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Spontaneous rupture of the intestine in the newborn
author assumes there is in addition a biologic basis such as a hemophilic tendency. In support of this he quotes the fact that 70 per cent of these hemorrhages occurred in male babies. Clinically the different forms of hemorrhage in the chest aurl abdomen are identical. Most children which survive the first 12 hours appear fairly normal for a number of days. Then they suddrnly l~~ome ill and die within a felv hours without presenting any local physical signs. In some cases, however: there are premonitory symptoms and a. diagnosis can bc mndc. Treatment is usually of no avail. J. P. GREESRILL.
Goldzieher Am.
and Greenwald:
J. Dis.
Child.
36:
Hemorrhage 3, 1925.
of
Suprarenals
in the Newborn
Infant.
Hemorrhages into the suprarenals are commonly found in autopsies on young infants, but only in few instances of sufficient degree to account for clinical phenomena. Diagnosis of the condition during life has been reported only once before. The authors present txo cases in newborn infants, diagnosed in vitam, with complete case reports, both treated with intravenous and subcutaneous injections of the cortical hormone, one case surviving. The authors feel that suprarennl hemorrhage can be diagnosed from the following symptoms : Sudden onset of high tempcratcre, rapid breathing, palpable tumor iu the abdomen and punctiform purpuric l~cmorrlu~ges of the skin or mucous membranes. Exsanguination or intestiual obstruction may justify surgical intervention; otherwise patients with symptoms of acute cortical insuficiency should be treated by continued administration of the corticnl hormone. S. E. PESETRIG.
Naujoks,
II. : The Etiology
of Cephalhematoma.
Arch.
f. Gynak.
136:
123,
1939.
The author attempted to produce a eephalhematom:~ by applying mechanical suction to an area 40 mm. in diameter on the scalp of a newborn infant n-hich had just died. After a few moments of contiuuous suctiou there resulted a projection of the scalp over the area involved. Section through this area showed an . cpipcrlosteal hematoma with edema of the scalp but no ccphalhematoma. He then repeated the experiment with another nelvly born but dead infant and produced the suction hcmatoma on one side of the head. On the opposite side’ of the head he produced trauma by applying strong pressure with a blunt .instrument followed The suction alone again produced an cpiperiosteal hemorrhage by the suction. while the suction plus the pressure produced a cephalhenmton~a. The author concludes therefore that the tangential force acting on the fetal head is of primary Stasis and suction are only importance in the production of the cepll:~lhe~~~ntom:~. of secondary importance. RALPH
Russell, Thomas: Spontaneous M. A. 90: 1431, 1925.
Rupture
of the Intestine
A.
in the Newborn.
IZEIS.
J. A.
A careful search of the literature revcnls twenty-two cases of rupture of the intestine in the newborn. In Bvo cases the rupture occurred duriug intrauterine life, as evidenced by the presence of well-organized ;rdlmsiuns and inspissated bile. In fourteen cases rupture happened duriug birth, whereas in four during or soon after birth as a complication of imperforate anus or rectum. A progressive distention of the abdomen was the predominating symptom, being well marked in most cases. All cases except one were reported in the German language. All observa-
REVIEWS
AND
889
ABSTRBCTS
tions are based on postmortem findings. The condition probably occurs more frequently than one would suppose from the small number of cases reported, and should be recognized by the clinicians as a pathologic entity. GROVER LIESE.
Sysak, N., and Wilfand, Med.
Klin.
23:
1452,
In recent years much Karrer “necrosis of the cutaneous induration of due to birth trauma such attempts at resuscitation. first few days of life as over these nodules and These areas of hardeniug extremities, the thorax, almost completely after
Necrosis of the Subcutaneous
R.:
Fat
in
the
Newborn.
1027.
has been written about a syndrome called by Bernheim subcutaneous fat in the newborn” and by Marfan “curable The disease is the newborn due to obstetrical trauma.” as compression by forceps or contracted pelvis or to violent The clinical manifestations usually appear during the The skin subcutaneous ,nodules or placques of varying sizes. placques is red, hard, immovable and cannot be folded. are found on the cheeks, the chin, the jaw, the upper the back, the shoulders and the hips, and they disappear an interval of time.
