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Peritoneoscopy in the diagnosis of abdominal tuberculosis
206
ABSTRACTS
control within 12 mo of operation, 29 required treatment for intermittent constipation, and 7 had diarrhea. Three (who had long segment resections) had episodes of severe dehydration and electrolyte disturbance. Thirty-nine had some degree of soiling but it was severe in only nine. Anastomotic strictures had responded to dilatation in 6 patients and required reoperation in 2. Five patients with inadequate resections had been cured by secondary operations. One rectovaginal and one rectourethral fistula had occurred. Of 61 married patients, 34 have children and none of these has Hirschsprung’s disease. Absence of ejaculation has been discovered in 2 and scarring of fallopian tubes in two. Nine had some urinary incontinence but all recovered between 3 and 11 yr after the operation.-R. C. M. Cock
lmperforete Anus: A 5-30 Yr Follow-Up Prospective. W. E.
Hirschsprung’s Disease-Long-Term
Kiesewetter and J. H. IF. Chang. Prog Pediatr 121,1977.
Results in Nonoper-
ated Cases. C. M. Madsen and 0. H. Nielsen. Prog Pediatr
Surg 10:103-110.1977. The high mortality in early infancy is stressed but not discussed in this paper. Thirty patients were discovered who had not been operated on by the age of 14 yr. Five with an ultrashort segment of aganglionosis (four proven histologically) all improved in adolescence. Eight with disease extending to the middle rectum improved in late childhood and then remained symptom free except 2 who deteriorated when 20 and 30 yr of age and needed surgery. Sample radiographs of an ‘improved’ patient show huge dilatation of the colon remaining despite very slight symptoms. Of 17 patients with aganglionosis extending to the upper rectum, all had severe symptoms in childhood. In one, symptoms persisted but surgery was refused. In 6 they persisted or recurred and rectosigmoidectomy was done between 15 and 20 yr of age, 2 dying postoperatively. Four deteriorated at older ages and then required emergency operations-three of them died. Long symptom-free periods are no guarantee against late fatal complications in Hirschsprung’s disease.-R. C. M. Cook Megacolon: Long-Term F. Soave. Prog Pediatr
Results of Surgical Treatment.
Surg 10:14l-149,
lntraluminal Anastomosis: A New Approach to the Surgical Treatment of Rectal Atresia. P. Upadhyaya. Z Kinderchir
(June),
Surg 10: 11 l-
Of 248 infants born with imperforate anus, 58 died (most from other congenital anomalies, 7 from causes related to the anorectal lesion or its treatment). The 141 of 191 patients traced for follow-up had good bowel control, in 27 it was fair. There were 23 patients with poor results-al1 in Ladd and Gross type III and IV lesions, I8 type III high. Reoperation had improved continence in 12 of 13 patients who had poor control. In all, continence was achieved more slowly than in the normal child and improvement occurred in many with increasing social awareness at puberty.-R. C. M. Cook Cure of Chronic Perineal Sinus With Gluteus Maximus Flap. A. Shaw and J. W. Futrell. Surg Gynecol 420, (September), 1978.
Obstet
147:417-
Persistent drainage from a chronically infected perineal sinus cavity may be an incapacitating complication of proctectomy for inflammatory bowel disease. The operative technique which proved successful in one teenager is described in detail. The procedure was performed in 2 stages, 5 days apart. One year postoperatively the wound is healed and there are no obvious deformities of the buttock.-George Holcomb. Jr.
1978.
Mortality, early and late complications, and results 8-10 yr after operation are tabulated for the 4 main types of procedures on the basis of’data from 24 pediatric surgical centers, concerning 2058 patients. Infection, leakage, stricture and constipation improve with age, and four-fifths of patients treated by all four techniques have satisfactory bowel function after 8-10 yr. Each type of operation seems inherently satisfactory and poor results probably follow technical operative errors.-R. C. M. Cook
24:178-183,
the atretic tissues and through the distal metal tube. The wire was placed blindly using the finger as a guideline. The ball was positioned into the proximal rectal pouch by sigmoidostomy. The wire is made tense by running it around the axes of the ratchet and the ball thus squeezes the tissue against the rim of the tube. Two children, 2 days and I yr old, were treated in this way and the ball was delivered after 45 days. No constipation or severe stenosis was seen in either patient. The technique of intraluminal anastomosis described achieves the objective of restoring the rectum without interfering with the local functional anatomy.Karl-Ludwig Waag
1978.
A new simplified technique for the surgical management of rectal atresia by a newly constructed instrument is described. It consists essentially of an instrument crushing the tissues between the two pouches of the atretic segments. The instrument is constructed of a metal ball, a metal tube and a ratchet wheel. The ball is pressed against the metal tube by a stainless steel wire running from the ball through
ABDOMEN Peritoneoscopy sis.
T.
ary/March),
E.
in the Diagnosis of Abdominal Tuberculo-
Udwadia. 1978.
Ind
J
Surg
40:91-95,
(Febru-
A study of Peritoneoscopy in 29 cases of proved abdominal tuberculosis is presented. In cases with obstructive manifestations, this investigation is of little additional help, as clinical and radiological pictures are quite typical. But in cases with abdominal lump and those with ascites, peritoneoscopy can help in diagnosis of tuberculosis. Investigation is quite safe. Perforation of small bowel occurred in one case, but was immediately diagnosed and operated with uneventful recovery.-S. S. Deshmukh Abdominal Tuberculosis in Children. S. K. Mitra, K. Yadav, S. Mehta. Lata Kumar. and I. C. Pathak. Ind J Surg 40:96-100, (February/March), 1978.
