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Abdominal calcifications in infants and children
INTERNATIONAL ABSTRACTS
transient bacteremia. Blood cultures were taken before, 5, 10, 15, and 20, minutes after the investigation. Transient bacteremia was demonstrated in 2 patients by growth of E. coil, Strept. fecalis and Bact. fragilis and in 2 other children blood cultures were at least contaminated. Sterile blood cultures were obtained in the remaining 5 children. No patient developed sepsis. The authors recommend perioperative antibiotic prophylaxis if rectal suction biopsy is necessary.-- Thomas A. Angerpointner Optical-acoustical Analogous Biofeedback Conditioning in the Treatment of Fecal Incontinence in Childhood. J.L. Koltai, K.
Ohama, S. Hofman-v.Kap-her, et al. Z Kinderchir 39:389-391, (December), 1984. The authors have performed stool training by means of opticalacoustical biofeedback conditioning in 9 patients for fecal incontinence due to anorectal malformations and Hirschsprung's disease. Training of sensitivity and voluntary contractions were performed and controlled electromanometrically, whereby pressure waves were transformed into analogous optical and acoustical signals that informed the patients of their proceedings. This method proved to be superior to other methods of conditioning since results could be shown quantitatively and faulty learning processes immediately.Thomas A. Angerpointner
ABDOMEN Abdominal Trauma in Children, D.G. Young. Aust N Z J Surg
54:439~141, (October), 1984. This paper reviews the records of 99 children admitted to a pediatric trauma centre over a 12 year period following significant abdominal trauma. The majority of patients were in the 8 to 10 year age group, and there were almost twice as many boys as girls. Motor vehicle accidents were responsible for the majority of admissions followed by falls from elevated objects. One third of the patients required laparotomy, and the most common organs damaged were spleen, liver, and the kidney. The author supports the use of peritoneal lavage as a diagnostic aid and points out that the advent of nuclear scanning, ultrasound, and computerised tomography, has made it possible to demonstrate many visceral injuries which stop bleeding spontaneously and heal with no sequelae without operative intervention. The only mortalities reported in this study were in patients with multiple injuries, particularly severe head injuries. The author supports the organisation of regional paediatric trauma centres as outlined by Hailer et al. The results of the study show that where children are cared for in major paediatric trauma centres, the outcome is improved.--Alasdair MacKellar Experience with the Management of Splenic Injuries. R.M. Filler.
Aust N Z J Surg 54:443-445, (October), 1984. This paper reviews the experience of treating 128 patients with splenic trauma over a 10 year period. All patients were aged 16 years or less and all except 1 had sustained non-penetrating abdominal injury. The diagnosis was established either at operation, by splenic scan, or by angiography. The decision to operate was made on clinical grounds. Patients who were stable on admission or after initial resuscitation were managed conservatively. In patients requiring surgery for massive bleeding or other injuries, the spleen was repaired where ever possible. Only 29% of patients required operation, and in three quarters of these patients the spleen was preserved. Delayed rupture of the spleen did not occur in the non-operative group, and septic complications have not been observed in any survivors. There were 14 deaths in the series, 11 from severe head injury and 3 from massive haemorrhage. The authors conclude that
863
non-operative treatment, reserving surgery for patients with massive bleeding, is safe and effective in children with splenic trauma. The first few hours after the injury are the most critical.--Alasdair MacKellar Abdominal Calcifications in Infants and Children. A,B. Pintbr, J,
Weisenbach, and F. Szemlbdy. Z Kinderchir 39:368-372, (December), 1984. The authors report on 63 patients up to 14 years of age with abdominal calcifications mostly found incidentally. Urological radiodensities were excluded. The calcifications were due to ovarian cysts and tumors, congenital retroperitoneal xanthofibroma, biliary calculi, retroperitoneal tumors such as neuroblastoma, Wilms' tumor, and teratomas, calcified lymph nodes, fecaliths and appendicoliths, calcified vascular changes such as, hematomas, hemangiomas, phleboliths, and aortic plaques, and due to meconium ileus and intestinal atresias. A migrating deposit in the omentum, a spontaneously amputated calcified ovary mimicking a vesical calculus, and a congenital retroperitoneal xanthofibroma caused the greatest difficulties in establishing a preoperative diagnosis. Amorphous, granular and irregular calcifications may be early hints of a malignancy.--Thomas A. Angerpointner Ventral Hernia in the Treatment of Omphalocele and Gastroschisis. K.R. Swartz, M. IV. Harrison, J.R. Campbell, el al. Ann Surg
201:347-350, (March), 1985. Twenty-three patients with omphalocele or gastroschisis and subsequently having secondary repair of ventral hernias are reviewed. The ventral defects resulted from elective skin flap coverage in 15 patients, prosthetic silo failure in 5, and non-operative management with eschar-inducing agents in 3. Ventral hernia repair was undertaken from 2 rues to 15 yrs of age with most patients between 6 mos and 2 yrs. Faseial closure was obtained in 20 of the 23 patients in one to 5 operations. Fifteen (65%) had fascial closure as a single procedure. In 8 patients, prosthetic material was used to close the defect. Five of these have subsequently had the prosthetic material removed and the fascia closed. Complications were minimal and there was no mortality. Ventral hernia with subsequent delayed closure is a useful technique when primary repair is not feasible or contraindicated.--Richard J. Andrassy Sonography of Thickened Gallbladder Wall: Causes in Children.
