- Email: [email protected]
Feeding and necrotizing enterocolitis
212
complex malformation is due to vascular accidents during early fetal life. The authors conclude that a subtle surgical technique is necessary with an attempt to preserve the largest portion of the already damaged small bowel.--Th. Angerpointner Meckel's Diverticulum: Its Association With Congenital Malformation and the Significance of Atypical Morphology,
M. H. Simms and J. J. Corker):. Br J Surg 67:216-219, 1980. The autopsy records of a Children's Hospital were reviewed retrospectively for a 20-yr period to determine the incidence of Meckel's diverticulum and its association with other congenital abnormalities. The overall incidence was 2.9% in 5919 autosies. An increased incidence was noted in association with esophageal atresia, anorectal agenesis and major neurological and cardiovascular abnormalities. The records of patients who presented with any form of vitellointestinal remnant were also reviewed over a 10 year period. In these 81 patients, 31 diverticula were discovered incidentally, 27 vitello-intestinal remnants were associated with umbilical anomalies and 23 diverticula were symptomatic. Histology was available in 72 patients and showed mueosal heterotopia in 61% of the symptomatic group as against 13% of the incidental group. In the absence of abnormal bands or nodularity in a Meckel's diverticulum, the authors suggest that resection is unnecessary as such diverticula are unlikely to cause complications.--E. Kiely Crohn's Disease in Childhood. P, A. M. Raine, D. G. Young,
and hi. Blair. Z Kinderchir 29/3:226-237, 1980. Nine out of 16 children with Crohn's disease aged 4-12 years were treated surgically. Surgical procedures included small bowel resection, right hemicolectomy and proctocolectomy and were performed at an average of 3 years after the onset of symptoms. The authors emphasize the poor long-term prognosis of Crohn's disease in childhood.--Th. Angerpointner Intussusception in Infancy and Childhood. 1. F. Hutchinson,
B. Olayiwola, and D. G. Young. Br J Surg 67:209-212, 1980. Two hundred and nine cases of intussusception gathered over a 10-yr period are reviewed. This experience is compared with two previous 10-yr reviews from the same center. The commonest presenting symptoms were abdominal pain (82.3%) and vomiting (79.9%). Bleeding per rectum (36.4%) and n palpable mass (50.2%) were less common. The diagnosis was made in 44.6% within 24 hr of onset of symptoms but at least 72 hr elapsed before diagnosis in 25.4% of cases. Five children died in this series, three of these deaths being directly attributable to intussusception. This was an improvement over the two previous reports from the same center. Hydrostatic reduction by barium enema was the preferred method of treatment but could only be undertaken in 27.3% of cases. Successful reduction was obtained in a little over half the cases treated in this fashion. Of those undergoing laparotomy 21% had resection with end-to-end anastomosis. The incidence of resection increased the longer the duration of symptoms.--E. Kiely
ABSTRACTS
Intussusception of the Appendiceal Stump. A. J. LaSalle,
R. J. Andrassy, C. P. Page, et al. Clin Pediatr 19(6):432435, (June), 1980. This report adds to the world's literature the nineteenth reported case of intussusception caused by the appendiceal stump after appendectomy. In surveying those cases, the authors found that symptoms associated with this entity were abdominal pain (95%), vomiting (47%), blood per rectum (26%), and a palpable abdominal mass (68%). Symptoms usually began about two weeks after appendectomy (84%) of patients. Barium enema examination was diagnostic in 87.5% of patients in whom it was performed. Theories for its occurrence include an abscessed invaginated stump acting as a lead point; a noninvaginated appendiceal stump acting as a lead point; and midgut malrotation with nonfixation of the cecum.--Jane F. Goldthorn Feeding and Necrotizing Enterocolitis. Herbert 1. Goldman.
Am J Dis Child 134:553-555, (June), 1980. Between 1964 and 1976, 26 infants were diagnosed as having necrotizing enterocolitis (NEC) in the neonatal unit at Long Island Jewish-Hillside Medical Center, New Hyde Park, N.Y. Twenty-five of these cases occurred between 1973 and 1976. The relationship of feeding practices to this clustering of NEC cases was investigated two ways. (1) A 10% sample of all admissions 1964 to 1976 was studied. A correlation was found between the yearly incidence of NEC and the percentage of infants in that year who had received large increases in daily feeding volume. The highest mean daily feeding volume occurred in 1974 and 1975, the two years of peak NEC incidence. (2) The feeding records of the 26 NEC cases were studied. Thirteen N E C patients had large increases in feeding volume within two days of N E C onset. Seven others received >150 ml of formula per kilogram per day prior to N E C onset. Rapid increase in feeding volume and the use of large volumes are suggested as important etiologic factors in N E C . - - J . J. Tepas Colonic Stricture Following Necrotizing Enterocolitis. A.
Azmy and H. B. Eekstein. Z Kinderchir 29/4:326-329, 1980. Three infants developed colonic strictures 3-6 wk after the acute onset of nccrotizing enterocolitis in 2 of whom previous laparotomies were performed: The strictures were resected and continuity of the bowel restored. The postoperative course was uneventful in all cases. Early diagnosis and prompt surgical intervention improved the mortality of necrotizing enterocolitis considerably. Late complications are therefore more frequently encountered and a colonic stricture should be suspected in any child with intestinal malfunction who survived necrotizing enterocolitis.--Th. Angerpointner Tuberculous Stenosis of the Transverse
Colon. IV.
