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Radiographic features of eosinophilic gastroenteritis (Allergic Gastroenteropathy) of childhood
860
Percutaneous Reestablishment of Feeding Gastrostomies.
B A. Sacks and D. J. Glotzer Surgery 85:575-576, (May), 1979. The authors present a simple way to re-estabhsh feeding gastrostomies xn patients who had previously undergone Stamm type gastrostomy which had subsequently been allowed to close. Their procedure is carried out m the x-ray department. Initially, the stomach is distended with air, either via a nasogastric tube or by the ingestion of effervescent powders. The previous scar is infiltrated with local anesthesia through all layers of the abdominal wall. A small skin incision is made at the site and a #18 Cournand needle is introduced and advanced into the stomach lumen. Proper position is ascertained by aspirating gas and is confirmed by the injection of water soluble contrast material fluoroscopically. A guide wire is then passed through the needle and is checked fluoroscopically to be coiled in the stomach. The needle is removed and successively larger dilators are passed over the wire to increase the tract size. Contrast material can he injected through each dilator to confirm position Finally, a Foley catheter with its up cut off is passed along the wire and the balloon inflated in the stomach Carefully applied, this technique may have value m certain pediatric surgicaI patients.--Eugene S. Wiener Neonatal Gastric Volvulus. J B Campbell. A JR 132.723-
725, (May), 1979 Three neonates presented with acute gastric volvulus manifested by non-bilious vomiting All three had eventration of the left hemtdtaphragm with gastric dilatauon. Barium studxes revealed gastric votvulus with obstruction at the pylorus. At surgery all three had acute mesenteroaxml volvulus without gangrene. Eight of 9 infants reported in the literature had some diaphragmaUc abnormality and 6 had mesenteroaxial. Plain films reveal gastric dilatation with a peculiar beak at the site of the d~stal twist Treatment requires immediate surgery with reduction of the volvulus, correction of predisposing condluons, gastropexy if gastric ligaments are absent or deficient, and gastrostomy. Randall W. Powell Gastric Triderrnal Teratoma in Infancy. K Mittal, G, Upad-
hyaya, J Pate/ Indian Pediatrics 15.79-81, 1978 A 13•215 benign teratoma of stomach was resected from a 3-mo-old male that presented as an enlarging mass with no other symptoms All sites of the stomach were involved in the fourteen similar cases the authors collected from the literature. They were all under 5 mo old Adequate local excision is satisfactory.--Henry Mlshalany
Pseudolymphoma in T w o Immunodeficient Children. R. C.
Brasch, S. Royal, A J. Ammann, and J. Crowe A JR 132:844-847, (May), 1979. Two patients, aged 16 mo and 10 yr, presented with immunodeficlency states first diagnosed m infancy After imtial stable courses both presented with retroperitoneal masses. The 10-yr-old girl also had findings on UGI of a large fundlc mass with evidence of lymphoid hyperplasia in the remainder of the stomach and duodenum. The 16-too-old
ABSTRACTS
presented with increasing hepatosplenomegaly and petechia. Computed tomography (CT) scans revealed large lobulated retroperitoneal masses. Both masses on histologic examination revealed benign lymphoid, hyperplasia. This condition usually occurs in the gastrointestinal tract and has not been reported in the retroperitoneum. CT scans cannot differentiate between benign and malignant lymphadenopathy thereby requiring biopsy for histologic diagnosis.--Randall W. Powell Radiographic Features of Eosinophilic Gastroenteritis (Allergic Gastroenteropathy) of Childhood. R. L. Tee~e, A, J.
