- Email: [email protected]
Management of the acute abdomen in children with leukemia
ABSTRACTS
987
be included as a step in early cases of congenital dislocation of the hip. In the authors' view this procedure should not be performed without very good reason. Judging from their results, it appears that acetabular development occurs satisfactorily in a large n u m b e r of instances as long as proper reduction is maintained. Seventy-two patients with 85 affected hips were studied; all had been over 1 yr old when admitted and over 10 at the time o f review. Acetabular development was assessed radiologically by m e a s u r e m e n t of the acetabular angle. Satisfactory development occurred in 80~. The reasons for failure in the others were failure to obtain and maintain congruity and development of ischemic necrosis due to manipulative reductions. When patients in w h o m these errors have occurred were eliminated from the series, satisfactory acetabular development in 9 5 ~ of hips was claimed. The authors appear to have proved their point that acetabuloplasty should not be necessary if the patient is admitted under the age of 4 or congruity obtained in the functional position under 489yr.--John A itken
Posterior Psoas Transfer and Hip Instability in Lumbar Myelomeningocele. Barrie Parker and Geoffrey Walker. J Bone Joint Surg 57B:53-58 (Feb), 1975. In 1959 Sharrard described posterior transfer of the ileopsoas muscle as an operation for the treatment of hip instability in children with myelomeningocele and with neurologic activity below lumbar 1 and 2. This paper deals with 72 patients in w h o m this procedure was carried out in an attempt to assess the value of the operation. Seventy-two posterior ileopsoas transfers were done in 44 children and these were reviewed 1-8 yr after operation. It was found that hip stability had improved in all, 94 being stable at the time of review. Fifty-seven percent of the patients had an acceptable functional result, which depended mainly on the level of neurologic activity. From these results the a u t h o r s think that transfers should be done as soon after the age of 9 mo as possible and if done after the age of 2 yr should be restricted to patients with neurologic activity in lumbar 3 and 4.--John A itken
During the 6-yr period 1967-1973, 173 p a tients were treated by ventriculoatrial s h u n t a n d 43 o f these have been analyzed in detail. All these patients were about 3 yr of age. O f the 27 survivors, 24 were investigated by psychologic tests. Mental development was n o r m a l in 14, while 10 showed mental retardation; of the 10, 8 can still attend school. Grave etiologic factors, like aqueduct occlusion, ventriculitis and occlusion, birth in asphyxia, late surgery, toxemic pregnancy, neonatal subarachnoidal hemorrhage, and p r e m a t u r e birth are considered primarily responsible for the retardation. The functional development that can be achieved by successful surgical treatment is discussed.--A ndrew Pint~r
Postmeningitic Hydrocephalus. B. Zumsteln and H. Zumstein. Schweiz Med Wochenschr 104:799795 (June), 1974.
Twenty-three patients with postmeningitic hydrocephalus have been followed. The a u t h o r s found that postmeningitic hydrocephalus has a tendency to s p o n t a n e o u s resolution but at a time when definitive cerebral d a m a g e has already occurred. Therefore, a s h u n t operation has to be performed as soon as possible, in any case within 6 m o after meningitis.--G. Egli NEOPLASMS
Management of the Acute Abdomen in Children With Leukemia. Philip R. Exelby, Amir Ghandchi, Nicolas Lansigan, and Ira Schwartz. Cancer 35: 826-829 (March), 1975.
Study of Hydrocephalic Patients Three Years After Surgery. E. Paralcz, L. V~kbssy, and Susan
A m o n g 286 children with acute leukemia seen at the Memorial Hospital (NYC) from 1966 to 1971, 16 developed an acute a b d o m i n a l disease entity during their course of therapy. Five o f these conditions were not noted until autopsy. Two were treated without surgery by election and died. A m o n g the nine children m a n a g e d by active surgical intervention, five were long-term survivors. However, three of the latter were in remission at the time of surgery. The pathologic entities in these 16 children were appendicitis, typhlitis (including infarction and perforation), intussusception, intestinal obstruction, pancreatitis, and liver abscess. In addition to supportive care, including broad-spectrum antibiotics, aggressive antileukemic therapy is r e c o m m e n d e d during the postoperative period following abdominal surgery in these children. --Daniel M. Hays
Kovbcs. Acta Paediatr Acad Sci Hung 15:205-209, 1974.