This is a study of fourteen cases of abdominal tuberculosis in children. The diagnosis of abdominal tuberculosis may be difficult in the absence of tuberculosis elsewhere. The disease
ABSTRACTS
control within 12 mo of operation, 29 required treatment for intermittent constipation, and 7 had diarrhea. Three (who had long segment resections) had episodes of severe dehydration and electrolyte disturbance. Thirty-nine had some degree of soiling but it was severe in only nine. Anastomotic strictures had responded to dilatation in 6 patients and required reoperation in 2. Five patients with inadequate resections had been cured by secondary operations. One rectovaginal and one rectourethral fistula had occurred. Of 61 married patients, 34 have children and none of these has Hirschsprung’s disease. Absence of ejaculation has been discovered in 2 and scarring of fallopian tubes in two. Nine had some urinary incontinence but all recovered between 3 and 11 yr after the operation.-R. C. M. Cock
lmperforete Anus: A 5-30 Yr Follow-Up Prospective. W. E.
Hirschsprung’s Disease-Long-Term
Kiesewetter and J. H. IF. Chang. Prog Pediatr 121,1977.
Results in Nonoper-
ated Cases. C. M. Madsen and 0. H. Nielsen. Prog Pediatr
Surg 10:103-110.1977. The high mortality in early infancy is stressed but not discussed in this paper. Thirty patients were discovered who had not been operated on by the age of 14 yr. Five with an ultrashort segment of aganglionosis (four proven histologically) all improved in adolescence. Eight with disease extending to the middle rectum improved in late childhood and then remained symptom free except 2 who deteriorated when 20 and 30 yr of age and needed surgery. Sample radiographs of an ‘improved’ patient show huge dilatation of the colon remaining despite very slight symptoms. Of 17 patients with aganglionosis extending to the upper rectum, all had severe symptoms in childhood. In one, symptoms persisted but surgery was refused. In 6 they persisted or recurred and rectosigmoidectomy was done between 15 and 20 yr of age, 2 dying postoperatively. Four deteriorated at older ages and then required emergency operations-three of them died. Long symptom-free periods are no guarantee against late fatal complications in Hirschsprung’s disease.-R. C. M. Cook Megacolon: Long-Term F. Soave. Prog Pediatr
Results of Surgical Treatment.
Surg 10:14l-149,
lntraluminal Anastomosis: A New Approach to the Surgical Treatment of Rectal Atresia. P. Upadhyaya. Z Kinderchir
(June),
Surg 10: 11 l-
Of 248 infants born with imperforate anus, 58 died (most from other congenital anomalies, 7 from causes related to the anorectal lesion or its treatment). The 141 of 191 patients traced for follow-up had good bowel control, in 27 it was fair. There were 23 patients with poor results-al1 in Ladd and Gross type III and IV lesions, I8 type III high. Reoperation had improved continence in 12 of 13 patients who had poor control. In all, continence was achieved more slowly than in the normal child and improvement occurred in many with increasing social awareness at puberty.-R. C. M. Cook Cure of Chronic Perineal Sinus With Gluteus Maximus Flap. A. Shaw and J. W. Futrell. Surg Gynecol 420, (September), 1978.
Obstet
147:417-
Persistent drainage from a chronically infected perineal sinus cavity may be an incapacitating complication of proctectomy for inflammatory bowel disease. The operative technique which proved successful in one teenager is described in detail. The procedure was performed in 2 stages, 5 days apart. One year postoperatively the wound is healed and there are no obvious deformities of the buttock.-George Holcomb. Jr.
1978.
Mortality, early and late complications, and results 8-10 yr after operation are tabulated for the 4 main types of procedures on the basis of’data from 24 pediatric surgical centers, concerning 2058 patients. Infection, leakage, stricture and constipation improve with age, and four-fifths of patients treated by all four techniques have satisfactory bowel function after 8-10 yr. Each type of operation seems inherently satisfactory and poor results probably follow technical operative errors.-R. C. M. Cook
24:178-183,
the atretic tissues and through the distal metal tube. The wire was placed blindly using the finger as a guideline. The ball was positioned into the proximal rectal pouch by sigmoidostomy. The wire is made tense by running it around the axes of the ratchet and the ball thus squeezes the tissue against the rim of the tube. Two children, 2 days and I yr old, were treated in this way and the ball was delivered after 45 days. No constipation or severe stenosis was seen in either patient. The technique of intraluminal anastomosis described achieves the objective of restoring the rectum without interfering with the local functional anatomy.Karl-Ludwig Waag
1978.
A new simplified technique for the surgical management of rectal atresia by a newly constructed instrument is described. It consists essentially of an instrument crushing the tissues between the two pouches of the atretic segments. The instrument is constructed of a metal ball, a metal tube and a ratchet wheel. The ball is pressed against the metal tube by a stainless steel wire running from the ball through
ABDOMEN Peritoneoscopy sis.
T.
ary/March),
E.
in the Diagnosis of Abdominal Tuberculo-
Udwadia. 1978.
Ind
J
Surg
40:91-95,
(Febru-
A study of Peritoneoscopy in 29 cases of proved abdominal tuberculosis is presented. In cases with obstructive manifestations, this investigation is of little additional help, as clinical and radiological pictures are quite typical. But in cases with abdominal lump and those with ascites, peritoneoscopy can help in diagnosis of tuberculosis. Investigation is quite safe. Perforation of small bowel occurred in one case, but was immediately diagnosed and operated with uneventful recovery.-S. S. Deshmukh Abdominal Tuberculosis in Children. S. K. Mitra, K. Yadav, S. Mehta. Lata Kumar. and I. C. Pathak. Ind J Surg 40:96-100, (February/March), 1978.
This is a study of fourteen cases of abdominal tuberculosis in children. The diagnosis of abdominal tuberculosis may be difficult in the absence of tuberculosis elsewhere. The disease