- Email: [email protected]
Primary peritonitis in infants and children
496
the presence of Shigella dysentery may result in serious complications. Appendicitis should always be considered in any case of diarrhea with right iliac fossa pain.--W.G. Scobie
Chronic Nonspecific Inflammatory Bowel Disease of the Cecum and Proximal Colon in Children With Grossly Normal-Appearing Colonic Mucosa: Diagnosis by Colonoscopic Biopsies. M.B. Hey-
man, J.A. Perman, L.D. Ferrell, et al. Pediatrics 80:255-261, (August), 1987.
Five children with chronic abdominal pain, diarrhea, and guaiacpositive stools are presented. Laboratory studies, barium enema, and proctosigmoidoscopy were nondiagnostic in each. Following mechanical bowel preparation, each child underwent total colonoscopy with multiple biopsies. Several sections demonstrated diffuse inflammatory changes that diminished in severity from proximal to distal colon. No patient had histologic criteria diagnostic of Crohn's disease or ulcerative colitis. Each of the four patients available for followup improved with prednisone or sulfasalazine. The authors suggest that these children may represent patients in an early stage of the development of inflammatory bowel disease. Biopsies from proximal colonic segments may provide diagnostically valuable information.--J.L. Zitsman
INTERNATIONAL ABSTRACTS
authors studied the influence of the stage of differentiation in an in vivo culture system, the choriallantoic membrane. Neural crest cells in cultured gut were demonstrated with antibodies directed against the HNK-1 epitope. Enteric neurons were demonstrated with neurofilament immunoreactivity. By culturing isolated gut segments of E4 embryos, the authors obtained aneuronal (neurofilament-negative) embryonal chick gut up to 25 days of development. In cocultures of aneuronal gut and the neural anlage (neural tube and neural crest) neural crest cell colonization was observed, even in advanced stages of differentiation. The significance of the results is discussed in terms of the etiology of Hirschsprung's disease.--Prem Purl Implantation of Artificial Sphincter for Anal Incontinence. J. Chris-
tiansen and M. Lorentzen. Lancet 2:244-245, (August), 1987.
The implantation of an artificial anal sphincter in a man with severe anal incontinence and myasthenia gravis is described. The prosthesis used, an AMS 800 artificial urinary sphincter, gave the patient complete control of defecation. The technique offers the possibility of curing anal incontinence of neuromuscular origin, for which there has been no treatment until now.--Prem Purl Pelvic Abscess Drainage by the Transrectal Catheter Approach in
Men. M.A. Mauro, P.F. Jaques, V.S. Mandell et al. A JR 144:477Faecal Bile Acids, Dysplasia, and Carcinoma in Ulcerative Colitis.
479, (March), 1985.
M.J. Hill, J.E. Lennard-Jones, D.M. Melville, et al. Lancet 2:185187, (July), 1987.
Prerectal pelvic abscesses have traditionally been treated by operative transrectal incision and drainage. Since percutaneous catheter drainage has been used successfully either to definitively drain intraabdominal abscesses or to provide a temporary relief in critically ill patients, this technique was applied in conjunction with the transrectal approach to drain prerectal abscesses percutaneously under fluoroscopic control. It was successful in three male patients.
A prospective study was undertaken between 1974 and 1985 of 102 patients with extensive ulcerative colitis (UC) of more than 10 years duration. Feces were collected for measurement of fecal bile acid concentrations (FBA), and the clinical outcome was recorded. The average fecal bile acid value among the 14 patients who showed carcinoma or definite dysplasia in the excised large bowel (9.86 [SE 0.81] mg/g FBA) was higher than in the 88 patients without dysplasia or carcinoma (7.51 [0.24] mg/g). These results lend support to the theory that bile acids are causally related to colorectal cancer.--Prem Purl
Adolescent Hirschsprung's Disease. S.J. Crankson, A.A. AI Krai-
da, A.Y. lzzidien, et al. J Roy Coil Surg (Ed) 32:216-220, (August), 1987.
