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Surgical technique for the prevention of recurrent intussusception in childhood
ABSTRACTS
Miller, B. M. Rodgers, et al. J Surg Res 28:39-43, (January), 1980. Three groups of piglets were studied regarding fasting and postprandial changes in serum gastrin levels with and without antrectomies. Group A contained eight piglets aged 4-11 days with a mean weight of 1.94 kg who had gastrin levels drawn through a central venous line while fasting and after orogastric introduction of Sustagen providing 1.7 g protein/kg. Group B contained six piglets aged 14-28 days with a mean weight of 3.2 kg. They were tested in a similar manner. Group C contained seven piglets matched to the animals in Group B. They underwent generous antrectomies and were subsequently fed Sustagen through a duodenal tube. Fasting and postprandial gastrin levels were measured. The older piglets without antrectomies demonstrated higher fasting and postprandial gastrin levels than the younger piglets and the piglets that had undergone antrectomies. The younger piglets also demonstrated a relative hypergastrinemia to levels in pigs six months of age and older. Low values found in animals without antrums confirm the fact that the gastric antrum is the source of serum gastrin. These findings parallel those observed in human neonates and suggest that the piglet is a suitable model for studying neonatal gastrin physiology.--Jane F. Goldthorn Apple Peel Small Bowel. G. Clerc, P. Mathieu, J. Bientz, et
al. Chir Pddiatr 20:191-195, (May-June), 1979. Two cases of "apple peel" small bowel syndrome, a relatively rare type of jejunal atresia with poor prognosis, are presented. Various other names have been used, such as, "Christmas Tree," "Maypole," "meso en queue de cochon" to describe this abnormality, in which a very narrow small intestine is wound, cork-screw fashion around a short, poorly vascularized mesentery. This segment may be long and non-functional, requiring resection. Frequent cause of death is ischemia of the bowel and anastomotic necrosis. A hypothetical pathophysiologic basis is discussed.--J. Deevey Enhancement of Ileal Adaptation by Prednisolone A f t e r Proximal Small Bowel Resection in the Rat. J. Scott, R. M.
Batt, T. J. Peters. Gut 20:858-864, (October), 1979. The authors studied the effect of prednisolone on the adapted ileum of the rat after jejunal resection. Three weeks after 50% proximal small bowel resection the test rats were fed pharmacologic doses of soluble prednisolone (0.75 mg/kg/day) for 1 wk and killed at 4 wk. Treated animals showed significant increases in three brush border enzymes per unit length of intestine compared with control groups. There was significant enhancement of brush border enzyme activity per milligram of epithelial cell DNA, and there was a similar increase of enterocyte R N A content. Cell proliferation was not stimulated by prednisolone. Thus, prednisolone can selectively enhance brush border digestive capacity after intestinal resection in the rat without increasing cell proliferation. If these observations can be extended to man, prednisolone may be of short term value in the short bowel syndrome.--Peter Gornall Surgical Technique for the Prevention of Recurrent Intussusception in Childhood. J. D. Burrington. Surg Gynecol
Obstet 150:573-574, (April), 1980.
699
In an attempt to reduce or eliminate recurrences following operative reduction of intussusception, the author described a technique to fix the terminal part of the ileum to the cecum and minimize its mobility. Thirty-seven patients have been observed from 6 wk to 6 yr using this procedure and there have been no recurrences observed.--George Holcomb, Jr. Transition From an Intrauterine Intussusception to an Intestinal Atresia. S. Asano, T. Wada, T. Kawanaka, et al.
Z. Kinderchir 28:43-47, (September), 1979. A male newborn with ileal atresia is presented. From the histologic finding of the specimen several conclusions can be drawn: An intussusception without any leading point can occur at any time during the prenatal period. The cause of intestinal atresia can be an intrauterine intussusception as demonstrated in this case by histology, in all patients with intestinal atresia serial sections of the specimen are essential.--Karl-Ludwig Waag Constipation in t h e Child. Y. Revillon, B. Jehannin, P. Arhan, et al. Chir P6diatr 20:181-184, (May-June), 1979.