Katz, H Goldman. and R M. Kettell. A JR 132:575-580, (April), 1979 Radiologic findings in eosinophilie gastroenterltis include a lacy antrum on air contrast study, nodularity of the mucosa and frequent abnormal radiographs of the small bowel Radiographic findings in patients aged 6 mo to 15 yr at diagnosis included only the lacy antrum pattern in 2 patients, antral nodularlty in 2 patients, and both findings in 1 patient. The 6-mo-old patient had an inadequate study of the antrum. None of the patients had the smooth, bald antral surface usually seen on a~r-contrast antral studies in children Resolution of these findings occurred after treatment with steroids. In the patient with a strong allergy history who develops growth retardation, abdominal pain, and diarrhea with laboratory findings of peripheral eosmophiha, proteinlosing enteropathy and iron-deficiency anemia on air contrast study of the antrum will reveal early changes seen with this dlsease.--Randall W Powell A Clinical Study of Young Infants A f t e r Small Intestinal Resection. T D. Bohane, K Haka-lkse. W. D. Biggar. J. R.
Hamilton, and D G. Gall. J Pedlatr 94:552-558, (April), 1979. The authors prospectively studied 15 infants who, before 3 mo of age, underwent resection of the small intestine-proximal in 3 infants, mid m 6, and distal in 6 Two died before I yr of age. Many required prolonged parenteral nutrition, but by 1 yr, 12 of the 13 survivors were on oral feedings only, and 7 were above the third percentile for height and weight. Development delay occurred in the early postoperative period but diminished w~th time. There was compensatory adaptation of the remaining gut, shown by improving fat and B~2 absorption and duodenal bile-salt concentrations. Bacterial contamination complicating endto-side anastomoses occurred m two cases, gastric hyperacidity in four of 12, and hyperoxaluria in eight of 14. Studies of immune competence revealed normal cellular immune function (l 1/1 I), transient hypogammaglobulinemla (2/14), hypocomplementemia (1/12), and serum autoantibodles (3/10). Thus, massive resection of the small intestine did not preclude spontaneous improvement in absorptive function, growth, and development.--George Holcomb, Jr. Congenital Ascites Due to Mesenteric Vessel Constriction Caused by i a l r o t a t i o n of the Intestines. J Herte/and P.
Volsted Pedersen Acta Paedtatr Stand 68:281-283, (February), 1979 A newborn premature girl with congenital, non-chylous ascites is presented The ascites recurred although laparocen-
Percutaneous Reestablishment of Feeding Gastrostomies.
B A. Sacks and D. J. Glotzer Surgery 85:575-576, (May), 1979. The authors present a simple way to re-estabhsh feeding gastrostomies xn patients who had previously undergone Stamm type gastrostomy which had subsequently been allowed to close. Their procedure is carried out m the x-ray department. Initially, the stomach is distended with air, either via a nasogastric tube or by the ingestion of effervescent powders. The previous scar is infiltrated with local anesthesia through all layers of the abdominal wall. A small skin incision is made at the site and a #18 Cournand needle is introduced and advanced into the stomach lumen. Proper position is ascertained by aspirating gas and is confirmed by the injection of water soluble contrast material fluoroscopically. A guide wire is then passed through the needle and is checked fluoroscopically to be coiled in the stomach. The needle is removed and successively larger dilators are passed over the wire to increase the tract size. Contrast material can he injected through each dilator to confirm position Finally, a Foley catheter with its up cut off is passed along the wire and the balloon inflated in the stomach Carefully applied, this technique may have value m certain pediatric surgicaI patients.--Eugene S. Wiener Neonatal Gastric Volvulus. J B Campbell. A JR 132.723-
725, (May), 1979 Three neonates presented with acute gastric volvulus manifested by non-bilious vomiting All three had eventration of the left hemtdtaphragm with gastric dilatauon. Barium studxes revealed gastric votvulus with obstruction at the pylorus. At surgery all three had acute mesenteroaxml volvulus without gangrene. Eight of 9 infants reported in the literature had some diaphragmaUc abnormality and 6 had mesenteroaxial. Plain films reveal gastric dilatation with a peculiar beak at the site of the d~stal twist Treatment requires immediate surgery with reduction of the volvulus, correction of predisposing condluons, gastropexy if gastric ligaments are absent or deficient, and gastrostomy. Randall W. Powell Gastric Triderrnal Teratoma in Infancy. K Mittal, G, Upad-
hyaya, J Pate/ Indian Pediatrics 15.79-81, 1978 A 13•215 benign teratoma of stomach was resected from a 3-mo-old male that presented as an enlarging mass with no other symptoms All sites of the stomach were involved in the fourteen similar cases the authors collected from the literature. They were all under 5 mo old Adequate local excision is satisfactory.--Henry Mlshalany
Pseudolymphoma in T w o Immunodeficient Children. R. C.
