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Radiologic diagnosis of gastric perforation in neonates
ABSTRACTS
786
Results the
of
Heller’s
Oesophagus.
Repair.
J. B/o&,
Br. J. Surg.
Operation The
A. N. Vorboch,
63:949-953,
for
Achalasia
Importance
of
of
Natal
and J. Leigh Co//is.
1976.
The authors retrospectively analyze a series of 104 adult patients who underwent a Heller’s operation for achalasia of the esophagus in the period 1948 to April, 1973. Only 4.6”,, had an associated hiatus hernia. The procedure was performed transabdominally, and the esophageal incision was extended “at least” one centimeter onto the stomach. Fifty-three patients early in the series had no hiatal repair, 44 patients had a “cautious” anterior hiatal repair, and I I patients. all in recent years. had a formal hiatal repair of the type previously described by Leigh Collis. There was no mortality. The symptomatic results were assessed at 4 yr postoperatively. Of the 53 patients who did not have a hiatal repair. 36 (68”,,) had no symptoms, I3 (24”,,) had residual dysphagia, and 9 (I 7”,,) had symptoms of gastroesophageal reflux. Of the 44 patients having a cautious hiatai repair, 24 (54.2”,,) were symptom free, I4 (32”,,) had dysphagia, and I I (25”,,) symptoms of reflux. Although patients who had a limited hiatal repair appear to do worse than those with no repair at all, the authors point out that on the whole this group had less severe postoperative symptoms. Finally. of the patients who had a formal hiatal repair, all eleven were symptom free. The authors qualify this apparent overwhelming superiority by noting that a few patients in the earlier groups who were symptom free at 4 yr subsequently developed dysphagia or gastroesophageal reflux. On the basis of the figures presented, the authors strongly advocate that a Heller’s cardiomyotomy should be accompanied by a formal antireflux procedure if good symptomatic results are to be achieved.-- A. M. K. Rickwood
Radiologic Neonates.
K. Kimuro,
Diagnosis S. Hoshimoto,
case. The importance of left-lateral, upright film for radiologic diagnosis of gastric perforation in neonates was also emphasized.-H. Suzuki
of
Gastric C. Tsugowo,
Perforation
in
K. Horikoshi,
Induction gastrin.
of
Pyloric
J. A. Dodge
Hypertrophy
by
Penta-
and A. A. Korim. Gut 17:280-
284, 1976 Two depot forms of pentagastrin. one suspended in a mixture of beeswax in arachis oil and the other in a base of phenol and gelatine. were prepared. Four groups of dogs were studied. In Group I. I4 pregnant bitches were given injections of pentagastrin for widely varying periods, In Group II. 8 bitches were similarly treated and further injections were given to their offspring. Groups III and IV were controls.The results for Group I were: I6 of 56 (29.1:;) pups developed pyloric hypertrophy. Nine pups (16.3”/“) had peptic ulcers. Four pups had both lesions. For Group II: 9 of 35 (25.7’,,) pups had pyloric hypertrophy and 5 (14.3’,,) had ulcers. The control groups showed no gastric or duodenal abnormalities. It is suggested that transplacental pentagastrin stimulation of the canine fetus is a valid animal model for infantile pyloric stenosis.J. J. Corker! Aspergillus-induced a
leukemic
J. Truman,
Small
Newborn. and S.
Bowel J
Obstruction
P.
Roof,
in
Donohoe,
Robboy. J. Zero Science
An infant being treated for congenital acute myelocytic leukemia with daunorubicin and cytosine arabinoside developed staphylococcic septicemia and later small bowel obstruction and an abdominal mass. This proved to be due to vascular infarction secondary to Aspergillus hyphae which were growing within mesenteric vessels. The authors call attention to this danger in patients with such neoplasms treated by chemotherapeutic and immunosuppressive agents, and by wide spectrum antibiotics, pointing out that treatment of disseminated aspergillosis is usually not successful. -William K. Sieber
et al. J. Jop. Sot. Pediotr. Surg. 13:l 17-
124 (February),
1977.
Retrospective studies on plain films of I I neonates with gastric perforation were carried out. The authors found that the abnormal shape and size of the gastric air bubble were characteristic to gastric perforation. Gastric air bubble was seen in IO of I I cases on either upright or supine plain films. Gastric air bubble was shrunken and irregular in eight, normalsize but irregular in two, and dilated in one
Barium with
Enema
Abdominal
A. C. Selke.
Surg.,
as a Diagnostic Pain.
Aid
J. Z. Jono,
Gynecol.
d Obrtet.
in
Children
R. P. B&I,
and
144:351-355
(March), 1977. Diagnostic barium enema is not a substitution for a well executed physical examination and its use should be reserved only for obscure situations. An abnormal roentgenogram provides valuable information since the fear of missing acute appendicitis in these children is
786
Results the
of
Heller’s
Oesophagus.