Two cases of adolescent Hirschsprung's disease are reported. A 13-year-old male constipated from birth presented with obstruction and a large abdominal mass that was found at laparotomy to be a calcified fecolith. Frozen section confirmed the diagnosis and a sigmoid colostomy was performed. He did very well after a Soave procedure. A 12-year-old female with chronic constipation and fecal impact/on had a transverse colostomy created after a positive rectal biopsy. She had a Swenson procedure with a good result. Barium enema and rectal biopsy are recommended in any adolescent with chronic constipation from birth. Surgical management is fully discussed.--W.G. Scobie
The Influence of the Stage of Differentiation of the Gut on the Migration of Neural Cells: An Experimental Study of Hirschsprung's Disease. J.H. Care/Me/jets, D. Tibboel, A.W.M. Van Der
ABDOMEN Primary Peritonitis in Infants and Children. S.H. E/n, G. Stringel,
and R.M. Bannatyne. Pediatr Surg Internat 2:235-237, (July), 1987.
Primary peritonitis is a diffuse inflammation of the peritoneal cavity for which there is no obvious focus of infection. During the last 15 years, at two children's hospitals, the authors have treated a total of 15 infants and children with primary peritonitis, excluding those with cirrhosis, nephrosis, or a neurosurgical ventriculoperitoneal shunt. All but one of the patients were female and 19 were between 5 and 10 years old. The presenting picture was one of short onset with high fever, vomiting, and generalized peritonitis. The infants and children were listless and toxic, and ten had white blood cell counts over 15,000. All were operated on with the diagnosis of ruptured appendicitis. The operative findings were typical in all cases: negative laparotomy, diffuse serositis, and cloudy slimy peritoneal fluid. Appendectomy without drainage was performed in each case. In this series, 14 peritoneal cultures were negative, seven grew Escherichia col/, three a streptococcal species, and one pneumococcus and meningococcus. There were no complications.--Prem Purl The Use of Ultrasonography in the Diagnosis of Biliary Atresia. T.
Kamp, et al. Pediatr Res 21:466-470, (May), 1987.
Okasora, A. Toyosaka, T. Murajij, et al. Pediatr Surg Internat 2:231-234, (July), 1987.
Based on experimental studies in mutant mouse strains, an imbalance between the rate of migration of neural crest cells and the rate of differentiation of the mesenchyme of the distal gut has been proposed as an etiologic factor in Hirschsprung's disease. The
Preoperative upper abdominal ultrasonograms of babies with biliary atresia were reviewed in order to determine the efficacy of this technique in the differential diagnosis of biliary atresia and neonatal hepatitis. In four patients with neonatal hepatitis and eight
the presence of Shigella dysentery may result in serious complications. Appendicitis should always be considered in any case of diarrhea with right iliac fossa pain.--W.G. Scobie
Chronic Nonspecific Inflammatory Bowel Disease of the Cecum and Proximal Colon in Children With Grossly Normal-Appearing Colonic Mucosa: Diagnosis by Colonoscopic Biopsies. M.B. Hey-
man, J.A. Perman, L.D. Ferrell, et al. Pediatrics 80:255-261, (August), 1987.
Five children with chronic abdominal pain, diarrhea, and guaiacpositive stools are presented. Laboratory studies, barium enema, and proctosigmoidoscopy were nondiagnostic in each. Following mechanical bowel preparation, each child underwent total colonoscopy with multiple biopsies. Several sections demonstrated diffuse inflammatory changes that diminished in severity from proximal to distal colon. No patient had histologic criteria diagnostic of Crohn's disease or ulcerative colitis. Each of the four patients available for followup improved with prednisone or sulfasalazine. The authors suggest that these children may represent patients in an early stage of the development of inflammatory bowel disease. Biopsies from proximal colonic segments may provide diagnostically valuable information.--J.L. Zitsman
INTERNATIONAL ABSTRACTS
authors studied the influence of the stage of differentiation in an in vivo culture system, the choriallantoic membrane. Neural crest cells in cultured gut were demonstrated with antibodies directed against the HNK-1 epitope. Enteric neurons were demonstrated with neurofilament immunoreactivity. By culturing isolated gut segments of E4 embryos, the authors obtained aneuronal (neurofilament-negative) embryonal chick gut up to 25 days of development. In cocultures of aneuronal gut and the neural anlage (neural tube and neural crest) neural crest cell colonization was observed, even in advanced stages of differentiation. The significance of the results is discussed in terms of the etiology of Hirschsprung's disease.--Prem Purl Implantation of Artificial Sphincter for Anal Incontinence. J. Chris-
tiansen and M. Lorentzen. Lancet 2:244-245, (August), 1987.
