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The effect of trauma on colonic healing
ABSTRACTS
hernia should be kept as upright as possible during sleep and during the day given frequent feeds to reduce the total duration of the presence of refluxed acid pepsin in the lower e s o p h a g u s . - - R . B. Zachary
Peptic Ulcer Disease: A Clinical Study in 73 Children. R. L. Deckelbaum, C. C. Roy, J. LusslerLazaroff, and C. L. Morin. Can. Med. Assoc. J. 111: 225-228 (August) 1974.
There were 73 children with peptic ulcer admitted to The Montreal Children's Hospital and L'Hopital Ste.-Justine from 1962 to 1974. The primary group consisted of 39 with duodenal ulcers, and nine with gastric ulcers. Secondary or stress ulcers accounted for onethird of the patients. Vomiting was a c o m m o n s y m p t o m in the younger children, while pain and bleeding were more c o m m o n in older children. Fifty-three patients received medical m a n a g e m e n t only, but recurrences were not u n c o m m o n . Sixteen patients required operation either for complications of their ulcers, or for control of s y m p t o m s . The 12 children operated upon for primary ulcers have all done well postoperatively.--Colin C. Ferguson
157
The Effect of Trauma
on Colonic Healing.
Thomas T. Irvin and Thomas K. Hunt. Br. J. Surg. 61:430-436, 1974.
Pathogenesis and Prevention of Disruption of Colonic Anastomoses in Traumatised Rats. Thomas T. Irvin and Thomas K. Hunt. Br. J. Surg. 61:437-439, 1974.
These two papers are reports of experimental surgery on rats. They d e m o n s t r a t e conclusively that, in these animals, t r a u m a in the region of the colon; for example, extensive dissection in the retroperitoneal tissues, h a s an adverse effect on colonic anastomoses. The second study shows that the incidence of anastomotic disruption was significantly reduced when the colon was defunctioned 4 wk prior to surgery and they were given intraperitoneal cephalothin during operation. They concluded that the immediate cause of anastomotic disruption was sepsis and suggest that the role of a defunctioning colostomy and intraperitoneal antimicrobial therapy be studied in h u m a n beings undergoing colonic surgery. This experimental study could have considerable bearing on the surgery of Hirschsprungs disease in i n f a n c y . - - R . B.
Zachary Duodenal Duplication Cysts: Diagnosis and Operative Management. Norman B. Ackerman. Surgery 76:330-333 (August) 1974. A cystic duplication of the d u o d e n u m causing 2 wk of nausea, vomiting, and epigastric pain in a 51-yr-old w o m a n is the basis of this report together with a brief review of the literature. The value of endoscopy in preoperative diagnosis, and the variety of surgical procedures for treatment are stressed.--William
K. Sieber Total Inversion Appendectomy, Modified. Domingo T. Alvear, Daniel J. Callahan, George P. Pilling, and Samuel L. Cresson, Am. Surg. 40:413416 (July) 1974.
The technique of total inversion appendectomy is described. It is r e c o m m e n d e d for all "clean" cases to avoid possible infection. It is not r e c o m m e n d e d for incidental appendectomy when the bowel has been opened anyway (as in colon resection) or when mesenteric lymphadenitis is present (to permit histologic examination). Fifty patients comprise the series. EdwardJ. Berman
Treatment of the Neuropathic Bowel by Electrical Stimulation of the Rectum. Francis Katona and H. B. Eckstein. Dev. Med. Child Neurol. 16: 336-339, 1974.
Seven children with myelomeningocele and associated paralysis of the bladder and bowel were treated by direct-current stimulation via rectal and urethral electrodes. This stimulation produces a wave form different from that using an anal plug. In the rectum the stimulus produces a reflex contraction of the bowel wall with an indirect effect upon the sphincter. These seven children had been treated in the past with suppositories and aperients but after 8 wk of treatment all of them had an improvement of bowel function. Some of them had developed sensation and a knowledge of the need to pass stool. R.E. Cudmore
Urological Complications of Correction of Imperforate Anus. L. Persky, A. Tucker, and R. J. Izant, Jr. J. Urol. 111:415-418 (March) 1974. Five case reports are presented illustrating urological complications encountered during the correction of imperforate anus. One was a divided urethra and the second one was severe stricture of the urethra with resultant uremia,
hernia should be kept as upright as possible during sleep and during the day given frequent feeds to reduce the total duration of the presence of refluxed acid pepsin in the lower e s o p h a g u s . - - R . B. Zachary
Peptic Ulcer Disease: A Clinical Study in 73 Children. R. L. Deckelbaum, C. C. Roy, J. LusslerLazaroff, and C. L. Morin. Can. Med. Assoc. J. 111: 225-228 (August) 1974.
