jr GENITOURINARY T R A C T An Unusual Case of Testicular Ectopia. J.F. Redman and J.P.
Brizzolara. J Urol 133:104-105, (January), 1985. Small Tube Peritoneovanous Shunting For The Management Of Neonatal Intractable Ascitas. V.F. Garcia, C.G. Howell, D. Barbott,
et al. Surg Gynecol Obstet 160:273-274, (March), 1985. An operative procedure is described which is designed to relieve progressive ascites in a neonate with Budd-Chiari syndrome. A slotted ventricular catheter (Holter-Hausner) is placed in the suprahepatic space under general anesthesia through an incision in the right upper quadrant. A subcutaneous tunnel is created in the anterior chest wall for a catheter with a very low subdural range type of cruciform slit valve. This valve is placed in a pouch beneath the pectoralis major muscle. An atrial catheter is attached to the slit valve, placed in a deep subcutaneous tunnel, and inserted into the right atrium through a separate incision in the internal jugular vein. Roentgenographic confirmation of the position of the catheter tip is essential. The shunt valve is pumped daily by direct compression to check patency and facilitate fluid flow. Strict attention is paid to restricting fluids and managing ventilation because of the anticipated intravascular overload. This procedure was tolerated well in a 2.2 kg female infant. There was prompt resolution of respiratory failure and ascites, and she was discharged from the hospital within two weeks of the operation. Within three months liver function had returned to normal, and patent hepatic veins were visualized on real time ultrasound studies. Four years later, the patient continues to thrive without evidence of recurrent ascites or liver dysfunction.--George Holcomb, Jr Inguinal Hernias After Ventriculoperitoneal Shunt Procedures in Pediatric Patients. F. Moazam, J.D. Glenn, B.J. Kaplan, el al. Surg
Gynecol Obstet 159:570-572, (December), 1984. The authors report the development of previously unrecognized inguinal hernias in 32 of 134 (23.3%) infants and children after placement of a VP shunt. The incidence was higher for shunts performed for intraventricular hemorrhage (47%) than for meningocele (19.5%). No patient presented with an incarcerated or strangulated hernia. There were no postoperative complications related to the repair or to the VP shunt itself. No VP shunt required revision in the postoperative period.--George Holcomb, Jr Scrotal Migration of Ventriculoperitoneal Shunts. M,J. Crofford
and D. Balsam. Am J Roentgenol 141:369-371, (August), 1983. The authors report 4 patients who developed inguinal hernias and/or hydroceles following V-P shunts with radiographs showing migration of the shunt tip into the hernia or hydrocele sac. One patient with coils of shunt tubing in the scrotum discovered on radiography experienced spontaneous migration of the tubing back into the peritoneal cavity.--Randall W. Powell
The authors report a case of testicular ectopia that represents the first instance of an ectopic testicle located cranial and lateral to the 9 internal ring between the external and internal oblique musculature.--George Holcomb, Jr Penile Denudation Injuries after Circumcision. J.R.
Sotolongo Jr,
S. Hoffman, and M.E. Gribetz. J Urol 133:102-103, (January), 1985. Three cases of iatrogenic phallic denudation were managed successfully nonoperatively. The concept of conservative, nonoperative management should be considered in denudation i n j u r i e s . George Holcomb, Jr Interlabial Masses in Little Girls: Review and Imaging Recommendation. A.R. Nussbaum and R.L. Lebowitz. Am J Roentgenol
141:65-71, (July), 1983. The authors review the clinical presentation and need for radiographic examinations of five entities that may present as interlabial masses. Ectopic ureterocele may prolapse through the urethra and present as a smooth round mass lying in the meatus. This causes a circumferential flow of urine if the mass does not completely obstruct the meatus. Because of the high incidence of reflux, obstruction, and duplication, the authors recommend a combination of urographic and sonographic studies. Radionucleide studies can be helpful in determining function of duplicated segments of the kidney. Urethral prolapse, occurring predominately in black females, presents as an edematous friable mass which encircles the urethral meatus. When the diagnosis can be made clinically, no radiographic studies are necessary since the entity is not associated with other anomalies. The paraurethral cyst presents as a mass that displaces the urethral meatus resulting in an eccentric urine stream. Aspiration of the mass will yield a small amount of milky fluid, and urographic, or endoscopic studies, are not necessary. Hydro (metro) colpos may present as a bulging mass at the vaginal introitus when the vaginal obstruction results from an intact hymen or very low transverse vaginal septum. This type is not usually associated with other congenital anomalies but may cause urinary and bowel compression symptoms. Sonography may aid in the pre-operative assessment of the genital tract. Hydro (metro) colpos secondary to vaginal atresia or higher vaginal septum nearly always occurs in association with other genito-urinary anomalies, and a complete urographic, and endoscopic evaluation, is mandatory. Rhabdomyosarcoma of the vagina often presents as a grape-like cluster protruding from the vaginal orifice and is easily recognized clinically. Sonography, urography, and endoscopy, can be utilized in the initial staging with sonography often utilized for follow-up during treatment,--Randall W. Powell
Cystectomy: A Catastrophic Complication of Herniorrhaphy. J,F.