The Management of Pulmonary Metastases in
NERVOUS SYSTEM
987
be included as a step in early cases of congenital dislocation of the hip. In the authors' view this procedure should not be performed without very good reason. Judging from their results, it appears that acetabular development occurs satisfactorily in a large n u m b e r of instances as long as proper reduction is maintained. Seventy-two patients with 85 affected hips were studied; all had been over 1 yr old when admitted and over 10 at the time o f review. Acetabular development was assessed radiologically by m e a s u r e m e n t of the acetabular angle. Satisfactory development occurred in 80~. The reasons for failure in the others were failure to obtain and maintain congruity and development of ischemic necrosis due to manipulative reductions. When patients in w h o m these errors have occurred were eliminated from the series, satisfactory acetabular development in 9 5 ~ of hips was claimed. The authors appear to have proved their point that acetabuloplasty should not be necessary if the patient is admitted under the age of 4 or congruity obtained in the functional position under 489yr.--John A itken
Posterior Psoas Transfer and Hip Instability in Lumbar Myelomeningocele. Barrie Parker and Geoffrey Walker. J Bone Joint Surg 57B:53-58 (Feb), 1975. In 1959 Sharrard described posterior transfer of the ileopsoas muscle as an operation for the treatment of hip instability in children with myelomeningocele and with neurologic activity below lumbar 1 and 2. This paper deals with 72 patients in w h o m this procedure was carried out in an attempt to assess the value of the operation. Seventy-two posterior ileopsoas transfers were done in 44 children and these were reviewed 1-8 yr after operation. It was found that hip stability had improved in all, 94 being stable at the time of review. Fifty-seven percent of the patients had an acceptable functional result, which depended mainly on the level of neurologic activity. From these results the a u t h o r s think that transfers should be done as soon after the age of 9 mo as possible and if done after the age of 2 yr should be restricted to patients with neurologic activity in lumbar 3 and 4.--John A itken
During the 6-yr period 1967-1973, 173 p a tients were treated by ventriculoatrial s h u n t a n d 43 o f these have been analyzed in detail. All these patients were about 3 yr of age. O f the 27 survivors, 24 were investigated by psychologic tests. Mental development was n o r m a l in 14, while 10 showed mental retardation; of the 10, 8 can still attend school. Grave etiologic factors, like aqueduct occlusion, ventriculitis and occlusion, birth in asphyxia, late surgery, toxemic pregnancy, neonatal subarachnoidal hemorrhage, and p r e m a t u r e birth are considered primarily responsible for the retardation. The functional development that can be achieved by successful surgical treatment is discussed.--A ndrew Pint~r
Postmeningitic Hydrocephalus. B. Zumsteln and H. Zumstein. Schweiz Med Wochenschr 104:799795 (June), 1974.
Twenty-three patients with postmeningitic hydrocephalus have been followed. The a u t h o r s found that postmeningitic hydrocephalus has a tendency to s p o n t a n e o u s resolution but at a time when definitive cerebral d a m a g e has already occurred. Therefore, a s h u n t operation has to be performed as soon as possible, in any case within 6 m o after meningitis.--G. Egli NEOPLASMS
Management of the Acute Abdomen in Children With Leukemia. Philip R. Exelby, Amir Ghandchi, Nicolas Lansigan, and Ira Schwartz. Cancer 35: 826-829 (March), 1975.
Study of Hydrocephalic Patients Three Years After Surgery. E. Paralcz, L. V~kbssy, and Susan
A m o n g 286 children with acute leukemia seen at the Memorial Hospital (NYC) from 1966 to 1971, 16 developed an acute a b d o m i n a l disease entity during their course of therapy. Five o f these conditions were not noted until autopsy. Two were treated without surgery by election and died. A m o n g the nine children m a n a g e d by active surgical intervention, five were long-term survivors. However, three of the latter were in remission at the time of surgery. The pathologic entities in these 16 children were appendicitis, typhlitis (including infarction and perforation), intussusception, intestinal obstruction, pancreatitis, and liver abscess. In addition to supportive care, including broad-spectrum antibiotics, aggressive antileukemic therapy is r e c o m m e n d e d during the postoperative period following abdominal surgery in these children. --Daniel M. Hays
Kovbcs. Acta Paediatr Acad Sci Hung 15:205-209, 1974.
The Management of Pulmonary Metastases in
NERVOUS SYSTEM