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Pulmonary sequestration. Report of an unusual case and review of the literature
92
INTERNATIONAL
these cases occurred in a child, experience with this problem is small so that review was considered appropriate. Trauma accounted for 4 of 7 patients in this series. Two patients had pyogenic hepatic abscesses complicated by bronchobiliary fistulas and a seventh patient had cirrhosis secondary to Banti’s syndrome. In the latter case a bronchobiliary fistula followed liver biopsy. Early aggressive treatment by thoracotomy is recommended. Adequate subcostal drainage of the hepatic bed under direct vision is considered mandatory along with secure closure of the diaphragmatic perforation. Decortication is performed for pleurobilia and lobectomy for bronchobiliary fistula. In some cases prophylactic decompression of the biliary tree is warranted.-E. J. Berman. CLINICAL ANALYSIS OF 59 MEDIASTINAL TUMORS IN CHILDREN. W. Ch. Hecker, R. Tiiter and J. Vogt-Moykopt. Thoraxchirurgie 15:382400, Aug. 1967. Autochthonous tumors of the mediastinum (sarcomas and vascular tumors) were found to be most frequent, accounting for 35 per cent of the total. They were followed by cysts and teratomas (29 per cent) and neurogenic tumors (14 per cent). The remainder could not be classified. Age incidence showed a preponderance of teratoid tumors in infancy and of carcinomas and sarcomas in late childhood. The rate of malignancy was 25 per cent for neurogenic tumors, 27 per cent for the entire group. Presenting symptoms were cough (27 per cent), pain (14 per cent), dyspnea (12 per cent) and fatigue (12 per cent). No complaints were present in 17 per cent. The diagnosis was made by x-ray examination including angiocardiography. Percutaneous needle biopsy was felt not to be indicated. Forty-eight tumors could be totally removed by operation. Four patients died during the immediate postoperative period. Fourteen were lost later due to metastasis. Thirty-seven patients are living and well, among them 3 operated for sympathicoblastoma and 3 for sarcoma.-E. H. Farthmann. OBSTRUCTIVE LOBAR E~~PHYSE~~A OF THE NEWBORN INFANT. G. F. Murray, J. 0. Talbert and J. Alex Huller. J. Thorac. Cardiov. Surg. 53:886, June 1967. Presented was a case of a newborn infant who had a mucous plug obstructing the right main stem bronchus without deformity in the cartilage or surrounding structures. A bronchotomy was performed and the plug was removed, with return of the lung to normal condition; whereas a lobectomy
ABSTBACXS
is usually required physema. A search of a mucous plug, preserved.-W. L.
OF
PEDLATRIC
SURCERY
in cases of congenital lobar emshould be made for possibility in which case the lung can be Riker.
CONGENITAL LOBAR E&ipHySEhIA AND CYSTIC PUL~IONARY DISEASE IN CHILDHOOD. H. Briigger. Padiat. Prax. 6:409-422, 1967. Congenital pulmonary lobar emphysema is frequently caused by developmental failure of cartilage formation in the peripheral bronchial branches. Further etiological factors can consist in extrabronchial compression. as by vascular anomalies. Symptoms may present as soon as in the first days or weeks of life with dyspnea, cyanosis and cough. Usually one of the upper or the right middle lobe is involved. Tension emphysema and shifting of the mediastinum may occur. With progression of this condition surgical intervention and removal of the involved part of the lung is necessary. Pulmonary cysts are acquired or congenital. Pneumatoceles may be sequellae of a pneumonia and usually disappear, while congenital cysts (solitary cysts, bronchogenic cysts, polycytic lungs) are developmentally preformed. Differential diagnoses is often decided by course and histology.-W. Leuterer. PULXONARY SEQUESTRATION. REPORT OF AS UNUSUAL CASE AND REVIEW OF THE LITERATURE. ATY Blesonsky. Thorax 22:351-357. July 1967. A cystic sequestration of the left lung with no systemic vascular connection prompted the author to conclude from a review of the literature that intra- and extra-lobar sequestrations are variations of the same abnormality and the presence of the systemic artery indicated another associated anomaly. The pathogenesis of the lesion rests with abnormal branchial and foregut budding due to failure of normal embryonic “organizer” control--W. K. Sieber. IDIOPATHIC PUL?rlOxAHY I~E~IOSIUIXROSIS.CLINICAL, RADIOLOGICAL, AND RESPIRATORY FUNCTION STUDIES. G. Repetto, C. L&boa, E. Emparansa, R. Ferretti, M. Neira, M. Etchart and J. Menghello. Pediatrics 40:24-31, July 1967. A review of 11 children with proved idiopathic pulmonary hemosiderosis is presented. The onset of the disease varied from 9 months to I3 years. Nine were girls and 2 were boys. Iron-deficiency anemia, recurrent hemoptysis, and in advanced cases clubbing of the fingers, and right ventricular hypertrophy as indicated by electrocardiographic tracings, were noted. Five of these 11 children are
