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Congenital short intestine with jejunal duplication
416
ABSTRACTS
RA angiogram revealed swirling of the dye in the RA and dilated IVC with slow filling of the RV, PA, LA, and LV. A thick peel was also seen around the right atrial wall. Resection of the thickened pericardium eliminated all symptoms. Constrictive pericarditis in infants occurs rarely and is characterized by a triad of a small heart, ascites, and elevated venous pressure but may only present as unexplained congestive heart failure. The definitive diagnostic test remains cardiac catheterization. This case, as in adults, demonstrates equilibration of all diastolic pressures with rapid volume expansion. Randall W. Powell ALIMENTARY TRACT The String Test for Gastroesophageal Reflux. W. M. Lieb-
man and P. Rosenthal. Am J Dis Child 134:775-776, (August), 1980.
The sensitivity of the string test for detection of gastroesophageal reflux was assessed in 15 infants and children, 5 mo to 11 yr of age (mean 2.8 yr) with vomiting, regurgitation, or lower respiratory tract symptoms. The results were compared with the barium esophagogram, esophageal manometry, and the acid reflux test (pH probe). Barium esophagogram showed reflux in 4 of 15 patients, pH probe in 7 of 15 patients and the string test in 6 of 15 patients. The string test is a simple, rapid, safe, and efficient screening method for patients with suspected gastroesophageal reflux.--J. J. Tepas II1 Surgical Treatment of Gastroesophageal Reflux in Children. L. Leape, M. L. Ramenofsky. Am J Dis Child
134:935 938, (October), 1980. One hundred children underwent Nissen's fundop]ication for complications of gastroesophageal reflux. Indications for fundoplication included refractory pneumonia, apneic spells, intractable vomiting, failure to thrive, esophagitis, esophageal stricture, and Sandifer's syndrome. Except for those with life-threatening complications, fundoplication was performed only in those who had failure with a strict medical antireflux regimen. Four patients were not helped by operation or had a recurrence of symptoms. Of these, three with refractory pneumonia were judged to be failures of selection since reflux was absent postoperatively. The fourth had massive reflux and recurrent vomiting. Eight other patients had radiologic evidence of reflux postoperatively. Six of these were asymptomatic and two had minor symptoms. There was 1 death and 11 postoperative complications.--& J. Tepas 111 Benign Hypertrophic Gastropathy: M~n~trier's Disease in Childhood and Adolescence. R. A. Bloom and J. R.
McQuaide. Clin Pediatr 19:533 540, (August), 1980.
A 17-yr-old black male presented with postprandial epigastric pain, vomiting, weight loss, and melena. A UGI revealed giant rugal folds in the proximal stomach. A biopsy at laparotomy revealed typical microscopic features of M6n6trier's disease. The patient improved over the next year and remains well. A review of 10 patients less than 20 yr of age with M6n6trier's disease revealed that patients in this age group usually present acutely with gastrointestinal
symptoms and/or symptoms due to the effects of hypoproteinemia. Unlike the disease in adults, children seem to completely resolve the disease with no serious sequelae. The main problem involves differentiating M6n6trier's disease from a gastric malignancy.--Randall IV. Powell Duodenal Ulcer Disease in Children. K. K. Maudar, J. Dutta, and S. Mitra. World J Surg 4:261 266, (March), 1980.
Eleven patients ranging in age from 3 days to 15 yr comprised this retrospective review from northeastern India, a region with a relatively high ulcer incidence. Three young patients (3 days, 4 days, and 4 mo) presented with acute perforations and all succumbed to septic complications. The older children presented with chronic symptoms consisting mainly of pain and vomiting. Two also had experienced melena. All eight older children failed to respond to medical management and underwent truncal vagotomy and drainage. All have done well with 6 receiving Visick grade 1 scores and 2 Visick grade II. The authors feel that in chronic duodenal ulcer disease in children surgical therapy should be the preferred method of treatment. The invited commentary disagreed with this approach. In a series of 116 patients over a 20-yr period, 76 patients presented with chronic duodenal ulcer disease and only 10 required some type of surgical therapy.--Randall W. Powell Congenital Short Intestine With Jejunal Duplication. K. Hatsuse, K. Mimura, H. lwase, et al. Jpn J Pediatr Surg 12:1677-1680, (December), 1980.
Congenital short intestine with jejunal duplication seen in a 3-day-old baby was reported. The authors collected 35 cases of intestinal duplication found in the newborn period from the Japanese literature, including the case presented here. Of these 35 cases, 18 were males, 12 were females, and sex was not described in 5 cases. Duplication was found in the duodenum in 2, the jejunum in 10, the jejuno-ileum in 1, the ileum in 14, the ileo-cecal region in 6, the cecum in 1, and the colon in 1 case. Associated malformations were found in 12 cases: duodenal atresia in 1, jejunal atresia in 5, ileal atresia in 3, malrotation in 2, and congenital short intestine in 1 case.--H. Suzuki The Neomucosa and its Surroundings After Jejunoserosal
Patching in Dogs. E. Gaton, B. Czernobilisky, L. Kraus, A. Motovic, L Glas, Y. Taub, and B. Man. J Surg Res 29:451465, (November), 1980.