Redman, D.W. Jacks, and P.D. O'Donnell. J Urol 133:97-98, (January), 1985.
The Abdominal Neourethra in Children: Technique and Long-Term Results. S.A. Koff. J Urol 133:244-247, (February), 1985.
Injury to the bladder is a known complication of inguinal herniorrhaphy. Infants less than 6 months old may be more at risk because the medial aspect of indirect inguinal hernia sacs are associated
The abdominal neourethra is a continent bladder tube that is applicable to selected children with anatomical urinary incontinence or urinary retention and a nonnavigable urethra. A 5 to 8 year
16.8) yielded 6 patients with common hepatic ducts measuring greater than 4 mm. Thirty eight patients had gallstones, 51 had no gallbladder abnormalities, 5 had nonshadowing opacities, and one had biliary sludge only. Of the 6 patients with enlargement of the common hepatic duct only 2 were found to have common duct stones. The authors feel that common hepatic duct measurements do not serve as a sensitive or specific indicator of biliary disease in patients with sickle cell disease.--Randa11 W. Powell
INTERNATIONAL ABSTRACTS
closely with the wall of bladder ("bladder ears"). The authors report 2 cases of almost complete excision of the bladder during routine herniorrhaphy. In 1 patient bilateral ureteroileocecoplasty provided a course of management free of complication.--George Holcomb, Jr GENITOURINARY T R A C T An Unusual Case of Testicular Ectopia. J.F. Redman and J.P.
Brizzolara. J Urol 133:104-105, (January), 1985. Small Tube Peritoneovanous Shunting For The Management Of Neonatal Intractable Ascitas. V.F. Garcia, C.G. Howell, D. Barbott,
et al. Surg Gynecol Obstet 160:273-274, (March), 1985. An operative procedure is described which is designed to relieve progressive ascites in a neonate with Budd-Chiari syndrome. A slotted ventricular catheter (Holter-Hausner) is placed in the suprahepatic space under general anesthesia through an incision in the right upper quadrant. A subcutaneous tunnel is created in the anterior chest wall for a catheter with a very low subdural range type of cruciform slit valve. This valve is placed in a pouch beneath the pectoralis major muscle. An atrial catheter is attached to the slit valve, placed in a deep subcutaneous tunnel, and inserted into the right atrium through a separate incision in the internal jugular vein. Roentgenographic confirmation of the position of the catheter tip is essential. The shunt valve is pumped daily by direct compression to check patency and facilitate fluid flow. Strict attention is paid to restricting fluids and managing ventilation because of the anticipated intravascular overload. This procedure was tolerated well in a 2.2 kg female infant. There was prompt resolution of respiratory failure and ascites, and she was discharged from the hospital within two weeks of the operation. Within three months liver function had returned to normal, and patent hepatic veins were visualized on real time ultrasound studies. Four years later, the patient continues to thrive without evidence of recurrent ascites or liver dysfunction.--George Holcomb, Jr Inguinal Hernias After Ventriculoperitoneal Shunt Procedures in Pediatric Patients. F. Moazam, J.D. Glenn, B.J. Kaplan, el al. Surg
Gynecol Obstet 159:570-572, (December), 1984. The authors report the development of previously unrecognized inguinal hernias in 32 of 134 (23.3%) infants and children after placement of a VP shunt. The incidence was higher for shunts performed for intraventricular hemorrhage (47%) than for meningocele (19.5%). No patient presented with an incarcerated or strangulated hernia. There were no postoperative complications related to the repair or to the VP shunt itself. No VP shunt required revision in the postoperative period.--George Holcomb, Jr Scrotal Migration of Ventriculoperitoneal Shunts. M,J. Crofford