Lambrecht, Th. Riebel, R. Winkler, et al. Z Kinderchir 29/4:317-325, 1980. Although tuberculosis of the gastrointestinal tract disappeared almost completely in the developed countries it must be kept in mind in the differential diagnosis of gastrointesti-
complex malformation is due to vascular accidents during early fetal life. The authors conclude that a subtle surgical technique is necessary with an attempt to preserve the largest portion of the already damaged small bowel.--Th. Angerpointner Meckel's Diverticulum: Its Association With Congenital Malformation and the Significance of Atypical Morphology,
M. H. Simms and J. J. Corker):. Br J Surg 67:216-219, 1980. The autopsy records of a Children's Hospital were reviewed retrospectively for a 20-yr period to determine the incidence of Meckel's diverticulum and its association with other congenital abnormalities. The overall incidence was 2.9% in 5919 autosies. An increased incidence was noted in association with esophageal atresia, anorectal agenesis and major neurological and cardiovascular abnormalities. The records of patients who presented with any form of vitellointestinal remnant were also reviewed over a 10 year period. In these 81 patients, 31 diverticula were discovered incidentally, 27 vitello-intestinal remnants were associated with umbilical anomalies and 23 diverticula were symptomatic. Histology was available in 72 patients and showed mueosal heterotopia in 61% of the symptomatic group as against 13% of the incidental group. In the absence of abnormal bands or nodularity in a Meckel's diverticulum, the authors suggest that resection is unnecessary as such diverticula are unlikely to cause complications.--E. Kiely Crohn's Disease in Childhood. P, A. M. Raine, D. G. Young,
and hi. Blair. Z Kinderchir 29/3:226-237, 1980. Nine out of 16 children with Crohn's disease aged 4-12 years were treated surgically. Surgical procedures included small bowel resection, right hemicolectomy and proctocolectomy and were performed at an average of 3 years after the onset of symptoms. The authors emphasize the poor long-term prognosis of Crohn's disease in childhood.--Th. Angerpointner Intussusception in Infancy and Childhood. 1. F. Hutchinson,
B. Olayiwola, and D. G. Young. Br J Surg 67:209-212, 1980. Two hundred and nine cases of intussusception gathered over a 10-yr period are reviewed. This experience is compared with two previous 10-yr reviews from the same center. The commonest presenting symptoms were abdominal pain (82.3%) and vomiting (79.9%). Bleeding per rectum (36.4%) and n palpable mass (50.2%) were less common. The diagnosis was made in 44.6% within 24 hr of onset of symptoms but at least 72 hr elapsed before diagnosis in 25.4% of cases. Five children died in this series, three of these deaths being directly attributable to intussusception. This was an improvement over the two previous reports from the same center. Hydrostatic reduction by barium enema was the preferred method of treatment but could only be undertaken in 27.3% of cases. Successful reduction was obtained in a little over half the cases treated in this fashion. Of those undergoing laparotomy 21% had resection with end-to-end anastomosis. The incidence of resection increased the longer the duration of symptoms.--E. Kiely
ABSTRACTS
Intussusception of the Appendiceal Stump. A. J. LaSalle,
R. J. Andrassy, C. P. Page, et al. Clin Pediatr 19(6):432435, (June), 1980. This report adds to the world's literature the nineteenth reported case of intussusception caused by the appendiceal stump after appendectomy. In surveying those cases, the authors found that symptoms associated with this entity were abdominal pain (95%), vomiting (47%), blood per rectum (26%), and a palpable abdominal mass (68%). Symptoms usually began about two weeks after appendectomy (84%) of patients. Barium enema examination was diagnostic in 87.5% of patients in whom it was performed. Theories for its occurrence include an abscessed invaginated stump acting as a lead point; a noninvaginated appendiceal stump acting as a lead point; and midgut malrotation with nonfixation of the cecum.--Jane F. Goldthorn Feeding and Necrotizing Enterocolitis. Herbert 1. Goldman.
Am J Dis Child 134:553-555, (June), 1980. Between 1964 and 1976, 26 infants were diagnosed as having necrotizing enterocolitis (NEC) in the neonatal unit at Long Island Jewish-Hillside Medical Center, New Hyde Park, N.Y. Twenty-five of these cases occurred between 1973 and 1976. The relationship of feeding practices to this clustering of NEC cases was investigated two ways. (1) A 10% sample of all admissions 1964 to 1976 was studied. A correlation was found between the yearly incidence of NEC and the percentage of infants in that year who had received large increases in daily feeding volume. The highest mean daily feeding volume occurred in 1974 and 1975, the two years of peak NEC incidence. (2) The feeding records of the 26 NEC cases were studied. Thirteen N E C patients had large increases in feeding volume within two days of N E C onset. Seven others received >150 ml of formula per kilogram per day prior to N E C onset. Rapid increase in feeding volume and the use of large volumes are suggested as important etiologic factors in N E C . - - J . J. Tepas Colonic Stricture Following Necrotizing Enterocolitis. A.
Azmy and H. B. Eekstein. Z Kinderchir 29/4:326-329, 1980. Three infants developed colonic strictures 3-6 wk after the acute onset of nccrotizing enterocolitis in 2 of whom previous laparotomies were performed: The strictures were resected and continuity of the bowel restored. The postoperative course was uneventful in all cases. Early diagnosis and prompt surgical intervention improved the mortality of necrotizing enterocolitis considerably. Late complications are therefore more frequently encountered and a colonic stricture should be suspected in any child with intestinal malfunction who survived necrotizing enterocolitis.--Th. Angerpointner Tuberculous Stenosis of the Transverse
Colon. IV.
Lambrecht, Th. Riebel, R. Winkler, et al. Z Kinderchir 29/4:317-325, 1980. Although tuberculosis of the gastrointestinal tract disappeared almost completely in the developed countries it must be kept in mind in the differential diagnosis of gastrointesti-