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Treatment of hematologic disorders in children by splenic artery ligation
iNTERNATIONAL ABSTRACTS
narrow strip of connective tissue occurred within 3 weeks. Histologic examination revealed a narrow strand of connective tissue with minimal cellular reaction. Three patients, one a 10-year-old with multiple splenic tears, have undergone successful splenorrhaphy utilizing the fibrin glue technique. The authors have also utilized the fibrin glue as an embolization agent in splenic injuries in hares.--Randall W. Powell Treatment of Hematologic Disorders in Children by Splenic Artery Ligation. A. Harouchi, N. Benchemsi, and M. Benou-
houd. Chir Pediatr 23:109-113, 1982. Eleven children (3 thalassemia, 4 spberocytosis, 4 secondary hypersplenism) underwent splenic artery ligation. One death was reported. The results of this method were considered satisfactory in spherocystosis and secondary hypersplenism. The results in thalassemia were poor. The purpose of this study was to advocate splenic artery ligation rather than splenectomy, especially in children under age 5. This is an interesting approach to a difficult problem but the series is small and complications and recurrent disease are not infrequent.--Michel Carcassonne
GENITOURINARY T R A C T Results of Modified Palomo~ Operation in Children. P. Kryl,
and M. Kroluper. Rozhl Chir 60:693-695, (October), 1981. Between 1974 and 1979 a modified Palomo's operation for varicocele was performed in 20 boys aged 10 to 16 years. To avoid possible postoperative atrophy of the testicle the authors modified Palomo's original operation by ligating the spermatic veins only. Arteries were left intact. In ten cases the result was considered to be excellent, satisfactory in five patients who had a small remnant of the varicocele empty most of the time, less satisfactory in two with the varicocele reduced to half of its original size, not good in two with the varicocele only a little smaller than before, and unsatisfactory in one case which remained unchanged.--E. Pekarovi~. Idiopathic Urethrorrhagia in Boys. G. W. Kaplan and W. A. Brock. J Urol 128:1001-1003, (November), 1982.
During an 11-year period, 21 toilet-trained, prepubertal boys were seen with blood spotting (urethrorrhagia) between voidings. Most patients presented in the winter and spring months as opposed to the summer and fall months. The median age at presentation was 7 years. The most frequent presenting symptom, in addition to urethrorrhagia, was dysuria. Laboratory and radiographic studies were frequently normal although red blood cells were seen microscopically in 57%. Bacterial cultures were always negative. Symptoms persisted for as long as 8 years (median between 6 and 12 months). The etiology of this symptom complex in these cases is unknown but is thought to be an infectious agent. Strictures developed in three patients, all of whom had had prior endoscopy. In none of the six patients in whom cystoscopy was omitted did a stricture devel0p. Inasmuch as endoscopy is unnecessary to rule out serious lesions that might mimic idiopathic urethrorrhagia, its use on a routine basis in these patients does not seem warranted to these autbors.--George Holcomb, Jr.
