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The histological structure of intestinal polyps
306
INTERNATJONAL ABSTRACTS OF PEDIATRIC SURGERY
citis. Through a McBurney incision a mildly inflamed appendix was taken out; but because of a tumor in the small bowel region this incision was closed, and a lower abdominal midline laparotomy was performed. A malignant tumor of the terminal ileum, perforated in the free peritoneal cavity was removed. The diagnosis of reticulosareoma was confirmed by microscopic examination. Surgery was followed by radiation therapy.--E. A. Kole. COMPLICATIONS OF ILEOSTOMY. Sidney M.
Fierst. Amer. J. Gastroenterol. 44:364360, 1965. Five hundred nine complications were encountered in 200 patients with ileostomies, 63 requiring surgical procedures. These complications are enumerated, discussed and suggestions for avoiding them naade.--Neville K. Connolly. COLOSTOMY: A SIMPLE TECHNIQUE AND OBSERVATIONS ON INDICATIONS. H. H.
Nixon. Z. Kinderchir. 3:98-103, 1966. The indications for colostomy in children are not sufficiently clear, and the author reports on 129 cases requiring colostomy, of whom 41 were newborn. In these, 169 different complications could be observed, of which excoriation of the skin, prolapse of the colostomy and diarrhea were the most common. Following these there are hemorrhage, infection and stenosis. His own method, which was carried out 29 times, shows a much smaller conaplication rate than the other methods. The essential part of this operation is to use a skin bridge which is pulled through under the intestine, which is then opened immediately. The second part of this work is devoted to problems of colostomy. The writer criticises transverse eolostomy in cases of Hirsehsprung's disease, especially in the newborn period, as following decompression the mesocolon shortens and may lead to technical difficulties in a later pull-through operation. He, therefore, recommends a co]ostomy in the transitional zone. In cases of long segment Hirschsprung's disease an immediate ileostomy is indicated. The indications for a colostomy are clearly demonstrated. The timing of a colostomy depends on the clinical condition especially if a corn-
plicating enterocolitis exists.-- S. Hofmann and H. B. Eckstein. THE HISTOLOGICAL STRUCTLrRE OF INTESTINAL POLYPS. C. C. Morson. Mtineh. Med. Wehnschr. 108:310-313, 1966. There are many different types of intestinal polyps and intestinal polyposis, a few of which are discussed in this article. Metaplastic (hyperplastic) polyps are very common harmless lesions which have a characteristic histology and are quite unrelated to adenomatous polyps or carcinoma, Peutz]eghers polyp.';, which may be single or multiple, are hamartomatous tumors containing a characteristic malformation of the nmseularis nmcosa. The risk of malignant change is low. Juvenile polyps, single, or presenting as polyposis, are also hamartomas but the malfornlation involves the connective tissue stroma of the mucous membrane without the participation of the nmscularis mueosa. This is the reason for occasional autoamputation. The juvenile polyp and juvenile polyposis have no malignant potential. On the other hand, the neoplastic polyps called adenoma, papillary adenoma or villous papilloma are precancerous tumors but very rarely change before puberty.--Eva Helming. CONTINENCE PRESERVING SURGICAL PROCEDURES IN HIRSCHSPRUNGS DISEASE. G. Bottger and H. Hurter. Z. Kinderchir. 3: 91-98, 1966. In the operation for Hirsehsprung's disease devised by Duhamel and inedited by Grob, it is necessary to pull the voluminous rectum through the anus. It is easy in this ease to damage the sphincter muscles. For this reason this modification recommends a suprasphincteric side-to-side anastomosis between the rectal pouch and the remaining colon, which is technically easier. This method was originally tried in dogs and later in cases of high rectal carcinomas, Finally, it was tried in Hirschsprung's disease. The authors do not report their results or the number of patients they have treated by this method.--S. Hofmann and H. B. Eckstein. ANO-REGTAL ACHALASIA. B. Duhanwl. Ann, Chir. infant. 6:345-347, 1965.
