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Atrial myxoma producing a saddle embolus in a child
186
ABSTRACTS
geal burn developed strictures, none required treatment. All patients with severe bums (2 without steroids, and 6 with steroids) developed clinically significant esophageal stricber ) , 1970. tures. On the basis of this experience the authors A saddle embolus of the aorta, upon reconclude that “early and prolonged adminismoval, proved to be a myxoma. Angiograms tration of steroids and antibiotics did not identified the left atria1 origin of the tumor. reduce the incidence of stricture formation.” It was successfully removed with recovery of the patient.-W. K. Sieber This conclusion is not warranted from this study as published. The available experiments on the subject indicate steroids reduce, but do not eliminate, esophageal stricture ALIMENTARY TRACT after bums. It is, therefore, among the less severely burned patients that one should look ESOPWGEAL ATRESIA AND TRACHEOESOPHA- for the effects of steroid therapy. Without control data and with no breakdown in reGEAL FISTIJLA. T. M. Holder and K. W. sults between adults and young children Ashcraft. Ann. Thorac. Surg. 9:445-467 (which two groups behave differently), the (May), 1970. reader is given no basis for drawing any such conclusions from this paper.-J. G. Presented is a collective review (61 refs. ). ATRIAL MYXOMA PRODUCINGA SADDLE EMBOLUS IN A CHILD. M. A. R. Khan and M. A. Muiahed. Thorax 25: 634-646 ( Septem-
--.I. G. Rosenkrantz
Rosenkrantz
AN EVALUATION OF Snmoms AND ANTIBIOTICSIN CAUSTIC BURNT OF THE ESOPHAGUS. W. R. Webb, P. Koutras, R. R. EckeT, and W. L. Sugg. Ann. Thorac. Surg: 9: 95-102 ( February), 1970.
ESOPHAGITIS. COMPLICATIONS TREATED BY TOTAL BYPUS WITHOUT ESOPHAGEAL RESECXON. H. J. Heir&h. Ann. Thorac. Surg. 10:203-211 (September), 1970.
In a prospective study, 68 patients with caustic ingestion were managed from January 1953 to June 1969. Ages of the patients were 8 months to 68 years: 42 under 5 years; 21 over 15 years. Esophagoscopy was done on all patients within 24 hours of injury. If esophagoscopy revealed no evidence of esophageal injury, treatment was symptomatic; if evidence of bum of the esophagus was noted, most patients received prednisone (100 mg/day for adults and 1.5 mg/kg/day or more for children) for a total of about 6 weeks, along with antibiotics (penicillin, tetracycline, amphicillin, streptomycin). Follow-up was by clinical criteria, barium swallow, and esophagoscopy. One patient, a 68-year-old man, died; 2 developed esophageal perforations (one at esophagoscopy and one during *dilatation). Forty-two of the 68 patients were judged to have burns of the esophagus (2 without evidence of oral injury). The bums appeared deep and severe in 8 patients. Fourteen patients did not receive steroids (2 with severe bums); 28 received steroids ( 6 among the severely burned group ) . Although 5 patients treated with steroids after less severe esopha-
A review of seven cases ( in adults) by the developer of the gastric tube replacement of the esophagus. The operation, as described by the author, includes splenectomy; in the young child the spleen can and should be preserved.-_/. G. Rosekrantz EXPERIENCEWITH THE THAL GASTROESOPHAGOPLASTY. W. S. Wise, C. H. Riuarola, G. D. Williams, W. 1. Fink, and D. C. Read. Ann. Thorac. Surg. IO:213222 (September), 1970. The authors report 15 patients with stricture or perforation of the lower esophagus who were managed by Thal’s procedure, with the gastric fundus applied to the esophageal defect, the advocate the addition of a Nissen phcation to minimize gastroesophageal reflux, and the use of a skin graft for large esophageal mucosal defects. Of the I4 survivors followed for 4-21 months, 9 swallow normally, 4 are improved, and 1 failed to improve. The operation as modified has seemed to prove its worth in the authors’ hands and should be considered for those children with comparable problems.-]. G. Rosenkrantz