The authors report a case in mhieh the symptoms appeared for the first time on the ninth day. In this case a moderate hypercholesterinemia was found (0.18 per cent). Histologic examination showed that the hard nodules were nests of lipoidcontaining, pseudoxanthomatous cells of various sizes, giant cells, large fat cells and masses of calciiied soaps. Many authors still consider this disease identical with sclcroderma but whereas some of the clinical manifestations are similar, the histological pictures are different. Furthermore this illness has a good prognosis whereas scleroderma is not completely curable. The authors believe the cause of these hard nodules is to be found in a disturbance of cholesterin metabolism in the form of a hypercholesterinemia. They do not believe that areas of necrosis first arise and are then follo\J-ed by inflammatory changes which are stimulated by the trauma of labor but they believe that in cholesterinophiIe ehildren, birth trauma acts as a stimulus to the collection of eholesterin in macrophages in the subcutaneous tissue. The authors suggest the name “subcutaneous pseudoxanthomatosis of the nelvborn ” for the condition. J. P. GREENIIILL.
Books THE PUERPERIUM. wives board, etc., etc. London. TUMEURS 15 planches THE Housed Cuthbert
hors
SOLIDES texte.
Received
By C. Nepean Second edition.
DE Gaston
Langridge, Allard &
Son
examiner & West
L’OVAIRE. Par Dr. J. Luis E. Doin 7 Cie, editeurs, Paris, 1931.
LOCEYER COLLECTION of obstetric and in the Charing Cross Hospital Medical School. H. J. Loekyer. John Bale, Sons &I Danielson,
to central Newman,
midLtd.,
de Mora.
A ret
gynaecological Catalogue Ltd., London,
specimens. prepared by 1930.
OPERATIVE GYNECOLOGY. By Harry Sturgeon Crossen, professor of clinical gynecology, Washington University School of Medicine, etc., etc., and Robert James Crossen, instructor in clinical gynecology and obstetrics. Fourth edition, containing 1246 illustrations and 2 color plates. The C. V. Mosby Co., St. Louis, 1930.
Goldzieher Am.
and Greenwald:
J. Dis.
Child.
36:
Hemorrhage 3, 1925.
of
Suprarenals
in the Newborn
Infant.
Hemorrhages into the suprarenals are commonly found in autopsies on young infants, but only in few instances of sufficient degree to account for clinical phenomena. Diagnosis of the condition during life has been reported only once before. The authors present txo cases in newborn infants, diagnosed in vitam, with complete case reports, both treated with intravenous and subcutaneous injections of the cortical hormone, one case surviving. The authors feel that suprarennl hemorrhage can be diagnosed from the following symptoms : Sudden onset of high tempcratcre, rapid breathing, palpable tumor iu the abdomen and punctiform purpuric l~cmorrlu~ges of the skin or mucous membranes. Exsanguination or intestiual obstruction may justify surgical intervention; otherwise patients with symptoms of acute cortical insuficiency should be treated by continued administration of the corticnl hormone. S. E. PESETRIG.
Naujoks,
II. : The Etiology
of Cephalhematoma.
Arch.
f. Gynak.
136:
123,
1939.
The author attempted to produce a eephalhematom:~ by applying mechanical suction to an area 40 mm. in diameter on the scalp of a newborn infant n-hich had just died. After a few moments of contiuuous suctiou there resulted a projection of the scalp over the area involved. Section through this area showed an . cpipcrlosteal hematoma with edema of the scalp but no ccphalhematoma. He then repeated the experiment with another nelvly born but dead infant and produced the suction hcmatoma on one side of the head. On the opposite side’ of the head he produced trauma by applying strong pressure with a blunt .instrument followed The suction alone again produced an cpiperiosteal hemorrhage by the suction. while the suction plus the pressure produced a cephalhenmton~a. The author concludes therefore that the tangential force acting on the fetal head is of primary Stasis and suction are only importance in the production of the cepll:~lhe~~~ntom:~. of secondary importance. RALPH
Russell, Thomas: Spontaneous M. A. 90: 1431, 1925.
