malrotation (2) and unknown (1). Not less than 16 infants had other severe malformations. Two types of operations were used: duodenojejunostomy in case of intrinsic atresia and annular pancreas, correction of the intestinal situs in case of malrotation OI volvulus. One infant died before surgery, 27 \vcrc operated upon, 16 are cured and 11 died after operation.-Al. Bet&x. DLWDEYAL
DIAPHHACNATIC
OBSTHUCTIOU
WITH
.I'NEU~IOPERITONEUP.I PRESENTING
IN A ~&YEAR01.n GIRL. 0. Huse, A. Shaw and H. R. Gould. Surgery 62:530-535, September 1967.
.ll~tl cask of a I3-year-old girl suffering from con:
GAS
PEROXIDE. New Eng.
A case report of a newborn with meconium
ileus
323
in which I per cent hydrogen peroxide in saline was used to irrigate the bowel to remove inspissated meconium. During this procedure there was observed the appearance of gas bubbles in the mesenteric blood vessels. and subsequently there developed gangrene of the distal small intestine. An experimental study was then performed on dogs. When solutions of 0.75 per cent or greater concentration of hydrogen peroxide were used, ga.r was regularly seen in the mesenteric veins and lymphatics and in the portal vein. In none of the animals did mesenteric thrombosis or intestinal gangrene develop, however.-W, H. Hendnn. MEC~NIUM PLUG SYNDROME WITH AGANGLIONOSIS G. Varl Leeuwen, W. C. Riley, L. Glenn and C. Woodrtlff. Pediatrics 40:665, October 1967. Two of 8 infants with meconium plug syndrome at Missouri University Medical Center later proved to have Hirschsprung’s disease. The authors point out that all infants with the meconium ping syndrome should be carefully followed for subsequent evidence of Hirschsprung’s disease.-W. K. Sieher NEONATAL PERFORATION OF THE APPENDIX 1~ A~SOCIATIOK WITH HIRSCHSPRUNG's DISEASE, L. W. Martin and E. V. Perrin. Ann. Sllrg. 166: 799-802. November 1967. The authors report on three newborns with perforation of the appendix secondary to Hirschsprung’s disease. In two patients there were no significant inflammatory changes, while in one there was an appendiceal abscess. The authors recommend exteriorization of the cecum as the procedure of choice in the surgical management of a perforated appendix in the neonate, since all of their newborns with perforation had Hirschsprung’s disease. Rectal biopsy is performed at a later date. If no ganglion cells are found. a formal transverse or sigmoid colostomy is performed.-K. M. Schneider. A PIIIILIUIWRY EVALUATIOX OF THE RESULTS ok‘ TREATMEST OF HIHSCHSPHUNG'S DISEASE BY THF. DUHAMEL-CROB ~IODIYICATION OF THE SWE~SON PULL-THROUCA OPFHATIOS. G. U'. Dorman, T. P. l’ottekr and L. Graiuier. Ann. Surg. 166: 78%791, November 19 i7. The authors report their results following surgery with 61 patients with Hirschsprung’s disease. Thirty-one patients had a Swenson pull-through operation and 30 had the Duhamel-Grob operation. A comparison of early complications reveals 2 deaths and 6 anastamotic leaks in the Swenson series. and no deaths and 3 leaks in the DuhamelGrob series. 1,ate complications inctudinq constipation reqliirinfi ttrllgs or enemas, enterccolitis,