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Excision of oesophageal varices
ABSTRACTS
The authors suggest similar staging in order to permit development of collateral circulation whenever length of the loop appears short or vascularity uncertain at op eration-Jens G. Rosenkranfz.
85
patients were less than two years of age at the time of operation; the youngest patient was three days old. A transthoracic approach was most commonly used, but the transabdominal approach was found satisfactory in cases EXCISION OF OESOPHAGEALVARICES. J. B. without esophagitis or stricture. The Allison self. Thorax 24:435, (July) 1969. procedure was most commonly employed. In some cases with severe esophagitis and Treatment of bleeding oesophageal varices stricture, a Belsey stomach plication below by total excision of the stomach and oesophthe diaphragm was performed. The purpose agus up to the aortic arch with jejunal interof all of the operations was to eliminate position between oesophagus and gastric esophageal reflux by placement of the esophantrum is suggested when a venous shunt is agogastric junction well into the peritoneal impossible or contraindicated. The technique cavity. Adjunctive procedures were carried is described and six cases are presented.out in one third of the cases. This was USUWilliam K. Sieber. ally retrograde dilatation of the stricture. Of 93 patients who were followed longer RESULTS OF SURGICAL TREATMENT OF than six months, 46 per cent had a good ESOPHAGEALHIATAL HERNIA IN INFANCY result. Twenty-seven per cent had a fair reAND CHILDHOOD. John L. Cahitf, Eoin sult. Failures occurred most frequently in Aberdeen and David .I. Watersron. Surgery patients with stricture. A satisfactory out66:597-602, (September) 1969. come was eventually obtained in most of the seventeen patients who required reoperation. Congenital esophageal hiatal hernia is A prospective study of simple gastropexy diagnosed much less frequently in the United was undertaken in eleven patients. This conStates than in England and Western Europe. sisted of fixation of the lesser curvature of It may be present in the first week of life. the stomach to the anterior abdominal wall. From 1954-1967, 755 cases of hiatal The operation presumes that the most imhernia were diagnosed in the Hospital for portant factor in the prevention of gastroSick Children, Great Ormond Street. Of esophageal reflux is to have the lower this group, 102 patients were treated suresophageal sphincter well below the diagically. phragm, in the peritoneal cavity, where it Vomiting, anemia and underdevelopment is subjected to positive rather than negative were the principal clinical features. Nearly pressure. Nine of these 11 patients were half had a stricture present at the time of symptom free after the operation. One pasurgery. Esophagitis was found in 94 per tient who presented initially with a stricture cent of patients with stricture, and 42 per was a failure, and another patient had reflux cent of patients without stricture. by barium swallow, but was asymptomatic. All patients had a sliding type of hiatal The presence of severe esophagitis or striohernia. Neirher paraesophageal hernia nor ture is considered to be a contraindication congenital short esophagus were found. for gastropexy alone. The operation is being Mental retardation, congenital hyperstudied further.-Dartiel T. Cloud. trophic pyloric stenosis and contortions of the neck were the most common associated anomalies. The latter apparently occurs in an ESOPHAGEALACHALAS~AIN CHILDHOOD.1. effort to relieve the baby’s discomfort from Martinez Mora, J. Boix-Ochoa, J. M. reflex esophagitis. Casasa and A. Moragas. Rev. Esp. Pedint. Patients without stricture were observed 24~27-40, 1968. a minimum of three months before surgery. They were kept in the upright position and This is a rare condition which manifests given thick feedings. The indications for opusually around the third to fourth year of eration were persistence of symptoms after age. Its clinical picture includes dysphagia, a period of nonoperative therapy, evidence vomiting. failure to thrive and, at times, of esophagitis with bleeding or ulceration, pneumonitis. The best correction seems to right-sided intrathoracic stomach with bIeedbe the classical Heller procedure with reing and stricture. Nearly one half of the section of a square muscular fragment and
The authors suggest similar staging in order to permit development of collateral circulation whenever length of the loop appears short or vascularity uncertain at op eration-Jens G. Rosenkranfz.
85
patients were less than two years of age at the time of operation; the youngest patient was three days old. A transthoracic approach was most commonly used, but the transabdominal approach was found satisfactory in cases EXCISION OF OESOPHAGEALVARICES. J. B. without esophagitis or stricture. The Allison self. Thorax 24:435, (July) 1969. procedure was most commonly employed. In some cases with severe esophagitis and Treatment of bleeding oesophageal varices stricture, a Belsey stomach plication below by total excision of the stomach and oesophthe diaphragm was performed. The purpose agus up to the aortic arch with jejunal interof all of the operations was to eliminate position between oesophagus and gastric esophageal reflux by placement of the esophantrum is suggested when a venous shunt is agogastric junction well into the peritoneal impossible or contraindicated. The technique cavity. Adjunctive procedures were carried is described and six cases are presented.out in one third of the cases. This was USUWilliam K. Sieber. ally retrograde dilatation of the stricture. Of 93 patients who were followed longer RESULTS OF SURGICAL TREATMENT OF than six months, 46 per cent had a good ESOPHAGEALHIATAL HERNIA IN INFANCY result. Twenty-seven per cent had a fair reAND CHILDHOOD. John L. Cahitf, Eoin sult. Failures occurred most frequently in Aberdeen and David .I. Watersron. Surgery patients with stricture. A satisfactory out66:597-602, (September) 1969. come was eventually obtained in most of the seventeen patients who required reoperation. Congenital esophageal hiatal hernia is A prospective study of simple gastropexy diagnosed much less frequently in the United was undertaken in eleven patients. This conStates than in England and Western Europe. sisted of fixation of the lesser curvature of It may be present in the first week of life. the stomach to the anterior abdominal wall. From 1954-1967, 755 cases of hiatal The operation presumes that the most imhernia were diagnosed in the Hospital for portant factor in the prevention of gastroSick Children, Great Ormond Street. Of esophageal reflux is to have the lower this group, 102 patients were treated suresophageal sphincter well below the diagically. phragm, in the peritoneal cavity, where it Vomiting, anemia and underdevelopment is subjected to positive rather than negative were the principal clinical features. Nearly pressure. Nine of these 11 patients were half had a stricture present at the time of symptom free after the operation. One pasurgery. Esophagitis was found in 94 per tient who presented initially with a stricture cent of patients with stricture, and 42 per was a failure, and another patient had reflux cent of patients without stricture. by barium swallow, but was asymptomatic. All patients had a sliding type of hiatal The presence of severe esophagitis or striohernia. Neirher paraesophageal hernia nor ture is considered to be a contraindication congenital short esophagus were found. for gastropexy alone. The operation is being Mental retardation, congenital hyperstudied further.-Dartiel T. Cloud. trophic pyloric stenosis and contortions of the neck were the most common associated anomalies. The latter apparently occurs in an ESOPHAGEALACHALAS~AIN CHILDHOOD.1. effort to relieve the baby’s discomfort from Martinez Mora, J. Boix-Ochoa, J. M. reflex esophagitis. Casasa and A. Moragas. Rev. Esp. Pedint. Patients without stricture were observed 24~27-40, 1968. a minimum of three months before surgery. They were kept in the upright position and This is a rare condition which manifests given thick feedings. The indications for opusually around the third to fourth year of eration were persistence of symptoms after age. Its clinical picture includes dysphagia, a period of nonoperative therapy, evidence vomiting. failure to thrive and, at times, of esophagitis with bleeding or ulceration, pneumonitis. The best correction seems to right-sided intrathoracic stomach with bIeedbe the classical Heller procedure with reing and stricture. Nearly one half of the section of a square muscular fragment and