The implantation of an artificial anal sphincter in a man with severe anal incontinence and myasthenia gravis is described. The prosthesis used, an AMS 800 artificial urinary sphincter, gave the patient complete control of defecation. The technique offers the possibility of curing anal incontinence of neuromuscular origin, for which there has been no treatment until now.--Prem Purl Pelvic Abscess Drainage by the Transrectal Catheter Approach in
Men. M.A. Mauro, P.F. Jaques, V.S. Mandell et al. A JR 144:477Faecal Bile Acids, Dysplasia, and Carcinoma in Ulcerative Colitis.
479, (March), 1985.
M.J. Hill, J.E. Lennard-Jones, D.M. Melville, et al. Lancet 2:185187, (July), 1987.
Prerectal pelvic abscesses have traditionally been treated by operative transrectal incision and drainage. Since percutaneous catheter drainage has been used successfully either to definitively drain intraabdominal abscesses or to provide a temporary relief in critically ill patients, this technique was applied in conjunction with the transrectal approach to drain prerectal abscesses percutaneously under fluoroscopic control. It was successful in three male patients.
A prospective study was undertaken between 1974 and 1985 of 102 patients with extensive ulcerative colitis (UC) of more than 10 years duration. Feces were collected for measurement of fecal bile acid concentrations (FBA), and the clinical outcome was recorded. The average fecal bile acid value among the 14 patients who showed carcinoma or definite dysplasia in the excised large bowel (9.86 [SE 0.81] mg/g FBA) was higher than in the 88 patients without dysplasia or carcinoma (7.51 [0.24] mg/g). These results lend support to the theory that bile acids are causally related to colorectal cancer.--Prem Purl
Adolescent Hirschsprung's Disease. S.J. Crankson, A.A. AI Krai-
da, A.Y. lzzidien, et al. J Roy Coil Surg (Ed) 32:216-220, (August), 1987.
Two cases of adolescent Hirschsprung's disease are reported. A 13-year-old male constipated from birth presented with obstruction and a large abdominal mass that was found at laparotomy to be a calcified fecolith. Frozen section confirmed the diagnosis and a sigmoid colostomy was performed. He did very well after a Soave procedure. A 12-year-old female with chronic constipation and fecal impact/on had a transverse colostomy created after a positive rectal biopsy. She had a Swenson procedure with a good result. Barium enema and rectal biopsy are recommended in any adolescent with chronic constipation from birth. Surgical management is fully discussed.--W.G. Scobie
The Influence of the Stage of Differentiation of the Gut on the Migration of Neural Cells: An Experimental Study of Hirschsprung's Disease. J.H. Care/Me/jets, D. Tibboel, A.W.M. Van Der
ABDOMEN Primary Peritonitis in Infants and Children. S.H. E/n, G. Stringel,
and R.M. Bannatyne. Pediatr Surg Internat 2:235-237, (July), 1987.
Primary peritonitis is a diffuse inflammation of the peritoneal cavity for which there is no obvious focus of infection. During the last 15 years, at two children's hospitals, the authors have treated a total of 15 infants and children with primary peritonitis, excluding those with cirrhosis, nephrosis, or a neurosurgical ventriculoperitoneal shunt. All but one of the patients were female and 19 were between 5 and 10 years old. The presenting picture was one of short onset with high fever, vomiting, and generalized peritonitis. The infants and children were listless and toxic, and ten had white blood cell counts over 15,000. All were operated on with the diagnosis of ruptured appendicitis. The operative findings were typical in all cases: negative laparotomy, diffuse serositis, and cloudy slimy peritoneal fluid. Appendectomy without drainage was performed in each case. In this series, 14 peritoneal cultures were negative, seven grew Escherichia col/, three a streptococcal species, and one pneumococcus and meningococcus. There were no complications.--Prem Purl The Use of Ultrasonography in the Diagnosis of Biliary Atresia. T.
Kamp, et al. Pediatr Res 21:466-470, (May), 1987.
Okasora, A. Toyosaka, T. Murajij, et al. Pediatr Surg Internat 2:231-234, (July), 1987.
Based on experimental studies in mutant mouse strains, an imbalance between the rate of migration of neural crest cells and the rate of differentiation of the mesenchyme of the distal gut has been proposed as an etiologic factor in Hirschsprung's disease. The
Preoperative upper abdominal ultrasonograms of babies with biliary atresia were reviewed in order to determine the efficacy of this technique in the differential diagnosis of biliary atresia and neonatal hepatitis. In four patients with neonatal hepatitis and eight