Noble plication in childhood intestinal obstruction

ill

i,

highu

lx~rcentap

of resection

ptit9,ts l,,,t has prqrf+

,nortalit\~

following

confirmetl

the need for rpsectinn.

sivel!. ciecreascti(to 0 in the pst 5 years). I Iistologic st,,dies of the infarcted Imwc*l I’osti,if;c,,c\ i,,tc3ti,,;d the i,npctio,, of thr feces in cliiltlr~n with first 19k5. Officr

n,a,i:~g~,rit~,it

of

tlio,,gh

,,,inccc~ptal~lt~

tho,,ght c,,,rrent

possibl\~ to 1~ a factor in the trend tow;,rtl :I ,,,or(’ lxolongc~tl

c(,,,rsca

to

the

ar,thors.

W;I<

l,osl)italizntion.--Rolcc,r,(~

lV?fOW

tlescrilxd

I)\, M’isslcr.

Thirt!

-five; c’;,ses ha\~

I>,,t with

int,,ss,,scc~ptio,,,

with

a,i inrrcasing

c\xtic

filxosis

the nr,,nlxr ol)strr,ction thr

ol,str,,ctio,, (1,~ to small I~owc~l u.ith c\stic fibrosis was

will is

newl,or,,

;~ntl Zollinger

,i,,,trbcr

s,,rviving increasr.

\;i,,iilikr ant1 for

of childrul

,,,e’c.o,,i,,,,, The

to this

i,,

IW~W rcyortc,tl

c’a,,se

il(a,,s of tht*

that sc’cn it, reason ~c’,~sv,I

has rcferrcd to the conditio,, as “,,,ec~oni,,,rr ilc,,s eq,,ivalent. Of 2.50 patients with V! die

S/‘C”““’

fil)rosis mrconi,mi ilr,,s rcl,,ix3knt occ,,rrrtl 7 times in 6 children. Two of these lx,tic~,,ts hat1 ,~icco,~i,,,~,

Atr~cmg 5

\vere

I,,

3

1.5 infants found

cases

ha\,i,ig

with the

chronic

cx,,sc’

I\ ,,~l’l”‘s”r’.o,l,;1. 011C~ c,,retl by hc,,,icolc~ton,~)

int,,ss,,sceptio,r

ol~str,,ctio,i

invngin;,tion.

was ol,vio,,s: lic’n,iingio,l,;l

on? (lx,tli

ad one Rlrcliel’s of the tlivrrticnlum (c,,rctl l,\, resrctio,, InttcT). In 2 (‘;,sc‘s 110 r&m WilS fOll,,d. Roth h;,tl sc\~cqxl attacks of int,,ss,,s~c.ption with ~lxmtanco,,s rc,tl,,ction l,vforr opation ,,rcrss;,ry. In these ci,~t’s. :lfter opxtivc~ tl,,ctio,,. fi\-ation of the. ce’c,,,n ;mtl plication of the lower part of the No f,,rther attacks \v;,b performrd. ol,scWrtl.--B. R~~i.sr,,clrl,l

ilr,,s

at I)irth,

onto of who,,l

was treated srqicnllv. Signifknt ,,plx’, rcspirator!~ tract infcLtions prccetl(~tl the, dren

had

i,l 3 of the not l,ee,,

7 c;W2b ;i,,tl F; chil-

rrc?ii%,g

pncx,tic

sup

plemmt. The cme patient treatctl s,,rgic,all! was thoqht to lia\,r al’l)entli~itis.-~d,(~llr[l .J. Hcrnfcm

was reKohl? ile,,,,, were

The SC\ cnth rcprtcd c’i,stJ of :,,I i,lf;l,rt sr,rvi\ ing 3 lx~rforatio,, of th(h Iargts Ixnz’el is descrild. This ,,,dr infant weighed 8 l~omds 5 o,,,ices at birth and was operatcxl ,,lxm

with

a tli;,gnosi~

of perforatrtl

visc,,s

at 36 hours of agr at which tinrp ;I puforation of the trmrsversr colon apprcntly pro~i,nal to ;, ,i,t~c.o,,i,mi pl,,g was fo,,,,tl Aftrr

;d~lo,~ri,ral

opxltio,,.

tr;mm;,

or

i,illa,~i,n~~tio,~ there is alw;l\s the possil~ilit~ of atlhcsions. To prr\‘uit rec,,rri,,g olxtrnction ant1 reptccl operations. plicatio,, of the intestind loops after Nol,le is s,,ggestctl: the technic is tlcscrild ant1 pcrs~,nal cilS?‘b are presrntctl. ,4ftu tlissc~ctitni of thr atlht~the intestinr is folclrtl into si1.c intcstine IOOl’S of 10 to 15 cm,. length :1,1cl the pr”lICI I~rmnchcs arc s,,turetl together. The last loop of tlic ileruni is fixed to the ccc’,,,,,. Whl ;,tlhrsio,r~ arr to lx, cq~rctctl prophylactic ant1 partial plicatio,, ma! I)? tlonc.---W. Lcirtmv

‘lb distal col~ni w:ls tlilatetl with sdinc Thr perforation in the transvc~rse colon \vns closed with sill; invuting s,,t,,rcs mntl no colostomy or drninage was lxdormd. The patient rcurvercatl. Tlrc, 6 lxcvio,,sh reporkd c;iscs are listctl togcthrr with il jiht ot tilt, \xriorls c31w3 of lxdor;,tio,, of the large l~owrl in neonatrs.-.~c,ri[Ic K. C0r,f,oJl~~