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Hydatid cysts in childhood
558 The mechanism of thrombus formation at the site of anastomoses in very small vessels is examined. In experimental rats it was found that magnesium sulfate solution could be used with benefit to irrigate the outside of the vessels for the first 20 min after the recommencement of blood flow. Leakage from the suture line had to be adequately stopped before irrigation was started because further thrombus formation is inhibited. This procedure gave a 90% chance of success in end-to-end anastomoses of arteries 0.5 mm in diameter.-,4. ioNeys Progressive Peripheral Fibromuscular Hyperplasia in an Infant: A Possible Manifestation of the Rubella Syndrome. David R. Srewarr, Robert A. Price, Robert Nebesar, and Samuel R. Schusrer. Surgery 73:374380 (March),
1973. This is a detailed case report of a child with progressive arterial insufficiency of the left lower extremity due to fibromuscular hyperplasia of the left femoral artery. Symptoms, first noted at 3 mo of age, were tempotarily improved by left lumbar sympathectomy but recurred, neccessitating amputation at age 3j/2 yr. Intimal and medial proliferation in the arteries was noted to be similar to those seen in congenital rubella syndrome. Common origin of the two conditions is suggested.- William K. Sieber Hydatid Cysts in Childhood. M. Carcassone, P. Aubrespy, V. Dor. and M. Chow Prog Pediatr Surg 5:1-35, 1973. Hydatid cysts may be seen outside the endemic areas, and 25% of cases occur in children. Forty-eight children presenting over a 6%yr period had cysts (often multiple) in the liver (27). lungs (14). brain (four), and other tissues (nine). Secondary echinococcus from rupture and operative spillage is especially likely with hepatic cysts and patients should be followed for 5 yr before a cure can be assumed. A raised eosinophil count is characteristic, the Casoni tests and Weinberg test are specific, but false negative results occur. The clinical effects depend on the location of the cysts but stunted growth is common. The mortality of the untreated condition is 27%. Children can become incidental hosts, interupting the usual dog/sheep sequence. The cysts in children are often surrounded by a very thin adventitia, which ruptures easily. It is only rarely calcified. The most useful investigation for hepatic cysts is splenoportog-
ABSTRACTS raphy. Treatment of all cysts (except cerebral) is best achieved by total pericystectomy. There was no mortality in this series.-R. C. M. Cook HEAD AND
NECK
A Study of the Elects of Early Bone-Grafting in Complete Clefts of the Lip and PalateFive Year Study. A. Jolleys and N. R. E. Roberrson. Br J Plas Surg XXV:229-237 (July), 1972. A prospective study of two groups of 14 patients is described. Each group was treated similarly, but in one group autogenous bone grafts were used to fill the bony defect in the alveolus at the age of 1 yr. The technique of matched pairs was used. Bony development of the face was studied by cephalometry, by measurements of plaster casts of the jaws, and by examination of the dental occlusion. The results in the grafted group at 5 yr of age were worse in all respects than in the control group.A. Jolleys
Laryngbtracheoesophageal Cleft Associated With Esophageal Atresia and Multiple Tracheoesophageal Fistulas in a Twin. G. H. Mahour, S. R. Cohen, and M. M. WooNey. J Thorac Cardiovasc Surg 65:223-226 (February), 1973. A neonate with laryngotracheoesophageal cleft, esophageal atresia with distal tracheoesop hageal Astula, and two proximal tracheoe,sophageal fistulas is presented with a favorable outcome. It is the seventh reported successful repair of laryngotracheoesophageal cleft and the first with associated major anomaiies. There are 12 references.-Thomas M. Holder THORAX
Surgical Respiratory Emergencies in the Newborn. S. Cywes. South Afr h&d J 46:15381544 (October), 1972. Respiratoty emergencies confronting the surgeon can be divided into two main groups: the preoperative congenital anomalies and the postoperative complications. The preoperative group can be further subdivided into intrinsic thoracic and lung lesions and extrinsic obstructive lesions. The intrinsic group includes congenital diaphragmatic hernia, congenital lobar emphysema, congenital cystic lung, and esophageal atresia. The author describes his plan of manaaement and
1973. This is a detailed case report of a child with progressive arterial insufficiency of the left lower extremity due to fibromuscular hyperplasia of the left femoral artery. Symptoms, first noted at 3 mo of age, were tempotarily improved by left lumbar sympathectomy but recurred, neccessitating amputation at age 3j/2 yr. Intimal and medial proliferation in the arteries was noted to be similar to those seen in congenital rubella syndrome. Common origin of the two conditions is suggested.- William K. Sieber Hydatid Cysts in Childhood. M. Carcassone, P. Aubrespy, V. Dor. and M. Chow Prog Pediatr Surg 5:1-35, 1973. Hydatid cysts may be seen outside the endemic areas, and 25% of cases occur in children. Forty-eight children presenting over a 6%yr period had cysts (often multiple) in the liver (27). lungs (14). brain (four), and other tissues (nine). Secondary echinococcus from rupture and operative spillage is especially likely with hepatic cysts and patients should be followed for 5 yr before a cure can be assumed. A raised eosinophil count is characteristic, the Casoni tests and Weinberg test are specific, but false negative results occur. The clinical effects depend on the location of the cysts but stunted growth is common. The mortality of the untreated condition is 27%. Children can become incidental hosts, interupting the usual dog/sheep sequence. The cysts in children are often surrounded by a very thin adventitia, which ruptures easily. It is only rarely calcified. The most useful investigation for hepatic cysts is splenoportog-
ABSTRACTS raphy. Treatment of all cysts (except cerebral) is best achieved by total pericystectomy. There was no mortality in this series.-R. C. M. Cook HEAD AND
NECK
A Study of the Elects of Early Bone-Grafting in Complete Clefts of the Lip and PalateFive Year Study. A. Jolleys and N. R. E. Roberrson. Br J Plas Surg XXV:229-237 (July), 1972. A prospective study of two groups of 14 patients is described. Each group was treated similarly, but in one group autogenous bone grafts were used to fill the bony defect in the alveolus at the age of 1 yr. The technique of matched pairs was used. Bony development of the face was studied by cephalometry, by measurements of plaster casts of the jaws, and by examination of the dental occlusion. The results in the grafted group at 5 yr of age were worse in all respects than in the control group.A. Jolleys
Laryngbtracheoesophageal Cleft Associated With Esophageal Atresia and Multiple Tracheoesophageal Fistulas in a Twin. G. H. Mahour, S. R. Cohen, and M. M. WooNey. J Thorac Cardiovasc Surg 65:223-226 (February), 1973. A neonate with laryngotracheoesophageal cleft, esophageal atresia with distal tracheoesop hageal Astula, and two proximal tracheoe,sophageal fistulas is presented with a favorable outcome. It is the seventh reported successful repair of laryngotracheoesophageal cleft and the first with associated major anomaiies. There are 12 references.-Thomas M. Holder THORAX
Surgical Respiratory Emergencies in the Newborn. S. Cywes. South Afr h&d J 46:15381544 (October), 1972. Respiratoty emergencies confronting the surgeon can be divided into two main groups: the preoperative congenital anomalies and the postoperative complications. The preoperative group can be further subdivided into intrinsic thoracic and lung lesions and extrinsic obstructive lesions. The intrinsic group includes congenital diaphragmatic hernia, congenital lobar emphysema, congenital cystic lung, and esophageal atresia. The author describes his plan of manaaement and