H.B. Patriquin, M. DiPietro, F.E. Barber, et al. Am J Roentgenol. 141:57-60, (July), 1983. A retrospective review of abdominal sonograms in 793 patients (age 1 d-16 yr) yielded 453 studies in which the gallbladder was well visualized. Significant abnormal findings were seen in 65 patients. Twenty patients had thickened gallbladder walls (>3 mm). Clinical factors involved in this group included hypoalbuminemia (13), ascites (5), recent meal with wall contraction (1), and systemic venous hypertension due to a blocked Fontan shunt (1). In the 45 patients with normal wall thickness, abnormalities found included gallstones (24), sludge (13), and ascites (8). This review tends to refute a previous report that a thickened gallbladder wall in a child is virtually diagnostic of active gallbladder disease.--Randall IV. Powell Sonographic Diameter of the Common Hepatic Duct in Sickle Cell Anemia. J.J. Cunningham. Am J RoentgenoI 141:321-324, (Au-
gust), 1983. This retrospective review of cholecystosonography in 95 patients with sickle cell disease (48 males, 47 females, 4-36 yr with mean of
transient bacteremia. Blood cultures were taken before, 5, 10, 15, and 20, minutes after the investigation. Transient bacteremia was demonstrated in 2 patients by growth of E. coil, Strept. fecalis and Bact. fragilis and in 2 other children blood cultures were at least contaminated. Sterile blood cultures were obtained in the remaining 5 children. No patient developed sepsis. The authors recommend perioperative antibiotic prophylaxis if rectal suction biopsy is necessary.-- Thomas A. Angerpointner Optical-acoustical Analogous Biofeedback Conditioning in the Treatment of Fecal Incontinence in Childhood. J.L. Koltai, K.
Ohama, S. Hofman-v.Kap-her, et al. Z Kinderchir 39:389-391, (December), 1984. The authors have performed stool training by means of opticalacoustical biofeedback conditioning in 9 patients for fecal incontinence due to anorectal malformations and Hirschsprung's disease. Training of sensitivity and voluntary contractions were performed and controlled electromanometrically, whereby pressure waves were transformed into analogous optical and acoustical signals that informed the patients of their proceedings. This method proved to be superior to other methods of conditioning since results could be shown quantitatively and faulty learning processes immediately.Thomas A. Angerpointner
ABDOMEN Abdominal Trauma in Children, D.G. Young. Aust N Z J Surg
54:439~141, (October), 1984. This paper reviews the records of 99 children admitted to a pediatric trauma centre over a 12 year period following significant abdominal trauma. The majority of patients were in the 8 to 10 year age group, and there were almost twice as many boys as girls. Motor vehicle accidents were responsible for the majority of admissions followed by falls from elevated objects. One third of the patients required laparotomy, and the most common organs damaged were spleen, liver, and the kidney. The author supports the use of peritoneal lavage as a diagnostic aid and points out that the advent of nuclear scanning, ultrasound, and computerised tomography, has made it possible to demonstrate many visceral injuries which stop bleeding spontaneously and heal with no sequelae without operative intervention. The only mortalities reported in this study were in patients with multiple injuries, particularly severe head injuries. The author supports the organisation of regional paediatric trauma centres as outlined by Hailer et al. The results of the study show that where children are cared for in major paediatric trauma centres, the outcome is improved.--Alasdair MacKellar Experience with the Management of Splenic Injuries. R.M. Filler.