Forty dogs, aged 6 mo-2 yr, underwent resection of 80% of the small bowel Twenty-four of the dogs had a transverse colon serosal patch measuring 4 by 12 cm applied to an incision in the antimesenteric border of the remaining jejunum. Sixteen dogs did not have serosal patching. The dogs were then compared clinically and after sacrifice the neomucosa in the patched dogs was studied histologically, morphometrically, and histochemically. All of these parameters indicated the formation of morphologically and functionally normal jejunal mucosa over a colonic serosal patch in dogs. Because of this, the patched dogs had disappearance of their diarrhea and attained normal weight gain and behavior
ABSTRACTS
RA angiogram revealed swirling of the dye in the RA and dilated IVC with slow filling of the RV, PA, LA, and LV. A thick peel was also seen around the right atrial wall. Resection of the thickened pericardium eliminated all symptoms. Constrictive pericarditis in infants occurs rarely and is characterized by a triad of a small heart, ascites, and elevated venous pressure but may only present as unexplained congestive heart failure. The definitive diagnostic test remains cardiac catheterization. This case, as in adults, demonstrates equilibration of all diastolic pressures with rapid volume expansion. Randall W. Powell ALIMENTARY TRACT The String Test for Gastroesophageal Reflux. W. M. Lieb-
man and P. Rosenthal. Am J Dis Child 134:775-776, (August), 1980.
The sensitivity of the string test for detection of gastroesophageal reflux was assessed in 15 infants and children, 5 mo to 11 yr of age (mean 2.8 yr) with vomiting, regurgitation, or lower respiratory tract symptoms. The results were compared with the barium esophagogram, esophageal manometry, and the acid reflux test (pH probe). Barium esophagogram showed reflux in 4 of 15 patients, pH probe in 7 of 15 patients and the string test in 6 of 15 patients. The string test is a simple, rapid, safe, and efficient screening method for patients with suspected gastroesophageal reflux.--J. J. Tepas II1 Surgical Treatment of Gastroesophageal Reflux in Children. L. Leape, M. L. Ramenofsky. Am J Dis Child
134:935 938, (October), 1980. One hundred children underwent Nissen's fundop]ication for complications of gastroesophageal reflux. Indications for fundoplication included refractory pneumonia, apneic spells, intractable vomiting, failure to thrive, esophagitis, esophageal stricture, and Sandifer's syndrome. Except for those with life-threatening complications, fundoplication was performed only in those who had failure with a strict medical antireflux regimen. Four patients were not helped by operation or had a recurrence of symptoms. Of these, three with refractory pneumonia were judged to be failures of selection since reflux was absent postoperatively. The fourth had massive reflux and recurrent vomiting. Eight other patients had radiologic evidence of reflux postoperatively. Six of these were asymptomatic and two had minor symptoms. There was 1 death and 11 postoperative complications.--& J. Tepas 111 Benign Hypertrophic Gastropathy: M~n~trier's Disease in Childhood and Adolescence. R. A. Bloom and J. R.
McQuaide. Clin Pediatr 19:533 540, (August), 1980.
A 17-yr-old black male presented with postprandial epigastric pain, vomiting, weight loss, and melena. A UGI revealed giant rugal folds in the proximal stomach. A biopsy at laparotomy revealed typical microscopic features of M6n6trier's disease. The patient improved over the next year and remains well. A review of 10 patients less than 20 yr of age with M6n6trier's disease revealed that patients in this age group usually present acutely with gastrointestinal
symptoms and/or symptoms due to the effects of hypoproteinemia. Unlike the disease in adults, children seem to completely resolve the disease with no serious sequelae. The main problem involves differentiating M6n6trier's disease from a gastric malignancy.--Randall IV. Powell Duodenal Ulcer Disease in Children. K. K. Maudar, J. Dutta, and S. Mitra. World J Surg 4:261 266, (March), 1980.
Eleven patients ranging in age from 3 days to 15 yr comprised this retrospective review from northeastern India, a region with a relatively high ulcer incidence. Three young patients (3 days, 4 days, and 4 mo) presented with acute perforations and all succumbed to septic complications. The older children presented with chronic symptoms consisting mainly of pain and vomiting. Two also had experienced melena. All eight older children failed to respond to medical management and underwent truncal vagotomy and drainage. All have done well with 6 receiving Visick grade 1 scores and 2 Visick grade II. The authors feel that in chronic duodenal ulcer disease in children surgical therapy should be the preferred method of treatment. The invited commentary disagreed with this approach. In a series of 116 patients over a 20-yr period, 76 patients presented with chronic duodenal ulcer disease and only 10 required some type of surgical therapy.--Randall W. Powell Congenital Short Intestine With Jejunal Duplication. K. Hatsuse, K. Mimura, H. lwase, et al. Jpn J Pediatr Surg 12:1677-1680, (December), 1980.
Congenital short intestine with jejunal duplication seen in a 3-day-old baby was reported. The authors collected 35 cases of intestinal duplication found in the newborn period from the Japanese literature, including the case presented here. Of these 35 cases, 18 were males, 12 were females, and sex was not described in 5 cases. Duplication was found in the duodenum in 2, the jejunum in 10, the jejuno-ileum in 1, the ileum in 14, the ileo-cecal region in 6, the cecum in 1, and the colon in 1 case. Associated malformations were found in 12 cases: duodenal atresia in 1, jejunal atresia in 5, ileal atresia in 3, malrotation in 2, and congenital short intestine in 1 case.--H. Suzuki The Neomucosa and its Surroundings After Jejunoserosal
Patching in Dogs. E. Gaton, B. Czernobilisky, L. Kraus, A. Motovic, L Glas, Y. Taub, and B. Man. J Surg Res 29:451465, (November), 1980.
Forty dogs, aged 6 mo-2 yr, underwent resection of 80% of the small bowel Twenty-four of the dogs had a transverse colon serosal patch measuring 4 by 12 cm applied to an incision in the antimesenteric border of the remaining jejunum. Sixteen dogs did not have serosal patching. The dogs were then compared clinically and after sacrifice the neomucosa in the patched dogs was studied histologically, morphometrically, and histochemically. All of these parameters indicated the formation of morphologically and functionally normal jejunal mucosa over a colonic serosal patch in dogs. Because of this, the patched dogs had disappearance of their diarrhea and attained normal weight gain and behavior