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these cases occurred in a child, experience with this problem is small so that review was considered appropriate. Trauma accounted for 4 of 7 patients in this series. Two patients had pyogenic hepatic abscesses complicated by bronchobiliary fistulas and a seventh patient had cirrhosis secondary to Banti’s syndrome. In the latter case a bronchobiliary fistula followed liver biopsy. Early aggressive treatment by thoracotomy is recommended. Adequate subcostal drainage of the hepatic bed under direct vision is considered mandatory along with secure closure of the diaphragmatic perforation. Decortication is performed for pleurobilia and lobectomy for bronchobiliary fistula. In some cases prophylactic decompression of the biliary tree is warranted.-E. J. Berman. CLINICAL ANALYSIS OF 59 MEDIASTINAL TUMORS IN CHILDREN. W. Ch. Hecker, R. Tiiter and J. Vogt-Moykopt. Thoraxchirurgie 15:382400, Aug. 1967. Autochthonous tumors of the mediastinum (sarcomas and vascular tumors) were found to be most frequent, accounting for 35 per cent of the total. They were followed by cysts and teratomas (29 per cent) and neurogenic tumors (14 per cent). The remainder could not be classified. Age incidence showed a preponderance of teratoid tumors in infancy and of carcinomas and sarcomas in late childhood. The rate of malignancy was 25 per cent for neurogenic tumors, 27 per cent for the entire group. Presenting symptoms were cough (27 per cent), pain (14 per cent), dyspnea (12 per cent) and fatigue (12 per cent). No complaints were present in 17 per cent. The diagnosis was made by x-ray examination including angiocardiography. Percutaneous needle biopsy was felt not to be indicated. Forty-eight tumors could be totally removed by operation. Four patients died during the immediate postoperative period. Fourteen were lost later due to metastasis. Thirty-seven patients are living and well, among them 3 operated for sympathicoblastoma and 3 for sarcoma.-E. H. Farthmann. OBSTRUCTIVE LOBAR E~~PHYSE~~A OF THE NEWBORN INFANT. G. F. Murray, J. 0. Talbert and J. Alex Huller. J. Thorac. Cardiov. Surg. 53:886, June 1967. Presented was a case of a newborn infant who had a mucous plug obstructing the right main stem bronchus without deformity in the cartilage or surrounding structures. A bronchotomy was performed and the plug was removed, with return of the lung to normal condition; whereas a lobectomy
ABSTBACXS
is usually required physema. A search of a mucous plug, preserved.-W. L.
OF
PEDLATRIC
SURCERY
in cases of congenital lobar emshould be made for possibility in which case the lung can be Riker.
CONGENITAL LOBAR E&ipHySEhIA AND CYSTIC PUL~IONARY DISEASE IN CHILDHOOD. H. Briigger. Padiat. Prax. 6:409-422, 1967. Congenital pulmonary lobar emphysema is frequently caused by developmental failure of cartilage formation in the peripheral bronchial branches. Further etiological factors can consist in extrabronchial compression. as by vascular anomalies. Symptoms may present as soon as in the first days or weeks of life with dyspnea, cyanosis and cough. Usually one of the upper or the right middle lobe is involved. Tension emphysema and shifting of the mediastinum may occur. With progression of this condition surgical intervention and removal of the involved part of the lung is necessary. Pulmonary cysts are acquired or congenital. Pneumatoceles may be sequellae of a pneumonia and usually disappear, while congenital cysts (solitary cysts, bronchogenic cysts, polycytic lungs) are developmentally preformed. Differential diagnoses is often decided by course and histology.-W. Leuterer. PULXONARY SEQUESTRATION. REPORT OF AS UNUSUAL CASE AND REVIEW OF THE LITERATURE. ATY Blesonsky. Thorax 22:351-357. July 1967. A cystic sequestration of the left lung with no systemic vascular connection prompted the author to conclude from a review of the literature that intra- and extra-lobar sequestrations are variations of the same abnormality and the presence of the systemic artery indicated another associated anomaly. The pathogenesis of the lesion rests with abnormal branchial and foregut budding due to failure of normal embryonic “organizer” control--W. K. Sieber. IDIOPATHIC PUL?rlOxAHY I~E~IOSIUIXROSIS.CLINICAL, RADIOLOGICAL, AND RESPIRATORY FUNCTION STUDIES. G. Repetto, C. L&boa, E. Emparansa, R. Ferretti, M. Neira, M. Etchart and J. Menghello. Pediatrics 40:24-31, July 1967. A review of 11 children with proved idiopathic pulmonary hemosiderosis is presented. The onset of the disease varied from 9 months to I3 years. Nine were girls and 2 were boys. Iron-deficiency anemia, recurrent hemoptysis, and in advanced cases clubbing of the fingers, and right ventricular hypertrophy as indicated by electrocardiographic tracings, were noted. Five of these 11 children are