INTERNATJONAL ABSTRACTS OF PEDIATRIC SURGERY
citis. Through a McBurney incision a mildly inflamed appendix was taken out; but because of a tumor in the small bowel region this incision was closed, and a lower abdominal midline laparotomy was performed. A malignant tumor of the terminal ileum, perforated in the free peritoneal cavity was removed. The diagnosis of reticulosareoma was confirmed by microscopic examination. Surgery was followed by radiation therapy.--E. A. Kole. COMPLICATIONS OF ILEOSTOMY. Sidney M.
Fierst. Amer. J. Gastroenterol. 44:364360, 1965. Five hundred nine complications were encountered in 200 patients with ileostomies, 63 requiring surgical procedures. These complications are enumerated, discussed and suggestions for avoiding them naade.--Neville K. Connolly. COLOSTOMY: A SIMPLE TECHNIQUE AND OBSERVATIONS ON INDICATIONS. H. H.
Nixon. Z. Kinderchir. 3:98-103, 1966. The indications for colostomy in children are not sufficiently clear, and the author reports on 129 cases requiring colostomy, of whom 41 were newborn. In these, 169 different complications could be observed, of which excoriation of the skin, prolapse of the colostomy and diarrhea were the most common. Following these there are hemorrhage, infection and stenosis. His own method, which was carried out 29 times, shows a much smaller conaplication rate than the other methods. The essential part of this operation is to use a skin bridge which is pulled through under the intestine, which is then opened immediately. The second part of this work is devoted to problems of colostomy. The writer criticises transverse eolostomy in cases of Hirsehsprung's disease, especially in the newborn period, as following decompression the mesocolon shortens and may lead to technical difficulties in a later pull-through operation. He, therefore, recommends a co]ostomy in the transitional zone. In cases of long segment Hirschsprung's disease an immediate ileostomy is indicated. The indications for a colostomy are clearly demonstrated. The timing of a colostomy depends on the clinical condition especially if a corn-
plicating enterocolitis exists.-- S. Hofmann and H. B. Eckstein. THE HISTOLOGICAL STRUCTLrRE OF INTESTINAL POLYPS. C. C. Morson. Mtineh. Med. Wehnschr. 108:310-313, 1966. There are many different types of intestinal polyps and intestinal polyposis, a few of which are discussed in this article. Metaplastic (hyperplastic) polyps are very common harmless lesions which have a characteristic histology and are quite unrelated to adenomatous polyps or carcinoma, Peutz]eghers polyp.';, which may be single or multiple, are hamartomatous tumors containing a characteristic malformation of the nmseularis nmcosa. The risk of malignant change is low. Juvenile polyps, single, or presenting as polyposis, are also hamartomas but the malfornlation involves the connective tissue stroma of the mucous membrane without the participation of the nmscularis mueosa. This is the reason for occasional autoamputation. The juvenile polyp and juvenile polyposis have no malignant potential. On the other hand, the neoplastic polyps called adenoma, papillary adenoma or villous papilloma are precancerous tumors but very rarely change before puberty.--Eva Helming. CONTINENCE PRESERVING SURGICAL PROCEDURES IN HIRSCHSPRUNGS DISEASE. G. Bottger and H. Hurter. Z. Kinderchir. 3: 91-98, 1966. In the operation for Hirsehsprung's disease devised by Duhamel and inedited by Grob, it is necessary to pull the voluminous rectum through the anus. It is easy in this ease to damage the sphincter muscles. For this reason this modification recommends a suprasphincteric side-to-side anastomosis between the rectal pouch and the remaining colon, which is technically easier. This method was originally tried in dogs and later in cases of high rectal carcinomas, Finally, it was tried in Hirschsprung's disease. The authors do not report their results or the number of patients they have treated by this method.--S. Hofmann and H. B. Eckstein. ANO-REGTAL ACHALASIA. B. Duhanwl. Ann, Chir. infant. 6:345-347, 1965.