ABSTRACTS
geal burn developed strictures, none required treatment. All patients with severe bums (2 without steroids, and 6 with steroids) developed clinically significant esophageal stricber ) , 1970. tures. On the basis of this experience the authors A saddle embolus of the aorta, upon reconclude that “early and prolonged adminismoval, proved to be a myxoma. Angiograms tration of steroids and antibiotics did not identified the left atria1 origin of the tumor. reduce the incidence of stricture formation.” It was successfully removed with recovery of the patient.-W. K. Sieber This conclusion is not warranted from this study as published. The available experiments on the subject indicate steroids reduce, but do not eliminate, esophageal stricture ALIMENTARY TRACT after bums. It is, therefore, among the less severely burned patients that one should look ESOPWGEAL ATRESIA AND TRACHEOESOPHA- for the effects of steroid therapy. Without control data and with no breakdown in reGEAL FISTIJLA. T. M. Holder and K. W. sults between adults and young children Ashcraft. Ann. Thorac. Surg. 9:445-467 (which two groups behave differently), the (May), 1970. reader is given no basis for drawing any such conclusions from this paper.-J. G. Presented is a collective review (61 refs. ). ATRIAL MYXOMA PRODUCINGA SADDLE EMBOLUS IN A CHILD. M. A. R. Khan and M. A. Muiahed. Thorax 25: 634-646 ( Septem-
--.I. G. Rosenkrantz
Rosenkrantz
AN EVALUATION OF Snmoms AND ANTIBIOTICSIN CAUSTIC BURNT OF THE ESOPHAGUS. W. R. Webb, P. Koutras, R. R. EckeT, and W. L. Sugg. Ann. Thorac. Surg: 9: 95-102 ( February), 1970.
ESOPHAGITIS. COMPLICATIONS TREATED BY TOTAL BYPUS WITHOUT ESOPHAGEAL RESECXON. H. J. Heir&h. Ann. Thorac. Surg. 10:203-211 (September), 1970.
In a prospective study, 68 patients with caustic ingestion were managed from January 1953 to June 1969. Ages of the patients were 8 months to 68 years: 42 under 5 years; 21 over 15 years. Esophagoscopy was done on all patients within 24 hours of injury. If esophagoscopy revealed no evidence of esophageal injury, treatment was symptomatic; if evidence of bum of the esophagus was noted, most patients received prednisone (100 mg/day for adults and 1.5 mg/kg/day or more for children) for a total of about 6 weeks, along with antibiotics (penicillin, tetracycline, amphicillin, streptomycin). Follow-up was by clinical criteria, barium swallow, and esophagoscopy. One patient, a 68-year-old man, died; 2 developed esophageal perforations (one at esophagoscopy and one during *dilatation). Forty-two of the 68 patients were judged to have burns of the esophagus (2 without evidence of oral injury). The bums appeared deep and severe in 8 patients. Fourteen patients did not receive steroids (2 with severe bums); 28 received steroids ( 6 among the severely burned group ) . Although 5 patients treated with steroids after less severe esopha-
A review of seven cases ( in adults) by the developer of the gastric tube replacement of the esophagus. The operation, as described by the author, includes splenectomy; in the young child the spleen can and should be preserved.-_/. G. Rosekrantz EXPERIENCEWITH THE THAL GASTROESOPHAGOPLASTY. W. S. Wise, C. H. Riuarola, G. D. Williams, W. 1. Fink, and D. C. Read. Ann. Thorac. Surg. IO:213222 (September), 1970. The authors report 15 patients with stricture or perforation of the lower esophagus who were managed by Thal’s procedure, with the gastric fundus applied to the esophageal defect, the advocate the addition of a Nissen phcation to minimize gastroesophageal reflux, and the use of a skin graft for large esophageal mucosal defects. Of the I4 survivors followed for 4-21 months, 9 swallow normally, 4 are improved, and 1 failed to improve. The operation as modified has seemed to prove its worth in the authors’ hands and should be considered for those children with comparable problems.-]. G. Rosenkrantz