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Traumatic pseudocysts of the pancreas in children
629
ABSTRACTS scription suggests it was sigmoid colon). This child had a transitional zone proximal to the coIostomy site and aganglionosis distal to the colostomy, followed by ganglionic bowel still more distally. There is no histology on the segment of colon resected subsequently and recurrent subacute obstruction is ascribed to chronic volvulus. Long-term cause is not given as the patient was transferred to another hospital. Case 4 is described as having aganglionic distal rectum, a ganglionic area higher in the rectum, a second agangIionic area, and the sigmoid colon having ganglion cells again. In this patient the site of the colostomy (transverse colon) is also said to be aganglionic. The authors suggest that this variant of “skip” lesions is more common than was previously appreciated. This article is so much at variance with the usual findings that many readers would wish more details than are given.-D. G. Young
ABDOMEN
Cystic Dilatation of the Bile Duct Causing Obstructive Jaundice in Infants. Report of Two Cases. J. PrBvot, M. Mourat, and J. Hummer. Ann. Chir. Inf. 12:323-328, 1971. Two cases of cystic dilatation of the bile ducts were observed in two young infants 2 mo of age. Both developed a progressive retention jaundice after 3-8 wk. Needle biopsy of the liver, as well as a Bengal Rose test, ruled out hepatitis and cirrhosis, but confirmed bile retention. At surgery, a cystic dilatation of the common duct without communication with the duodenum was found in both cases. An anastomosis with the intestine was possible, once directly (choledochoduodenal), once by means of a Roux-en-Y intestinal loop. Both infants were cured of the bile retention, but the follow-up is too short to rule out a residual cholostatic cirrhosis.-M. Bettex Traumatic Pseudocysts of the Pancreas in Children. U. G. Stauffer and M. Grob. Helv. Paediat. Acta 2M25-835 (December), 1971.
Since the first communication on posttraumatic pseudocyst ln a child in 1922, only 52 other cases have been pubIished. In consideration of the rising rate of childrens’ accidents, the authors predict a higher incidence of this injury sequel for the future. They observed three cases within 12 mo, two boys, 7% and 6% yr old, and a girl aged 6 yr. They all had the same accident, falling off a scooter and being hit in the epigastrium by handlebars. The further history consisted of an initial period of severe upper abdominal pain with vomiting for a few days, followed by a free interval varying from 2 days to 7 wk. The diagnosis, made by palpation of a resistance in the epigastrium, high amylase level in blood, and radiological abdominal investigation, was confirmed by surgery at the 26th, 28th and 57th day respectively, after trauma. The cysts found were the size of an orange to that of a double fist. One case was treated by external drainage but then sufferred temporarily from electrolyte and water disbalance due to excessive fluid loss. The two other patients were cured uneventfully by internal drainage through cystojejunostomy by Roux-Y-anastomosis, which the authors consider the most suitable treatment with respect to the later prognosis. -C. Bretscher Disturbance of Consciousness and Convulsions Owing to Islet Cell Tumor in a 7 Year Old Girl. E. Werder, H. H. Ehrat, R. Morger, H. Herzer, H. Ludin, and Ruth Illig. Helv. Paediat. Acta 26:131-143 (June), 1971. In a 7-yr-old girl, first mistaken as an epileptic case, etiology of consciousness disturbance and convulsions was found in an isIet cell tumor. Metabolic tests revealed hypoglycemia, and the localization of the insuloma was established by pancreatic scintillography and, in particular, by selective visceral angiography through the coeliac trunk and superior mesenteric artery. Normal response to tolbutamld was explained by presumed insensibility to tolbutamid in tumoral islet cells. Diazoxide therapy during a period of 2 mo eliminated hypoglycemic signs, but is recommended by the authors only as temporary treatment with regard to various side effects. Therapy
ABSTRACTS scription suggests it was sigmoid colon). This child had a transitional zone proximal to the coIostomy site and aganglionosis distal to the colostomy, followed by ganglionic bowel still more distally. There is no histology on the segment of colon resected subsequently and recurrent subacute obstruction is ascribed to chronic volvulus. Long-term cause is not given as the patient was transferred to another hospital. Case 4 is described as having aganglionic distal rectum, a ganglionic area higher in the rectum, a second agangIionic area, and the sigmoid colon having ganglion cells again. In this patient the site of the colostomy (transverse colon) is also said to be aganglionic. The authors suggest that this variant of “skip” lesions is more common than was previously appreciated. This article is so much at variance with the usual findings that many readers would wish more details than are given.-D. G. Young
ABDOMEN
Cystic Dilatation of the Bile Duct Causing Obstructive Jaundice in Infants. Report of Two Cases. J. PrBvot, M. Mourat, and J. Hummer. Ann. Chir. Inf. 12:323-328, 1971. Two cases of cystic dilatation of the bile ducts were observed in two young infants 2 mo of age. Both developed a progressive retention jaundice after 3-8 wk. Needle biopsy of the liver, as well as a Bengal Rose test, ruled out hepatitis and cirrhosis, but confirmed bile retention. At surgery, a cystic dilatation of the common duct without communication with the duodenum was found in both cases. An anastomosis with the intestine was possible, once directly (choledochoduodenal), once by means of a Roux-en-Y intestinal loop. Both infants were cured of the bile retention, but the follow-up is too short to rule out a residual cholostatic cirrhosis.-M. Bettex Traumatic Pseudocysts of the Pancreas in Children. U. G. Stauffer and M. Grob. Helv. Paediat. Acta 2M25-835 (December), 1971.
Since the first communication on posttraumatic pseudocyst ln a child in 1922, only 52 other cases have been pubIished. In consideration of the rising rate of childrens’ accidents, the authors predict a higher incidence of this injury sequel for the future. They observed three cases within 12 mo, two boys, 7% and 6% yr old, and a girl aged 6 yr. They all had the same accident, falling off a scooter and being hit in the epigastrium by handlebars. The further history consisted of an initial period of severe upper abdominal pain with vomiting for a few days, followed by a free interval varying from 2 days to 7 wk. The diagnosis, made by palpation of a resistance in the epigastrium, high amylase level in blood, and radiological abdominal investigation, was confirmed by surgery at the 26th, 28th and 57th day respectively, after trauma. The cysts found were the size of an orange to that of a double fist. One case was treated by external drainage but then sufferred temporarily from electrolyte and water disbalance due to excessive fluid loss. The two other patients were cured uneventfully by internal drainage through cystojejunostomy by Roux-Y-anastomosis, which the authors consider the most suitable treatment with respect to the later prognosis. -C. Bretscher Disturbance of Consciousness and Convulsions Owing to Islet Cell Tumor in a 7 Year Old Girl. E. Werder, H. H. Ehrat, R. Morger, H. Herzer, H. Ludin, and Ruth Illig. Helv. Paediat. Acta 26:131-143 (June), 1971. In a 7-yr-old girl, first mistaken as an epileptic case, etiology of consciousness disturbance and convulsions was found in an isIet cell tumor. Metabolic tests revealed hypoglycemia, and the localization of the insuloma was established by pancreatic scintillography and, in particular, by selective visceral angiography through the coeliac trunk and superior mesenteric artery. Normal response to tolbutamld was explained by presumed insensibility to tolbutamid in tumoral islet cells. Diazoxide therapy during a period of 2 mo eliminated hypoglycemic signs, but is recommended by the authors only as temporary treatment with regard to various side effects. Therapy