There were 73 children with peptic ulcer admitted to The Montreal Children's Hospital and L'Hopital Ste.-Justine from 1962 to 1974. The primary group consisted of 39 with duodenal ulcers, and nine with gastric ulcers. Secondary or stress ulcers accounted for onethird of the patients. Vomiting was a c o m m o n s y m p t o m in the younger children, while pain and bleeding were more c o m m o n in older children. Fifty-three patients received medical m a n a g e m e n t only, but recurrences were not u n c o m m o n . Sixteen patients required operation either for complications of their ulcers, or for control of s y m p t o m s . The 12 children operated upon for primary ulcers have all done well postoperatively.--Colin C. Ferguson
157
The Effect of Trauma
on Colonic Healing.
Thomas T. Irvin and Thomas K. Hunt. Br. J. Surg. 61:430-436, 1974.
Pathogenesis and Prevention of Disruption of Colonic Anastomoses in Traumatised Rats. Thomas T. Irvin and Thomas K. Hunt. Br. J. Surg. 61:437-439, 1974.
These two papers are reports of experimental surgery on rats. They d e m o n s t r a t e conclusively that, in these animals, t r a u m a in the region of the colon; for example, extensive dissection in the retroperitoneal tissues, h a s an adverse effect on colonic anastomoses. The second study shows that the incidence of anastomotic disruption was significantly reduced when the colon was defunctioned 4 wk prior to surgery and they were given intraperitoneal cephalothin during operation. They concluded that the immediate cause of anastomotic disruption was sepsis and suggest that the role of a defunctioning colostomy and intraperitoneal antimicrobial therapy be studied in h u m a n beings undergoing colonic surgery. This experimental study could have considerable bearing on the surgery of Hirschsprungs disease in i n f a n c y . - - R . B.
Zachary Duodenal Duplication Cysts: Diagnosis and Operative Management. Norman B. Ackerman. Surgery 76:330-333 (August) 1974. A cystic duplication of the d u o d e n u m causing 2 wk of nausea, vomiting, and epigastric pain in a 51-yr-old w o m a n is the basis of this report together with a brief review of the literature. The value of endoscopy in preoperative diagnosis, and the variety of surgical procedures for treatment are stressed.--William
K. Sieber Total Inversion Appendectomy, Modified. Domingo T. Alvear, Daniel J. Callahan, George P. Pilling, and Samuel L. Cresson, Am. Surg. 40:413416 (July) 1974.
The technique of total inversion appendectomy is described. It is r e c o m m e n d e d for all "clean" cases to avoid possible infection. It is not r e c o m m e n d e d for incidental appendectomy when the bowel has been opened anyway (as in colon resection) or when mesenteric lymphadenitis is present (to permit histologic examination). Fifty patients comprise the series. EdwardJ. Berman
Treatment of the Neuropathic Bowel by Electrical Stimulation of the Rectum. Francis Katona and H. B. Eckstein. Dev. Med. Child Neurol. 16: 336-339, 1974.
Seven children with myelomeningocele and associated paralysis of the bladder and bowel were treated by direct-current stimulation via rectal and urethral electrodes. This stimulation produces a wave form different from that using an anal plug. In the rectum the stimulus produces a reflex contraction of the bowel wall with an indirect effect upon the sphincter. These seven children had been treated in the past with suppositories and aperients but after 8 wk of treatment all of them had an improvement of bowel function. Some of them had developed sensation and a knowledge of the need to pass stool. R.E. Cudmore
Urological Complications of Correction of Imperforate Anus. L. Persky, A. Tucker, and R. J. Izant, Jr. J. Urol. 111:415-418 (March) 1974. Five case reports are presented illustrating urological complications encountered during the correction of imperforate anus. One was a divided urethra and the second one was severe stricture of the urethra with resultant uremia,