Aust N Z J Surg 54:443-445, (October), 1984. This paper reviews the experience of treating 128 patients with splenic trauma over a 10 year period. All patients were aged 16 years or less and all except 1 had sustained non-penetrating abdominal injury. The diagnosis was established either at operation, by splenic scan, or by angiography. The decision to operate was made on clinical grounds. Patients who were stable on admission or after initial resuscitation were managed conservatively. In patients requiring surgery for massive bleeding or other injuries, the spleen was repaired where ever possible. Only 29% of patients required operation, and in three quarters of these patients the spleen was preserved. Delayed rupture of the spleen did not occur in the non-operative group, and septic complications have not been observed in any survivors. There were 14 deaths in the series, 11 from severe head injury and 3 from massive haemorrhage. The authors conclude that
863
non-operative treatment, reserving surgery for patients with massive bleeding, is safe and effective in children with splenic trauma. The first few hours after the injury are the most critical.--Alasdair MacKellar Abdominal Calcifications in Infants and Children. A,B. Pintbr, J,
Weisenbach, and F. Szemlbdy. Z Kinderchir 39:368-372, (December), 1984. The authors report on 63 patients up to 14 years of age with abdominal calcifications mostly found incidentally. Urological radiodensities were excluded. The calcifications were due to ovarian cysts and tumors, congenital retroperitoneal xanthofibroma, biliary calculi, retroperitoneal tumors such as neuroblastoma, Wilms' tumor, and teratomas, calcified lymph nodes, fecaliths and appendicoliths, calcified vascular changes such as, hematomas, hemangiomas, phleboliths, and aortic plaques, and due to meconium ileus and intestinal atresias. A migrating deposit in the omentum, a spontaneously amputated calcified ovary mimicking a vesical calculus, and a congenital retroperitoneal xanthofibroma caused the greatest difficulties in establishing a preoperative diagnosis. Amorphous, granular and irregular calcifications may be early hints of a malignancy.--Thomas A. Angerpointner Ventral Hernia in the Treatment of Omphalocele and Gastroschisis. K.R. Swartz, M. IV. Harrison, J.R. Campbell, el al. Ann Surg
201:347-350, (March), 1985. Twenty-three patients with omphalocele or gastroschisis and subsequently having secondary repair of ventral hernias are reviewed. The ventral defects resulted from elective skin flap coverage in 15 patients, prosthetic silo failure in 5, and non-operative management with eschar-inducing agents in 3. Ventral hernia repair was undertaken from 2 rues to 15 yrs of age with most patients between 6 mos and 2 yrs. Faseial closure was obtained in 20 of the 23 patients in one to 5 operations. Fifteen (65%) had fascial closure as a single procedure. In 8 patients, prosthetic material was used to close the defect. Five of these have subsequently had the prosthetic material removed and the fascia closed. Complications were minimal and there was no mortality. Ventral hernia with subsequent delayed closure is a useful technique when primary repair is not feasible or contraindicated.--Richard J. Andrassy Sonography of Thickened Gallbladder Wall: Causes in Children.
H.B. Patriquin, M. DiPietro, F.E. Barber, et al. Am J Roentgenol. 141:57-60, (July), 1983. A retrospective review of abdominal sonograms in 793 patients (age 1 d-16 yr) yielded 453 studies in which the gallbladder was well visualized. Significant abnormal findings were seen in 65 patients. Twenty patients had thickened gallbladder walls (>3 mm). Clinical factors involved in this group included hypoalbuminemia (13), ascites (5), recent meal with wall contraction (1), and systemic venous hypertension due to a blocked Fontan shunt (1). In the 45 patients with normal wall thickness, abnormalities found included gallstones (24), sludge (13), and ascites (8). This review tends to refute a previous report that a thickened gallbladder wall in a child is virtually diagnostic of active gallbladder disease.--Randall IV. Powell Sonographic Diameter of the Common Hepatic Duct in Sickle Cell Anemia. J.J. Cunningham. Am J RoentgenoI 141:321-324, (Au-
gust), 1983. This retrospective review of cholecystosonography in 95 patients with sickle cell disease (48 males, 47 females, 4-36 yr with mean of