and D. Balsam. Am J Roentgenol 141:369-371, (August), 1983. The authors report 4 patients who developed inguinal hernias and/or hydroceles following V-P shunts with radiographs showing migration of the shunt tip into the hernia or hydrocele sac. One patient with coils of shunt tubing in the scrotum discovered on radiography experienced spontaneous migration of the tubing back into the peritoneal cavity.--Randall W. Powell
The authors report a case of testicular ectopia that represents the first instance of an ectopic testicle located cranial and lateral to the 9 internal ring between the external and internal oblique musculature.--George Holcomb, Jr Penile Denudation Injuries after Circumcision. J.R.
Sotolongo Jr,
S. Hoffman, and M.E. Gribetz. J Urol 133:102-103, (January), 1985. Three cases of iatrogenic phallic denudation were managed successfully nonoperatively. The concept of conservative, nonoperative management should be considered in denudation i n j u r i e s . George Holcomb, Jr Interlabial Masses in Little Girls: Review and Imaging Recommendation. A.R. Nussbaum and R.L. Lebowitz. Am J Roentgenol
141:65-71, (July), 1983. The authors review the clinical presentation and need for radiographic examinations of five entities that may present as interlabial masses. Ectopic ureterocele may prolapse through the urethra and present as a smooth round mass lying in the meatus. This causes a circumferential flow of urine if the mass does not completely obstruct the meatus. Because of the high incidence of reflux, obstruction, and duplication, the authors recommend a combination of urographic and sonographic studies. Radionucleide studies can be helpful in determining function of duplicated segments of the kidney. Urethral prolapse, occurring predominately in black females, presents as an edematous friable mass which encircles the urethral meatus. When the diagnosis can be made clinically, no radiographic studies are necessary since the entity is not associated with other anomalies. The paraurethral cyst presents as a mass that displaces the urethral meatus resulting in an eccentric urine stream. Aspiration of the mass will yield a small amount of milky fluid, and urographic, or endoscopic studies, are not necessary. Hydro (metro) colpos may present as a bulging mass at the vaginal introitus when the vaginal obstruction results from an intact hymen or very low transverse vaginal septum. This type is not usually associated with other congenital anomalies but may cause urinary and bowel compression symptoms. Sonography may aid in the pre-operative assessment of the genital tract. Hydro (metro) colpos secondary to vaginal atresia or higher vaginal septum nearly always occurs in association with other genito-urinary anomalies, and a complete urographic, and endoscopic evaluation, is mandatory. Rhabdomyosarcoma of the vagina often presents as a grape-like cluster protruding from the vaginal orifice and is easily recognized clinically. Sonography, urography, and endoscopy, can be utilized in the initial staging with sonography often utilized for follow-up during treatment,--Randall W. Powell
Cystectomy: A Catastrophic Complication of Herniorrhaphy. J,F.
Redman, D.W. Jacks, and P.D. O'Donnell. J Urol 133:97-98, (January), 1985.
The Abdominal Neourethra in Children: Technique and Long-Term Results. S.A. Koff. J Urol 133:244-247, (February), 1985.
Injury to the bladder is a known complication of inguinal herniorrhaphy. Infants less than 6 months old may be more at risk because the medial aspect of indirect inguinal hernia sacs are associated
The abdominal neourethra is a continent bladder tube that is applicable to selected children with anatomical urinary incontinence or urinary retention and a nonnavigable urethra. A 5 to 8 year