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A rare association of malformations: Gastroschisis and reduplicated gall bladder: Report of two cases
550
ABSTRACTS
and abdominal distension and fluid accumulation took place. the 14tb day, laparotomy disclosed biliary peritonitis and ~ 7-mm tear of the anterior wall of the common hepatic duct 3 mm below its bifurcation. Drainage with a Kerr tube was not possible and transduodenal catheter drainage of the common bile duet was carried out. The recovery was uneventful and a cholangiogram 8 mo postoperatively was normal,--C. A. Montagnani Hepatic Function Following Portoenterostomy for Extrahepatio Bifiary Atresia. J. M, Sondheimer, B. Shandling, J. L.
Weber, E. Cutz, and D. G. Gall, Can Med Assoc J 118:255-258 (February), 1978. Liver structure and function in I0 children with extrahepatic biliary atresia were studied after portoenteric anastomosis (Kasai operation), Five patients were considered "improved" with bile flows adequate to reduce the serum bilirubin concentration, Three of these became anicteric. The remaining five babies continued "unimproved" with continuing high serum bilirubin levels. Repeated liver biopsies, and liver function studies continued postoperatively to be abnormal, The authors conclude that neither structure nor function of the liver become normal following p o r t o e n t e r o s t o m y even in clinically-well, anicteric patients,--Colin C. Ferguson A Rare Association of Malformations: Gastroschisis and Reduplicated Gall Bladder: Report of Two Cases, A, Ciar-
dini and G, Bini. Rass Ital Chir Pediatr (October-December), 1976,
18, 86-93
Two newborn babies, a boy and a girl, weighing 2.1 kg and 2,58 kg respectively, presented with gastroschisis and bifid or completely reduplicated gallbladder, Primary reduction of the herniated viscera and closure of the abdominal wall was followed by death in the baby girl with reduplicated gallbladder and by uneventful recovery in the baby boy with bifid gallbladder. Embryology and pathology are discussed, C. A, Montagnani
admitted to hospital with anaphylactoid purpura, abdominal pain, and hematuria. Sixteen days after treatment with steroids, he became hypertensive and had a grand mal seizure. He became comatose and anuric and required hemodialysis. Fifty-five days after admission he had recovered, but an IN.P, showed extravasation of urine at the right pelvi-ureteric junction with bilateral hydronephrosis. ExpLoration revealed disruption of the upper end of the right ureter in two places. Repair by a pyeloplasty was carried out. A renal scan 11 mo later showed no evidence of a leak. Disruption of the pelvi-ureteric junction is rare and usually associated with major trauma. The authors stress the importance of I.V.P. in all cases of hematuria. W. G, Scobie Micturition Orodynamic Flow Studies in Children, C. F.
Fir/it, P. Smey, and L. R. King. J Urol 119:250253 (February), 1978. Voiding abnormalities are encountered frequently in pediatric patients. Symptoms of daytime incontinence, frequency and nocturnal enuresis in any combination may indicate underlying neurophysi01ogic detrusor imbalance. Thirty-four children, with hard-core voiding abnormalities, were evaluated with urodynamic techniques. Several categories of abnormal voiding patterns were identified. All patients received specific pharmacotherapy based on presenting signs and symptoms, and voiding pattern abnormality. Of the 24 patients who have been treated in this manner and were evaluated, 83.5% have had complete remission of symptoms while on therapy, the remainder being improved, but still having occasional symptoms.--George Holcomb
MUSCULOSKELETAL SYSTEM Revascularized Periosteal G r a f t s ~ A New Method to Produce Functional New Bone Without Bone Grafting, J. M .
Finley, R. D. Acland, and M, B, Wood. Plast Reconstr Surg 61 : 1-6 (January), 1978.
Ten children, with renal abscesses treated during the last 25 yr, are reviewed, The diagnosis was not readily apparent before hospitalization, Excretory urography with nephrotomography proved to be the most valuable diagnostic study. Angiography was useful in differentiating the abscess from other intrarenal processes. Staphylococcus aureus was the most common infecting organism. Urinary tract anomalies were noted most frquently with gram-negative infections. Treatment consisted of drainage of the abscess in eight children. Nephrectomy was required in two girls, each of whom had multiple extensive gram-negative carbuncles,--George Holcomb
Replacement of bone in the form of bone grafting is unpredictable and reabsorption is quite frequent. The microvascular transfer of living bone is limited due to size and configuration of thegrafts. An alternative to bonegrafting, that is vascularized periosteal grafts, is postulated, In this study, free periosteal grafts transferred to the groin of dogs, were completely resorbed. However, vaseularized periosteal grafts showed new bone formation. Vascularized periosteal grafts, when transferred to tibial defects, showed a complete bridging of the gap by 6 wk and were associated with an ability of the animal to stand normally. In contrast, control animals having unrepaired tibial defects, showed no bone regeneration either on x-ray or at the time of sacrifice. This initial study points to a significant contribution in the use of microsurgical techniques associated with bone formation,--A. B. Sokol
Avulsion of the Pelvi, Oreteric Junction After Minor Trauma Complicated by Anaphylactoid Purpura, W, D, A. Ford and
Auger Injuries in Children. R: M. Letts and W. Gammon. Can Med Assoc J 118:519-522 (March), 1978.