A review of 102 children, 68% male and 37% female between the ages of 2 yr and 14 yr with constipation is studied with regard to (1) stool patterns compared to patients with Hirschsprung's Disease, (2) study of cases classified as "anorganic" constipation, (3) investigation of "false" incontinence corresponding to soiling with a full rectum, (4) patients presenting with a "pseudo-surgical" acute abdomen or "pseudo-tumor." The authors conclude that (1) constipation in children appears at a much earlier age than previously thought, (2) a modified anorectal sensitivity is present in constipated children allowing more rectal distention than normal, (3) the activity of the sphincter (by manometry) is different in constipated and normal children, (4) data from these children resembles that of some M M C cases where a permanent increase in sphincter activity causes the fecal bolus to remain high in the rectum.--J. Deevey Pickrell's Gracilis Muscle Transplantation and Its Effects on Anorectal Continence. A Five Year Prospective Study.
A. M. Holschneider, J. P~sehel, H. Kraeft, et al. Z Kinderchir 27:135-143, (June), 1979. There were 33 patients with a gracilis muscle transplantation and 21 children with a high imperforate anus studied clinically and electromanometrically in a 5-yr prospective study. Clinically, 14 children became clean after muscle transplantation, 10 continued soiling under stress and in 9 patients there was no improvement. Manornetrically a normal continence or a continence grade 1 could be shown in 25 patients after Pickrell's operation. 8 patients had poor results or remained incontinent.--Karl Ludwig Waag Colonic Muscle Autografts for Treatment of Anal Incontinence. E. Schmidt and H.-P. Bruch. Z Kinderchir 27:187-
190, (June), 1979. A new procedure for the treatment of anal incontinence is presented. Free transplantation of the muscle layer of the large gut can produce continence replacing the internal anal sphincter. The advantage of smooth muscle as an ideal
Miller, B. M. Rodgers, et al. J Surg Res 28:39-43, (January), 1980. Three groups of piglets were studied regarding fasting and postprandial changes in serum gastrin levels with and without antrectomies. Group A contained eight piglets aged 4-11 days with a mean weight of 1.94 kg who had gastrin levels drawn through a central venous line while fasting and after orogastric introduction of Sustagen providing 1.7 g protein/kg. Group B contained six piglets aged 14-28 days with a mean weight of 3.2 kg. They were tested in a similar manner. Group C contained seven piglets matched to the animals in Group B. They underwent generous antrectomies and were subsequently fed Sustagen through a duodenal tube. Fasting and postprandial gastrin levels were measured. The older piglets without antrectomies demonstrated higher fasting and postprandial gastrin levels than the younger piglets and the piglets that had undergone antrectomies. The younger piglets also demonstrated a relative hypergastrinemia to levels in pigs six months of age and older. Low values found in animals without antrums confirm the fact that the gastric antrum is the source of serum gastrin. These findings parallel those observed in human neonates and suggest that the piglet is a suitable model for studying neonatal gastrin physiology.--Jane F. Goldthorn Apple Peel Small Bowel. G. Clerc, P. Mathieu, J. Bientz, et
al. Chir Pddiatr 20:191-195, (May-June), 1979. Two cases of "apple peel" small bowel syndrome, a relatively rare type of jejunal atresia with poor prognosis, are presented. Various other names have been used, such as, "Christmas Tree," "Maypole," "meso en queue de cochon" to describe this abnormality, in which a very narrow small intestine is wound, cork-screw fashion around a short, poorly vascularized mesentery. This segment may be long and non-functional, requiring resection. Frequent cause of death is ischemia of the bowel and anastomotic necrosis. A hypothetical pathophysiologic basis is discussed.--J. Deevey Enhancement of Ileal Adaptation by Prednisolone A f t e r Proximal Small Bowel Resection in the Rat. J. Scott, R. M.
