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Congenital epulis
522
INTERNATIONAL
Children’s Hospital Medical Center, Boston for the treatment of gas gangrene, there were 3 cases in which post-traumatic crepitation occurred without evidence of bacterial invasion. The authors note that crepitation might develop following dissemination of trapped environmental air within tissue, the production of gas by chemical reaction between a metallic foreign body and tissue fluid and as a result of compressed air injected into the wound. The clinical and radiographic findings seen in these patients is discussed. They conclude that the knowledge of both bacterial and nonbacterial causes of post-traumatic crepitation will allow adequate treatment without unnecessary debridement or amputation.--B. M. Henderson. TUMORS OF THE BREAST IN ADOLESCENT FEMALES. W. A. Daniel, Jr., and Michelle D. Mathews. Pediatrics 41:74<3-749 (April) 1968. At the Adolescent Unit of the University of Alabama Medical Center in Birmingham, Alabama, 95 girls, 12 to 21 years of age, had breast tumors removed in the lo-year period from 1956 to 1966. Ninety (94 per cent) of the masses proved to be fibroadenomas. In 25 per cent the fibroadenomas were multiple.-W. K. Sieber.
HEAD
AND
NECK
CONGENITAL EPULIS. R. Nicole and S. Scheidegger. Z. Kinder. Chir. 5:315-319, 1968. The authors discuss two rare cases of epulis in the new born. These presented as walnut-sized tumors which were attached to the alveolar edge. Secondary defects of the mucosa can result. Treatment consisted in radical extirpation of the tumour. Pathology is stressed.-S. Hofmann and H. B. Eckstein. TONSILLECTOXIY AND AmivoroEcTohrY ‘&VIEW OF PUBLISHED EVIDENCE FOR AND AGAINST THE T AND A.” H. E. Evans. Clin. Pediat. 7:71-75, 1968. After reviewing recent and past published data on the T and A controversy, the author concludes that the most conservative approach should be used, since there seems to be no compelling evidence of any long-term benefit from a T and A.81. 6. Gilbert.
THORAX CHYLOTHORAX IN INFANCY. Wojciech ax 23:214-215 (March) 1968.
Jeske.
Thor-
ABSTBACIS
OF PEDIATRIC
SURGERY
This discussion of chylothorax in infancy presents a single case in a newborn infant. After the first aspiration pneumothorax occurred and definitive treatment was accomplished by intercostal tube drainage. Conservative approach is urged reserving surgery for those patients where the condition persists-w. K. Sieber. THE USEOF MEDIUX-CHAIN TRIGLYCERIDES INTHE TREAT~LIENT OF CHYLOTHORAX IN A CHILD. Ivan Lichter, G. L. Hill, and E. R. Nye. Ann. Thorac. Surg. 5:352-355 (April) 1968. A 2%-year-old child with an esophageal stricture due to peptic regurgitation associated with a hiatus hernia developed a persistent chylothorax following two operative procedures for successful repair of the esophageal hiatal hernia and the stricture. The chylothorax did not respond to repeated aspirations, but when the diet was changed almost entirely to medium-chain fatty acids to sustain adequate nourishment, the flow and loss through the thoracic duct decreased to the point of complete obliteration of the chylothorax. The absorption of medium-chain triglycerides takes place by the portal vein and no absorption occurs via the lymphatics; therefore, a diet containing almost entirely medium-chain triglycerides will bypass the thoracic duct component of digestive absorption. This appears to be a well documented case report with the successful utilization of medium-chain triglycerides and certainly merits further clinical trial.-,I. A. Hailer, Jr. CONGENITAL STENOSIS OF THE RIGHT MAINSTEM BRONCHUS-A CASE REPORT, Nora Chung, J. H. Hertzler, R. H. Gregg, M. Wael Lofti, and A. I. Brough. Pediatrics 41:739-742 (April) 1968. Congenital stenosis of the right mainstem bronchus in a S-month-old boy was demonstrated by bronchography. The 1 cm. long area was resected and continuity restored by end to end branchial anastomosis. No follow-up information is provided. Only 2 similar cases have been reported. -W. K. Sieber. RUPTUHE OF THE BRONCHUS IN CHILDHOOD. E. Sperling. Z. K. Chir. 5:333-342, 1968. A 7-year-old boy is reported who was operated on 61/1 months following injury resulting in a traumatic rupture of the left main bronchus with complete collapse of the left wing. Reconstruction was successful. In time the collapsed lung was totally expanded.-S. Hofmann and H. B. Eckstein.