GENITOURINARY TRACT Renal Abscess in Children, A. R. Rote, S. B, Bauer, and A. B. Retik. J Urol 119:254-258 (February), 1978.
i. S, Kirkland. J R Coil Surg Edinb 23:44-46, (January), 1978. A 12-yr-old boy complained of right loin pain after a difficult dive into a swimming pool, Four days later, he was
A 6-yr review of auger farm injuries occurring in Manitoba revealed that 23 children sustained major trauma which resulted in amputation of 17 limbs. In this wellillustrated paper, the authors not only show examples of
ABSTRACTS
and abdominal distension and fluid accumulation took place. the 14tb day, laparotomy disclosed biliary peritonitis and ~ 7-mm tear of the anterior wall of the common hepatic duct 3 mm below its bifurcation. Drainage with a Kerr tube was not possible and transduodenal catheter drainage of the common bile duet was carried out. The recovery was uneventful and a cholangiogram 8 mo postoperatively was normal,--C. A. Montagnani Hepatic Function Following Portoenterostomy for Extrahepatio Bifiary Atresia. J. M, Sondheimer, B. Shandling, J. L.
Weber, E. Cutz, and D. G. Gall, Can Med Assoc J 118:255-258 (February), 1978. Liver structure and function in I0 children with extrahepatic biliary atresia were studied after portoenteric anastomosis (Kasai operation), Five patients were considered "improved" with bile flows adequate to reduce the serum bilirubin concentration, Three of these became anicteric. The remaining five babies continued "unimproved" with continuing high serum bilirubin levels. Repeated liver biopsies, and liver function studies continued postoperatively to be abnormal, The authors conclude that neither structure nor function of the liver become normal following p o r t o e n t e r o s t o m y even in clinically-well, anicteric patients,--Colin C. Ferguson A Rare Association of Malformations: Gastroschisis and Reduplicated Gall Bladder: Report of Two Cases, A, Ciar-
dini and G, Bini. Rass Ital Chir Pediatr (October-December), 1976,
18, 86-93
Two newborn babies, a boy and a girl, weighing 2.1 kg and 2,58 kg respectively, presented with gastroschisis and bifid or completely reduplicated gallbladder, Primary reduction of the herniated viscera and closure of the abdominal wall was followed by death in the baby girl with reduplicated gallbladder and by uneventful recovery in the baby boy with bifid gallbladder. Embryology and pathology are discussed, C. A, Montagnani
admitted to hospital with anaphylactoid purpura, abdominal pain, and hematuria. Sixteen days after treatment with steroids, he became hypertensive and had a grand mal seizure. He became comatose and anuric and required hemodialysis. Fifty-five days after admission he had recovered, but an IN.P, showed extravasation of urine at the right pelvi-ureteric junction with bilateral hydronephrosis. ExpLoration revealed disruption of the upper end of the right ureter in two places. Repair by a pyeloplasty was carried out. A renal scan 11 mo later showed no evidence of a leak. Disruption of the pelvi-ureteric junction is rare and usually associated with major trauma. The authors stress the importance of I.V.P. in all cases of hematuria. W. G, Scobie Micturition Orodynamic Flow Studies in Children, C. F.
Fir/it, P. Smey, and L. R. King. J Urol 119:250253 (February), 1978. Voiding abnormalities are encountered frequently in pediatric patients. Symptoms of daytime incontinence, frequency and nocturnal enuresis in any combination may indicate underlying neurophysi01ogic detrusor imbalance. Thirty-four children, with hard-core voiding abnormalities, were evaluated with urodynamic techniques. Several categories of abnormal voiding patterns were identified. All patients received specific pharmacotherapy based on presenting signs and symptoms, and voiding pattern abnormality. Of the 24 patients who have been treated in this manner and were evaluated, 83.5% have had complete remission of symptoms while on therapy, the remainder being improved, but still having occasional symptoms.--George Holcomb
MUSCULOSKELETAL SYSTEM Revascularized Periosteal G r a f t s ~ A New Method to Produce Functional New Bone Without Bone Grafting, J. M .
Finley, R. D. Acland, and M, B, Wood. Plast Reconstr Surg 61 : 1-6 (January), 1978.
Ten children, with renal abscesses treated during the last 25 yr, are reviewed, The diagnosis was not readily apparent before hospitalization, Excretory urography with nephrotomography proved to be the most valuable diagnostic study. Angiography was useful in differentiating the abscess from other intrarenal processes. Staphylococcus aureus was the most common infecting organism. Urinary tract anomalies were noted most frquently with gram-negative infections. Treatment consisted of drainage of the abscess in eight children. Nephrectomy was required in two girls, each of whom had multiple extensive gram-negative carbuncles,--George Holcomb
Replacement of bone in the form of bone grafting is unpredictable and reabsorption is quite frequent. The microvascular transfer of living bone is limited due to size and configuration of thegrafts. An alternative to bonegrafting, that is vascularized periosteal grafts, is postulated, In this study, free periosteal grafts transferred to the groin of dogs, were completely resorbed. However, vaseularized periosteal grafts showed new bone formation. Vascularized periosteal grafts, when transferred to tibial defects, showed a complete bridging of the gap by 6 wk and were associated with an ability of the animal to stand normally. In contrast, control animals having unrepaired tibial defects, showed no bone regeneration either on x-ray or at the time of sacrifice. This initial study points to a significant contribution in the use of microsurgical techniques associated with bone formation,--A. B. Sokol
Avulsion of the Pelvi, Oreteric Junction After Minor Trauma Complicated by Anaphylactoid Purpura, W, D, A. Ford and
Auger Injuries in Children. R: M. Letts and W. Gammon. Can Med Assoc J 118:519-522 (March), 1978.
GENITOURINARY TRACT Renal Abscess in Children, A. R. Rote, S. B, Bauer, and A. B. Retik. J Urol 119:254-258 (February), 1978.
i. S, Kirkland. J R Coil Surg Edinb 23:44-46, (January), 1978. A 12-yr-old boy complained of right loin pain after a difficult dive into a swimming pool, Four days later, he was
A 6-yr review of auger farm injuries occurring in Manitoba revealed that 23 children sustained major trauma which resulted in amputation of 17 limbs. In this wellillustrated paper, the authors not only show examples of