Batt, T. J. Peters. Gut 20:858-864, (October), 1979. The authors studied the effect of prednisolone on the adapted ileum of the rat after jejunal resection. Three weeks after 50% proximal small bowel resection the test rats were fed pharmacologic doses of soluble prednisolone (0.75 mg/kg/day) for 1 wk and killed at 4 wk. Treated animals showed significant increases in three brush border enzymes per unit length of intestine compared with control groups. There was significant enhancement of brush border enzyme activity per milligram of epithelial cell DNA, and there was a similar increase of enterocyte R N A content. Cell proliferation was not stimulated by prednisolone. Thus, prednisolone can selectively enhance brush border digestive capacity after intestinal resection in the rat without increasing cell proliferation. If these observations can be extended to man, prednisolone may be of short term value in the short bowel syndrome.--Peter Gornall Surgical Technique for the Prevention of Recurrent Intussusception in Childhood. J. D. Burrington. Surg Gynecol
Obstet 150:573-574, (April), 1980.
699
In an attempt to reduce or eliminate recurrences following operative reduction of intussusception, the author described a technique to fix the terminal part of the ileum to the cecum and minimize its mobility. Thirty-seven patients have been observed from 6 wk to 6 yr using this procedure and there have been no recurrences observed.--George Holcomb, Jr. Transition From an Intrauterine Intussusception to an Intestinal Atresia. S. Asano, T. Wada, T. Kawanaka, et al.
Z. Kinderchir 28:43-47, (September), 1979. A male newborn with ileal atresia is presented. From the histologic finding of the specimen several conclusions can be drawn: An intussusception without any leading point can occur at any time during the prenatal period. The cause of intestinal atresia can be an intrauterine intussusception as demonstrated in this case by histology, in all patients with intestinal atresia serial sections of the specimen are essential.--Karl-Ludwig Waag Constipation in t h e Child. Y. Revillon, B. Jehannin, P. Arhan, et al. Chir P6diatr 20:181-184, (May-June), 1979.
A review of 102 children, 68% male and 37% female between the ages of 2 yr and 14 yr with constipation is studied with regard to (1) stool patterns compared to patients with Hirschsprung's Disease, (2) study of cases classified as "anorganic" constipation, (3) investigation of "false" incontinence corresponding to soiling with a full rectum, (4) patients presenting with a "pseudo-surgical" acute abdomen or "pseudo-tumor." The authors conclude that (1) constipation in children appears at a much earlier age than previously thought, (2) a modified anorectal sensitivity is present in constipated children allowing more rectal distention than normal, (3) the activity of the sphincter (by manometry) is different in constipated and normal children, (4) data from these children resembles that of some M M C cases where a permanent increase in sphincter activity causes the fecal bolus to remain high in the rectum.--J. Deevey Pickrell's Gracilis Muscle Transplantation and Its Effects on Anorectal Continence. A Five Year Prospective Study.
A. M. Holschneider, J. P~sehel, H. Kraeft, et al. Z Kinderchir 27:135-143, (June), 1979. There were 33 patients with a gracilis muscle transplantation and 21 children with a high imperforate anus studied clinically and electromanometrically in a 5-yr prospective study. Clinically, 14 children became clean after muscle transplantation, 10 continued soiling under stress and in 9 patients there was no improvement. Manornetrically a normal continence or a continence grade 1 could be shown in 25 patients after Pickrell's operation. 8 patients had poor results or remained incontinent.--Karl Ludwig Waag Colonic Muscle Autografts for Treatment of Anal Incontinence. E. Schmidt and H.-P. Bruch. Z Kinderchir 27:187-
190, (June), 1979. A new procedure for the treatment of anal incontinence is presented. Free transplantation of the muscle layer of the large gut can produce continence replacing the internal anal sphincter. The advantage of smooth muscle as an ideal