Rupture
of the Intestine
A.
in the Newborn.
IZEIS.
J. A.
A careful search of the literature revcnls twenty-two cases of rupture of the intestine in the newborn. In Bvo cases the rupture occurred duriug intrauterine life, as evidenced by the presence of well-organized ;rdlmsiuns and inspissated bile. In fourteen cases rupture happened duriug birth, whereas in four during or soon after birth as a complication of imperforate anus or rectum. A progressive distention of the abdomen was the predominating symptom, being well marked in most cases. All cases except one were reported in the German language. All observa-
REVIEWS
AND
889
ABSTRBCTS
tions are based on postmortem findings. The condition probably occurs more frequently than one would suppose from the small number of cases reported, and should be recognized by the clinicians as a pathologic entity. GROVER LIESE.
Sysak, N., and Wilfand, Med.
Klin.
23:
1452,
In recent years much Karrer “necrosis of the cutaneous induration of due to birth trauma such attempts at resuscitation. first few days of life as over these nodules and These areas of hardeniug extremities, the thorax, almost completely after
Necrosis of the Subcutaneous
R.:
Fat
in
the
Newborn.
1027.
has been written about a syndrome called by Bernheim subcutaneous fat in the newborn” and by Marfan “curable The disease is the newborn due to obstetrical trauma.” as compression by forceps or contracted pelvis or to violent The clinical manifestations usually appear during the The skin subcutaneous ,nodules or placques of varying sizes. placques is red, hard, immovable and cannot be folded. are found on the cheeks, the chin, the jaw, the upper the back, the shoulders and the hips, and they disappear an interval of time.
The authors report a case in mhieh the symptoms appeared for the first time on the ninth day. In this case a moderate hypercholesterinemia was found (0.18 per cent). Histologic examination showed that the hard nodules were nests of lipoidcontaining, pseudoxanthomatous cells of various sizes, giant cells, large fat cells and masses of calciiied soaps. Many authors still consider this disease identical with sclcroderma but whereas some of the clinical manifestations are similar, the histological pictures are different. Furthermore this illness has a good prognosis whereas scleroderma is not completely curable. The authors believe the cause of these hard nodules is to be found in a disturbance of cholesterin metabolism in the form of a hypercholesterinemia. They do not believe that areas of necrosis first arise and are then follo\J-ed by inflammatory changes which are stimulated by the trauma of labor but they believe that in cholesterinophiIe ehildren, birth trauma acts as a stimulus to the collection of eholesterin in macrophages in the subcutaneous tissue. The authors suggest the name “subcutaneous pseudoxanthomatosis of the nelvborn ” for the condition. J. P. GREENIIILL.
Books THE PUERPERIUM. wives board, etc., etc. London. TUMEURS 15 planches THE Housed Cuthbert
hors
SOLIDES texte.
Received
By C. Nepean Second edition.
DE Gaston
Langridge, Allard &
Son
examiner & West
L’OVAIRE. Par Dr. J. Luis E. Doin 7 Cie, editeurs, Paris, 1931.
LOCEYER COLLECTION of obstetric and in the Charing Cross Hospital Medical School. H. J. Loekyer. John Bale, Sons &I Danielson,
to central Newman,
midLtd.,
de Mora.
A ret
gynaecological Catalogue Ltd., London,
specimens. prepared by 1930.
OPERATIVE GYNECOLOGY. By Harry Sturgeon Crossen, professor of clinical gynecology, Washington University School of Medicine, etc., etc., and Robert James Crossen, instructor in clinical gynecology and obstetrics. Fourth edition, containing 1246 illustrations and 2 color plates. The C. V. Mosby Co., St. Louis, 1930.