Repair.
J. B/o&,
Br. J. Surg.
Operation The
A. N. Vorboch,
63:949-953,
for
Achalasia
Importance
of
of
Natal
and J. Leigh Co//is.
1976.
The authors retrospectively analyze a series of 104 adult patients who underwent a Heller’s operation for achalasia of the esophagus in the period 1948 to April, 1973. Only 4.6”,, had an associated hiatus hernia. The procedure was performed transabdominally, and the esophageal incision was extended “at least” one centimeter onto the stomach. Fifty-three patients early in the series had no hiatal repair, 44 patients had a “cautious” anterior hiatal repair, and I I patients. all in recent years. had a formal hiatal repair of the type previously described by Leigh Collis. There was no mortality. The symptomatic results were assessed at 4 yr postoperatively. Of the 53 patients who did not have a hiatal repair. 36 (68”,,) had no symptoms, I3 (24”,,) had residual dysphagia, and 9 (I 7”,,) had symptoms of gastroesophageal reflux. Of the 44 patients having a cautious hiatai repair, 24 (54.2”,,) were symptom free, I4 (32”,,) had dysphagia, and I I (25”,,) symptoms of reflux. Although patients who had a limited hiatal repair appear to do worse than those with no repair at all, the authors point out that on the whole this group had less severe postoperative symptoms. Finally. of the patients who had a formal hiatal repair, all eleven were symptom free. The authors qualify this apparent overwhelming superiority by noting that a few patients in the earlier groups who were symptom free at 4 yr subsequently developed dysphagia or gastroesophageal reflux. On the basis of the figures presented, the authors strongly advocate that a Heller’s cardiomyotomy should be accompanied by a formal antireflux procedure if good symptomatic results are to be achieved.-- A. M. K. Rickwood
Radiologic Neonates.
K. Kimuro,
Diagnosis S. Hoshimoto,
case. The importance of left-lateral, upright film for radiologic diagnosis of gastric perforation in neonates was also emphasized.-H. Suzuki
of
Gastric C. Tsugowo,
Perforation
in
K. Horikoshi,
Induction gastrin.
of
Pyloric
J. A. Dodge
Hypertrophy
by
Penta-
and A. A. Korim. Gut 17:280-
284, 1976 Two depot forms of pentagastrin. one suspended in a mixture of beeswax in arachis oil and the other in a base of phenol and gelatine. were prepared. Four groups of dogs were studied. In Group I. I4 pregnant bitches were given injections of pentagastrin for widely varying periods, In Group II. 8 bitches were similarly treated and further injections were given to their offspring. Groups III and IV were controls.The results for Group I were: I6 of 56 (29.1:;) pups developed pyloric hypertrophy. Nine pups (16.3”/“) had peptic ulcers. Four pups had both lesions. For Group II: 9 of 35 (25.7’,,) pups had pyloric hypertrophy and 5 (14.3’,,) had ulcers. The control groups showed no gastric or duodenal abnormalities. It is suggested that transplacental pentagastrin stimulation of the canine fetus is a valid animal model for infantile pyloric stenosis.J. J. Corker! Aspergillus-induced a
leukemic
J. Truman,
Small
Newborn. and S.
Bowel J
Obstruction
P.
Roof,
in
Donohoe,
Robboy. J. Zero Science
An infant being treated for congenital acute myelocytic leukemia with daunorubicin and cytosine arabinoside developed staphylococcic septicemia and later small bowel obstruction and an abdominal mass. This proved to be due to vascular infarction secondary to Aspergillus hyphae which were growing within mesenteric vessels. The authors call attention to this danger in patients with such neoplasms treated by chemotherapeutic and immunosuppressive agents, and by wide spectrum antibiotics, pointing out that treatment of disseminated aspergillosis is usually not successful. -William K. Sieber
et al. J. Jop. Sot. Pediotr. Surg. 13:l 17-
124 (February),
1977.
Retrospective studies on plain films of I I neonates with gastric perforation were carried out. The authors found that the abnormal shape and size of the gastric air bubble were characteristic to gastric perforation. Gastric air bubble was seen in IO of I I cases on either upright or supine plain films. Gastric air bubble was shrunken and irregular in eight, normalsize but irregular in two, and dilated in one
Barium with
Enema
Abdominal
A. C. Selke.
Surg.,
as a Diagnostic Pain.
Aid
J. Z. Jono,
Gynecol.
d Obrtet.
in
Children
R. P. B&I,
and
144:351-355
(March), 1977. Diagnostic barium enema is not a substitution for a well executed physical examination and its use should be reserved only for obscure situations. An abnormal roentgenogram provides valuable information since the fear of missing acute appendicitis in these children is