Brasch, S. Royal, A J. Ammann, and J. Crowe A JR 132:844-847, (May), 1979. Two patients, aged 16 mo and 10 yr, presented with immunodeficlency states first diagnosed m infancy After imtial stable courses both presented with retroperitoneal masses. The 10-yr-old girl also had findings on UGI of a large fundlc mass with evidence of lymphoid hyperplasia in the remainder of the stomach and duodenum. The 16-too-old
ABSTRACTS
presented with increasing hepatosplenomegaly and petechia. Computed tomography (CT) scans revealed large lobulated retroperitoneal masses. Both masses on histologic examination revealed benign lymphoid, hyperplasia. This condition usually occurs in the gastrointestinal tract and has not been reported in the retroperitoneum. CT scans cannot differentiate between benign and malignant lymphadenopathy thereby requiring biopsy for histologic diagnosis.--Randall W. Powell Radiographic Features of Eosinophilic Gastroenteritis (Allergic Gastroenteropathy) of Childhood. R. L. Tee~e, A, J.
Katz, H Goldman. and R M. Kettell. A JR 132:575-580, (April), 1979 Radiologic findings in eosinophilie gastroenterltis include a lacy antrum on air contrast study, nodularity of the mucosa and frequent abnormal radiographs of the small bowel Radiographic findings in patients aged 6 mo to 15 yr at diagnosis included only the lacy antrum pattern in 2 patients, antral nodularlty in 2 patients, and both findings in 1 patient. The 6-mo-old patient had an inadequate study of the antrum. None of the patients had the smooth, bald antral surface usually seen on a~r-contrast antral studies in children Resolution of these findings occurred after treatment with steroids. In the patient with a strong allergy history who develops growth retardation, abdominal pain, and diarrhea with laboratory findings of peripheral eosmophiha, proteinlosing enteropathy and iron-deficiency anemia on air contrast study of the antrum will reveal early changes seen with this dlsease.--Randall W Powell A Clinical Study of Young Infants A f t e r Small Intestinal Resection. T D. Bohane, K Haka-lkse. W. D. Biggar. J. R.
Hamilton, and D G. Gall. J Pedlatr 94:552-558, (April), 1979. The authors prospectively studied 15 infants who, before 3 mo of age, underwent resection of the small intestine-proximal in 3 infants, mid m 6, and distal in 6 Two died before I yr of age. Many required prolonged parenteral nutrition, but by 1 yr, 12 of the 13 survivors were on oral feedings only, and 7 were above the third percentile for height and weight. Development delay occurred in the early postoperative period but diminished w~th time. There was compensatory adaptation of the remaining gut, shown by improving fat and B~2 absorption and duodenal bile-salt concentrations. Bacterial contamination complicating endto-side anastomoses occurred m two cases, gastric hyperacidity in four of 12, and hyperoxaluria in eight of 14. Studies of immune competence revealed normal cellular immune function (l 1/1 I), transient hypogammaglobulinemla (2/14), hypocomplementemia (1/12), and serum autoantibodles (3/10). Thus, massive resection of the small intestine did not preclude spontaneous improvement in absorptive function, growth, and development.--George Holcomb, Jr. Congenital Ascites Due to Mesenteric Vessel Constriction Caused by i a l r o t a t i o n of the Intestines. J Herte/and P.
Volsted Pedersen Acta Paedtatr Stand 68:281-283, (February), 1979 A newborn premature girl with congenital, non-chylous ascites is presented The ascites recurred although laparocen-