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Complications of gastric and duodenal ulcers in infancy and childhood
278 Therefore, a conduit, as possible
INTEFWATIOSAL
the esophageal substitute acts only as and should be kept straight and short for good function--W. L. Riker.
AND DUODENAL GASTRIC CO~~PLICATIOP\‘S OF ULCERS IN INFANCY AND CHILDHOOD. 1. G. Raffensperger, 1. B. Condon and J. Greengard. Surg. Gynec. Obstet. 123:1269-1274, December 1966. In reviewing 80 patients in the newborn period to 16 years of age who had a gastric or duodenal ulcer diagnosed by autopsy, laparotomy or roentgenologic examination at the Cook County Children’s Hospital from 1937 to 1965, the authors found gastric perforation, duodenal perforation and hemorrhage from duodenal ulcer to be the most frequently encountered surgical complications. All 13 patients newborn infants.
with gastric perforation One infant survived.
were
Of 23 patients with perforated duodenal ulcer, 4 were newborns, I8 were infants 15 days to 1 year of age and 1 patient was a 15 year old boy. Two of the nelvborn infants and the 15 year old boy survived. Of 37 patients with hcmorrhnge from tluodcnal ulcer, 4 were newborns, 16 were infmts 15 days to 1 year of age and li were children over 1 year of age. One newborn, 3 infants 15 days to 1 year of age and 16 patients oser 1 year of age survived. The authors felt that a definitive operation on a poor risk infant with massive hemorrhage yielded a tlctter opportunity far survival than could be obtained by conservative treatment. They found no ill efiects following vagotomy and drainage procedure for complication of prptic ulcer in 7 children, and in an additional 4 children undcrgoing the same procedure for rrflns esophagitkF. 1. Hurbt~rg. SYNI)Ro\LE 0,. "(:AsTH~-COLIC: IKTERFE~ESCE." E. Rocirdtcl, J. .\lortincz-More cd .l. Cusasu. Ikv. Esl~. !‘(~tliat. 22:3OS-315. klay-June 1966.
‘fhr authors describe cast’s \\,ith a Ilktory of vomiting starting on the second or third day after birtll. X-rays she\<, interposition of an unu~nlly long left colon, between the diaphragm and the le\scsr cur\,aturts of tht. stom,lch. Sometimes the tranyvrrse colon, dilated by gas, is betlveen the
ABSTR4CTS
OF PEDIATHIC
SCRCERY
left lobe of the liver and the stomach. These gas dilated coils compress the stomach. The treatment is the same as for the gastric plicature syndrome: the baby is placed in the prone position with the head low, and frequent small feedings are given through a gastric tube. The vomiting ceases and, after a few da!,s. the baby is fed by mouth, but the prone maintained for 2 months.-_/. R. de
position
is
Oliceircl.
INTRAh1URAL HEhZATOhlA OF THE DUOUENUAI .4m JEJUNUK G. J. Demo&e, F. T. Tirol, I-. -4. Lo Russo and A. E. Norducci. Amer. J. Surg. 112, 947-954, December 1966. Three further cases of intramural hematoma of the duodenum and jejunum following traum:! are reported. Ninety-seven documented reports were collected from the literature and 83 of these ;~ppeared since 1949. The 3 cases reported occurred in 1964, showing that this condition ib perhap, more common when it is looked for. This kkm is typically preceded by a latent period hetwrr,n the injury and the symptoms. Symptoms arc‘ upper abdominal pain, vomiting and constipation with the passage of gas. On physical examination upper abdominal distention may be noted \vith guarding but without rigidity and a mass may 1~ felt. but sometimes this is masked by the guarding, .X-ray examination with bnrimn may 1~ characteristic and should be undertaken. It i\ also important to study the patient to exclude bleeding diathesis. The authors recommend laparotom) im d evacuation of the clot ~5 the method of treatment of choice, claiming that it minimizes morbidity and confirms the diagnosis so that no other injury is missctl.--N. K. Connolly. PARTIAL INTESTINAL OBSXKJCTIOS BORN
DUE
BOWEL.
Med.
TO
IiIWiINC
OF THE
1~ THE
PHOXIMAL
NEWSitIA1.L
1. W. Chamberloin. Ncv Eng. 275:1241-l-343, December 1966.
J.
This is a report of 3 ntqmnttss with inte\tin;rl obstruction due to abnormal kinking in asso&tion \vith peritoneal bands involving the duodenum in 2 and the most proximal jcjunum in the third. -411 3 cases preyented ;I\ high small bowel ohktruction. The colon was normally rot:ktcd it1 e&r cae.-.lV. H. flrrdrcw. SEox4TAL PEHTONITI~ DUE TO INTR~WEHIXE PEHFOHATION OF MECKEL'S DIVEHTICULLX. L. Gubern Salisachs and S. Ferrer Pi. Arch. (1~. Pedint. (Barcelona) 17:ZS3-316, I\Iay-June 1966.
