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Generalised neurofibromatosis in the abdominal cavity in a child
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peripheral blood smear. The latter laboratory findings seem to have been the key to the proper diagnosis, and are probably the result of lack of splenic function, a sort of "autosplenectomy." This condition can only occur with lack of the normal anchoring ligaments, the so-called wandering spleen. The treatment was splenectomy. No prophylactic antibiotics were given to this child because he was 4 yr old and because he had no underlying primary splenic disease.-S.L. Gans Generalised Neurofibromatosis in the Abdominal Cavity in a Child. W. Wolanskl. Z. Kinder. Chir. 13, 267-271 (1973).
A 3-yr-old boy is reported with neurofibromatosis of the small intestine fitting in with the generalized neurofibromatosis described by von Reeklinghausen. At operation, a tumor of the small bowel measuring 6 cm in diameter was found 30 cm proximal to the ileocaecal valve. Five years later, a repeat laparotomy was performed because of appendicitis, and multiple enlarged lymph glands were encountered and regarded as recurrent tumor. These could not all be removed surgically. In spite of this, the child has now been followed for over 10 yr and has remained well.--S. Hofmann and H.B. Eckstein Ten Cases of Pancreatitis in Childhood. J. Bienaym~. Ann. Chir. Inf. 14, 5-54 (January/ February) 1973.
Based on ten cases of patients, aged between 2 yr 3 mo and 10 yr, observed in the surgical unit of the Sick Children's Hospital in Paris 19621968, this study is an extended review on acute pancreatitis in childhood. Posttraumatic and postoperative pancreatitis, pancreatitis in connection with epidemic parotitis, pancreatitis due to exocrine pancreatic insufficiency, mucoviscidosis, and pancreatic parasites are excluded from the report. The patients presented with fat necrosis (4), pancreatic hemorrhage (2), diffuse pancreatitis (4), ascites (6), pleural effusion (3), pseudocyst (3), such congenital malformations as cystic dilatation of the common bile duct, stenosis of the papilla of Vater, and intrapancreatic duodenal duplication (3), multifocal peritonitis (2), and chronic evolution of initially acute pancreatitis followed 3 yr later by lithiasis of the bile ducts (2). Detailed descriptions are given of the polymorphic clinical signs, the etiology, and the prognosis (particu-
ABSTRACTS
larly bad in cases of pancreatitis due to chemical therapy). Treatment should at first be medical: intravenous infusions, fasting, atropine, analgesics, and antibiotics; the use of corticoids and enzyme antagonists is controversial. Surg!cal treatment is recommended only in cases of uncertain diagnosis, for removal of pancreatic necrosis and drainage of pseudocysts, as well as in cases of biliary or pancreatic obstruction, stenosis, or compression. Surgical treatment was performed in nine of ten cases: simple laparatomy (4), triple thoracotomy (1), external cyst drainage (2), removal of obstructions (3), and pancreatectomy (2). One girl, who primarily suffered from a nephrotic syndrome and was treated with corticoids, died at 2 yr 10 mo of age from cardiac and respiratory failure 2 days after operation. The other children showed favorable evolution. C. Bretscher-Dutoit False Pancreatic Cyst Due to Chronic Pancreatitis. J. Borde, J. Lefort, and P. Wallon. Ann. Chit. Inf. 14:69-72 (January/February) 1973.
Pancreatic pseudocyst and chronic pancreatitis without traumatic history is extremely rare in children. The authors describe the case of a 14-yr-old girl admitted for abdominal pain. Three months before, progressive asthenia and anorexia had appeared, and 3 yr before the patient had been examined for transient umbilical pains; there was no history of abdominal trauma. Increased serum and urine amylase and serum lipase were suggestive of pancreatitis, and the girl was treated medically. Recurrent abdominal pains and a left-sided pleural effusion followed 2 mo later. Exploratory laparotomy revealed a pancreatic pseudocyst and chronic pancreatitis. This recurred 3 mo after the first intervention, but was treated medically. Five-month follow-up shows a consistent improvement.--C. Bretscher-Dutoit Acute Pancreatitis and Cholelithiasis in Children. Report of Two Cases. M. Gruner and M. Vialas. Ann. Chir. Inf. 14:73-80 (January/February) 1973.
