Comparison of bowel function after ileo-rectal anastomosis for ulcerative colitis and colonic polyposis

ABSTRACTS Of the 159 patients treated surgically 112 (7@'~/,) had malrotations as the only anomaly. In this group 12 (10g;) died postoperatively. Forty-seven (30~,~,) patients had malrotation and an associated anomaly. In this group 16 (34~/o) died postoperatively. The associated anomalies, except for 3 instances of erythroblastosis fetalis and 6 instances of congenital heart disease, involved the gastrointestinal tract. The authors emphasize that all patients with diaphragmatic hernias and omphaloceles have " s o m e degree of incomplete rotation of the bowel." Midgut volvulus was present in 77 of the 159 patients operated upon. Twelve (I5'~,) of the patients with volvulus required an intestinal resection. Nine of 11 patients with volvulus and bloody stools survived. The authors outline the surgical technique followed in this institution indicating that they have not encountered an instance of recurrent volvulus following their method of surgical m a n a g e m e n t . - - William K. Sieber Ten Cases of Meckel's Diverticulum in Children Treated by Segmental Ileal Resection Followed by Termino-Terminal Anastomosis. J. Loup. Ann. Chit. Infant. 17:73-79, (January/February) 1976. In favor of this method, (even if the diverticulum is asymptomatic) is the fact that the end-to-end anastomosis permits a secure excision of possibly ectopic tissue at the base of the diverticulum. The anatomic results and the functional results appear to be more satisfactory.--C. Jaussi-Bovet Gallstones after Illeastomy and Ileal Resection. G. L. Hill, W. S. J. Mair, and J. C. Goligher. Gut 16:932-936, 1975. One hundred eight adult patients who had had ileostomies with or without ileal resection more than one year previously were studied radiologically. Gallstones were present in 26 (24.5'!;) and this is three times the expected incidence. J. J. Corker)' Neonatal Necrotizing Enterocolitis--a Personal Experience. A. R. Roty, Jr., J. B. Kilway, A. L. Brown, II, and M. Peelen. Surgery 80:340-342 (September) 1976. Forty-one neonates with necrotizing enterocolitis were managed from 1973-1975 inclusive at Kalamazoo, Michigan. Twenty-seven (66~;) required laparotomy. The mortality in this group was 59~ (16 patients). Fourteen were treated medically. Of these, 4 (28"~,,) survived.

263 The overall survival rate was 36~ (15 patients). The authors stress the problems in diagnosis and m a n a g e m e n t of these frustrating cases. William K. Sieber Idiopathic Infarction of Appendices Epiploica in Children: Report of 2 Cases. C. le Coultre and P. Braun. Ann. Chit. Infant. 17:61-64 (January/ February) 1976. This condition is rare in children. Two cases with a symptomatology, which mimics acute appendicitis, and the etiology (by torsion or by thrombosis) are discussed. A review of 42 cases from the literature is presented and the importance of checking the condition of the appendices epiploica in any surgical investigation for acute abdominal conditions is stressed. C. Jaussi-Bovet Comparison of Bowel Function after IleoRectal Anastomosis for Ulcerative Colitis and Colonic Polyposis. C. R. Newton and W. N. W. Baker. Gut 16:785-791, 1975. Two groups of adult patients who had had ileo-rectal anastomosis were studied. In 135 (Group A) the operation was for ulcerative colitis and in 45 (Group B) it was for colonic polyposis. The mean follow-up time was 8.1 yr in the colitic group and 12.7 yr in the polyposis group. The mean bowel frequency in G r o u p A was 4.5/24 hr whereas it was 3.5/24 hr in G r o u p B. Four per cent and 5~ respectively, of each group had a bowel action every night between midnight and 6 a.m. Seventy-eight per cent of G r o u p A and 83~'. of G r o u p B had no urgency of defecation. Fifty-one per cent of G r o u p A and 9~'L of G r o u p B regularly took drugs or medication of one sort of another. Tbirteen per cent of G r o u p A and 7~;~ of G r o u p B reported watery stools after milk ingestion. J. J. Corkery Hirschsprung's Disease. Problems in Diagnosis and Management. S. Cywes. S. A. Journal of Surgery, 13:219-222 (December) 1975. Problems in the diagnosis and m a n a g e m e n t of 188 patients seen over a period from 1956 1974 are discussed. These are reviewed with reference to radiological diagnosis, rectal pressure studies, rectal biopsy and the histological diagnosis. The problems in management pertaining to the colostomy and the role of the internal sphincter are outlined.--M. R. Q. Davies