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Children’s Hospital Medical Center, Boston for the treatment of gas gangrene, there were 3 cases in which post-traumatic crepitation occurred without evidence of bacterial invasion. The authors note that crepitation might develop following dissemination of trapped environmental air within tissue, the production of gas by chemical reaction between a metallic foreign body and tissue fluid and as a result of compressed air injected into the wound. The clinical and radiographic findings seen in these patients is discussed. They conclude that the knowledge of both bacterial and nonbacterial causes of post-traumatic crepitation will allow adequate treatment without unnecessary debridement or amputation.--B. M. Henderson. TUMORS OF THE BREAST IN ADOLESCENT FEMALES. W. A. Daniel, Jr., and Michelle D. Mathews. Pediatrics 41:74<3-749 (April) 1968. At the Adolescent Unit of the University of Alabama Medical Center in Birmingham, Alabama, 95 girls, 12 to 21 years of age, had breast tumors removed in the lo-year period from 1956 to 1966. Ninety (94 per cent) of the masses proved to be fibroadenomas. In 25 per cent the fibroadenomas were multiple.-W. K. Sieber.
HEAD
AND
NECK
CONGENITAL EPULIS. R. Nicole and S. Scheidegger. Z. Kinder. Chir. 5:315-319, 1968. The authors discuss two rare cases of epulis in the new born. These presented as walnut-sized tumors which were attached to the alveolar edge. Secondary defects of the mucosa can result. Treatment consisted in radical extirpation of the tumour. Pathology is stressed.-S. Hofmann and H. B. Eckstein. TONSILLECTOXIY AND AmivoroEcTohrY ‘&VIEW OF PUBLISHED EVIDENCE FOR AND AGAINST THE T AND A.” H. E. Evans. Clin. Pediat. 7:71-75, 1968. After reviewing recent and past published data on the T and A controversy, the author concludes that the most conservative approach should be used, since there seems to be no compelling evidence of any long-term benefit from a T and A.81. 6. Gilbert.
THORAX CHYLOTHORAX IN INFANCY. Wojciech ax 23:214-215 (March) 1968.
Jeske.
Thor-
ABSTBACIS
OF PEDIATRIC
SURGERY
This discussion of chylothorax in infancy presents a single case in a newborn infant. After the first aspiration pneumothorax occurred and definitive treatment was accomplished by intercostal tube drainage. Conservative approach is urged reserving surgery for those patients where the condition persists-w. K. Sieber. THE USEOF MEDIUX-CHAIN TRIGLYCERIDES INTHE TREAT~LIENT OF CHYLOTHORAX IN A CHILD. Ivan Lichter, G. L. Hill, and E. R. Nye. Ann. Thorac. Surg. 5:352-355 (April) 1968. A 2%-year-old child with an esophageal stricture due to peptic regurgitation associated with a hiatus hernia developed a persistent chylothorax following two operative procedures for successful repair of the esophageal hiatal hernia and the stricture. The chylothorax did not respond to repeated aspirations, but when the diet was changed almost entirely to medium-chain fatty acids to sustain adequate nourishment, the flow and loss through the thoracic duct decreased to the point of complete obliteration of the chylothorax. The absorption of medium-chain triglycerides takes place by the portal vein and no absorption occurs via the lymphatics; therefore, a diet containing almost entirely medium-chain triglycerides will bypass the thoracic duct component of digestive absorption. This appears to be a well documented case report with the successful utilization of medium-chain triglycerides and certainly merits further clinical trial.-,I. A. Hailer, Jr. CONGENITAL STENOSIS OF THE RIGHT MAINSTEM BRONCHUS-A CASE REPORT, Nora Chung, J. H. Hertzler, R. H. Gregg, M. Wael Lofti, and A. I. Brough. Pediatrics 41:739-742 (April) 1968. Congenital stenosis of the right mainstem bronchus in a S-month-old boy was demonstrated by bronchography. The 1 cm. long area was resected and continuity restored by end to end branchial anastomosis. No follow-up information is provided. Only 2 similar cases have been reported. -W. K. Sieber. RUPTUHE OF THE BRONCHUS IN CHILDHOOD. E. Sperling. Z. K. Chir. 5:333-342, 1968. A 7-year-old boy is reported who was operated on 61/1 months following injury resulting in a traumatic rupture of the left main bronchus with complete collapse of the left wing. Reconstruction was successful. In time the collapsed lung was totally expanded.-S. Hofmann and H. B. Eckstein.