Few cases of acute pancreatitis associated with cholelithiasis have been reported in children. The authors describe two cases, both in girls, aged 10 and 14 yr~ The first patient was obese and presented with epigastric pain, subicterus, fever, leukocytosis, bile in the urine, and increased transaminase. Later, gallbladder calcification on radiology and increased serum amylase led to a diagnosis of acute chole-
peripheral blood smear. The latter laboratory findings seem to have been the key to the proper diagnosis, and are probably the result of lack of splenic function, a sort of "autosplenectomy." This condition can only occur with lack of the normal anchoring ligaments, the so-called wandering spleen. The treatment was splenectomy. No prophylactic antibiotics were given to this child because he was 4 yr old and because he had no underlying primary splenic disease.-S.L. Gans Generalised Neurofibromatosis in the Abdominal Cavity in a Child. W. Wolanskl. Z. Kinder. Chir. 13, 267-271 (1973).
A 3-yr-old boy is reported with neurofibromatosis of the small intestine fitting in with the generalized neurofibromatosis described by von Reeklinghausen. At operation, a tumor of the small bowel measuring 6 cm in diameter was found 30 cm proximal to the ileocaecal valve. Five years later, a repeat laparotomy was performed because of appendicitis, and multiple enlarged lymph glands were encountered and regarded as recurrent tumor. These could not all be removed surgically. In spite of this, the child has now been followed for over 10 yr and has remained well.--S. Hofmann and H.B. Eckstein Ten Cases of Pancreatitis in Childhood. J. Bienaym~. Ann. Chir. Inf. 14, 5-54 (January/ February) 1973.
Based on ten cases of patients, aged between 2 yr 3 mo and 10 yr, observed in the surgical unit of the Sick Children's Hospital in Paris 19621968, this study is an extended review on acute pancreatitis in childhood. Posttraumatic and postoperative pancreatitis, pancreatitis in connection with epidemic parotitis, pancreatitis due to exocrine pancreatic insufficiency, mucoviscidosis, and pancreatic parasites are excluded from the report. The patients presented with fat necrosis (4), pancreatic hemorrhage (2), diffuse pancreatitis (4), ascites (6), pleural effusion (3), pseudocyst (3), such congenital malformations as cystic dilatation of the common bile duct, stenosis of the papilla of Vater, and intrapancreatic duodenal duplication (3), multifocal peritonitis (2), and chronic evolution of initially acute pancreatitis followed 3 yr later by lithiasis of the bile ducts (2). Detailed descriptions are given of the polymorphic clinical signs, the etiology, and the prognosis (particu-
ABSTRACTS
larly bad in cases of pancreatitis due to chemical therapy). Treatment should at first be medical: intravenous infusions, fasting, atropine, analgesics, and antibiotics; the use of corticoids and enzyme antagonists is controversial. Surg!cal treatment is recommended only in cases of uncertain diagnosis, for removal of pancreatic necrosis and drainage of pseudocysts, as well as in cases of biliary or pancreatic obstruction, stenosis, or compression. Surgical treatment was performed in nine of ten cases: simple laparatomy (4), triple thoracotomy (1), external cyst drainage (2), removal of obstructions (3), and pancreatectomy (2). One girl, who primarily suffered from a nephrotic syndrome and was treated with corticoids, died at 2 yr 10 mo of age from cardiac and respiratory failure 2 days after operation. The other children showed favorable evolution. C. Bretscher-Dutoit False Pancreatic Cyst Due to Chronic Pancreatitis. J. Borde, J. Lefort, and P. Wallon. Ann. Chit. Inf. 14:69-72 (January/February) 1973.
Pancreatic pseudocyst and chronic pancreatitis without traumatic history is extremely rare in children. The authors describe the case of a 14-yr-old girl admitted for abdominal pain. Three months before, progressive asthenia and anorexia had appeared, and 3 yr before the patient had been examined for transient umbilical pains; there was no history of abdominal trauma. Increased serum and urine amylase and serum lipase were suggestive of pancreatitis, and the girl was treated medically. Recurrent abdominal pains and a left-sided pleural effusion followed 2 mo later. Exploratory laparotomy revealed a pancreatic pseudocyst and chronic pancreatitis. This recurred 3 mo after the first intervention, but was treated medically. Five-month follow-up shows a consistent improvement.--C. Bretscher-Dutoit Acute Pancreatitis and Cholelithiasis in Children. Report of Two Cases. M. Gruner and M. Vialas. Ann. Chir. Inf. 14:73-80 (January/February) 1973.
Few cases of acute pancreatitis associated with cholelithiasis have been reported in children. The authors describe two cases, both in girls, aged 10 and 14 yr~ The first patient was obese and presented with epigastric pain, subicterus, fever, leukocytosis, bile in the urine, and increased transaminase. Later, gallbladder calcification on radiology and increased serum amylase led to a diagnosis of acute chole-