INTEFWATIOSAL
the esophageal substitute acts only as and should be kept straight and short for good function--W. L. Riker.
AND DUODENAL GASTRIC CO~~PLICATIOP\‘S OF ULCERS IN INFANCY AND CHILDHOOD. 1. G. Raffensperger, 1. B. Condon and J. Greengard. Surg. Gynec. Obstet. 123:1269-1274, December 1966. In reviewing 80 patients in the newborn period to 16 years of age who had a gastric or duodenal ulcer diagnosed by autopsy, laparotomy or roentgenologic examination at the Cook County Children’s Hospital from 1937 to 1965, the authors found gastric perforation, duodenal perforation and hemorrhage from duodenal ulcer to be the most frequently encountered surgical complications. All 13 patients newborn infants.
with gastric perforation One infant survived.
were
Of 23 patients with perforated duodenal ulcer, 4 were newborns, I8 were infants 15 days to 1 year of age and 1 patient was a 15 year old boy. Two of the nelvborn infants and the 15 year old boy survived. Of 37 patients with hcmorrhnge from tluodcnal ulcer, 4 were newborns, 16 were infmts 15 days to 1 year of age and li were children over 1 year of age. One newborn, 3 infants 15 days to 1 year of age and 16 patients oser 1 year of age survived. The authors felt that a definitive operation on a poor risk infant with massive hemorrhage yielded a tlctter opportunity far survival than could be obtained by conservative treatment. They found no ill efiects following vagotomy and drainage procedure for complication of prptic ulcer in 7 children, and in an additional 4 children undcrgoing the same procedure for rrflns esophagitkF. 1. Hurbt~rg. SYNI)Ro\LE 0,. "(:AsTH~-COLIC: IKTERFE~ESCE." E. Rocirdtcl, J. .\lortincz-More cd .l. Cusasu. Ikv. Esl~. !‘(~tliat. 22:3OS-315. klay-June 1966.
‘fhr authors describe cast’s \\,ith a Ilktory of vomiting starting on the second or third day after birtll. X-rays she\<, interposition of an unu~nlly long left colon, between the diaphragm and the le\scsr cur\,aturts of tht. stom,lch. Sometimes the tranyvrrse colon, dilated by gas, is betlveen the
ABSTR4CTS
OF PEDIATHIC
SCRCERY
left lobe of the liver and the stomach. These gas dilated coils compress the stomach. The treatment is the same as for the gastric plicature syndrome: the baby is placed in the prone position with the head low, and frequent small feedings are given through a gastric tube. The vomiting ceases and, after a few da!,s. the baby is fed by mouth, but the prone maintained for 2 months.-_/. R. de
position
is
Oliceircl.
INTRAh1URAL HEhZATOhlA OF THE DUOUENUAI .4m JEJUNUK G. J. Demo&e, F. T. Tirol, I-. -4. Lo Russo and A. E. Norducci. Amer. J. Surg. 112, 947-954, December 1966. Three further cases of intramural hematoma of the duodenum and jejunum following traum:! are reported. Ninety-seven documented reports were collected from the literature and 83 of these ;~ppeared since 1949. The 3 cases reported occurred in 1964, showing that this condition ib perhap, more common when it is looked for. This kkm is typically preceded by a latent period hetwrr,n the injury and the symptoms. Symptoms arc‘ upper abdominal pain, vomiting and constipation with the passage of gas. On physical examination upper abdominal distention may be noted \vith guarding but without rigidity and a mass may 1~ felt. but sometimes this is masked by the guarding, .X-ray examination with bnrimn may 1~ characteristic and should be undertaken. It i\ also important to study the patient to exclude bleeding diathesis. The authors recommend laparotom) im d evacuation of the clot ~5 the method of treatment of choice, claiming that it minimizes morbidity and confirms the diagnosis so that no other injury is missctl.--N. K. Connolly. PARTIAL INTESTINAL OBSXKJCTIOS BORN
DUE
BOWEL.
Med.
TO
IiIWiINC
OF THE
1~ THE
PHOXIMAL
NEWSitIA1.L
1. W. Chamberloin. Ncv Eng. 275:1241-l-343, December 1966.
J.
This is a report of 3 ntqmnttss with inte\tin;rl obstruction due to abnormal kinking in asso&tion \vith peritoneal bands involving the duodenum in 2 and the most proximal jcjunum in the third. -411 3 cases preyented ;I\ high small bowel ohktruction. The colon was normally rot:ktcd it1 e&r cae.-.lV. H. flrrdrcw. SEox4TAL PEHTONITI~ DUE TO INTR~WEHIXE PEHFOHATION OF MECKEL'S DIVEHTICULLX. L. Gubern Salisachs and S. Ferrer Pi. Arch. (1~. Pedint. (Barcelona) 17:ZS3-316, I\Iay-June 1966.