525 Surgical Treatment of Balanic and Distal Penile Hypospadia.
G. L. Zigiotti and N. Pappalepore. Rass It Chir Ped 22:335343, (October-December), 1980. The authors have applied Van der Meulen's technique in 17 patients from 1975 to 1978. The average age was 6.7 years. There were six mental stenoses, two patients presented a slight curvature, and two had maldescended testis. Two of the 17 patients had already been operated with the technique of GilVernet and Mathieu. One of the 17 patients operated with Van der Meulen's technique required reoperation for an inexplicable stenosis of the bulbar urethra. With the use of Van der Meulen's technique the authors had no fistula or stenosis; one patient, however, has a spraying urinary stream, three had slight rotation of the penis to the right, and in three there is an excess of preputial skin. The authors found this a valuable technique; the only disadvantage was a preputial edema in the first postoperative weeks.--Paolo Magillo The Repair of Urethral Fistulas Occurring After Hypospa-
dins Repair. M. A. Dennis and R. D. Walker, III. J Urol 128:1004-1005, (November), 1982. A successful method for repair of urethral fistulas following hypospadias correction and utilizing the technique of "pants over vest" has been developed by the authors. This repair was accomplished in 14 patients with no fistula recurrence. The average hospitalization was 2.7 days. Only 7 of 14 patients required urinary diversion which averaged 3.7 days.--George Holcomb, Jr. Posterior Urethral Valves, Unilateral Reflux and Renal Dysplasia: A Syndrome. D. L. Hoover and J. IV. Duckett, Jr. J
Urol 128:994-997, (November), 1982. Infants with posterior urethral valves and persistent unilateral reflux after valve resection often have an associated nonfunctioning dysplastic kidney. Spurious function of the unit with reflux may be apparent on the delayed films of the excretory urogram. Misinterpretation of the initial radiographic studies performed without coincident bladder drainage results in the missed diagnosis of this syndrome and misguided surgical management. Of 82 patients with urethral valves, 17 (21%) had persistent unilateral reflux. A renal scan was useful in determining nonfunction in 11 (65%) of those patients with persistent unilateral reflux and in one with bilateral reflux. The functionless kidney was on the left side in 11 of 12 cases (92%). Early nephroureterectomy is advocated to improve voiding dynamics. The prognosis is generally excellent. The embryogenesis of the syndrome is discussed as it relates to the "bud theory" of renal dysplasia and posterior urethral valves.--George Holcomb, Jr. Ureterovascular Hydronephrosis and the "Aberrant" Renal Vessels. F. D. Stephens. J Urol 128:984-987, (November),
1982. The pelvis, an angulated upper segment of the ureter, and the lower anterior renal segmental vessels entangle to produce hydronephrosis. However, which of the three structures provokes obstruction is conjectural. The structural relations in this anomaly were compared to those of normal kidneys, hydronephroses from other causes, and nonrotated kidneys.
narrow strip of connective tissue occurred within 3 weeks. Histologic examination revealed a narrow strand of connective tissue with minimal cellular reaction. Three patients, one a 10-year-old with multiple splenic tears, have undergone successful splenorrhaphy utilizing the fibrin glue technique. The authors have also utilized the fibrin glue as an embolization agent in splenic injuries in hares.--Randall W. Powell Treatment of Hematologic Disorders in Children by Splenic Artery Ligation. A. Harouchi, N. Benchemsi, and M. Benou-
houd. Chir Pediatr 23:109-113, 1982. Eleven children (3 thalassemia, 4 spberocytosis, 4 secondary hypersplenism) underwent splenic artery ligation. One death was reported. The results of this method were considered satisfactory in spherocystosis and secondary hypersplenism. The results in thalassemia were poor. The purpose of this study was to advocate splenic artery ligation rather than splenectomy, especially in children under age 5. This is an interesting approach to a difficult problem but the series is small and complications and recurrent disease are not infrequent.--Michel Carcassonne
GENITOURINARY T R A C T Results of Modified Palomo~ Operation in Children. P. Kryl,
and M. Kroluper. Rozhl Chir 60:693-695, (October), 1981. Between 1974 and 1979 a modified Palomo's operation for varicocele was performed in 20 boys aged 10 to 16 years. To avoid possible postoperative atrophy of the testicle the authors modified Palomo's original operation by ligating the spermatic veins only. Arteries were left intact. In ten cases the result was considered to be excellent, satisfactory in five patients who had a small remnant of the varicocele empty most of the time, less satisfactory in two with the varicocele reduced to half of its original size, not good in two with the varicocele only a little smaller than before, and unsatisfactory in one case which remained unchanged.--E. Pekarovi~. Idiopathic Urethrorrhagia in Boys. G. W. Kaplan and W. A. Brock. J Urol 128:1001-1003, (November), 1982.
During an 11-year period, 21 toilet-trained, prepubertal boys were seen with blood spotting (urethrorrhagia) between voidings. Most patients presented in the winter and spring months as opposed to the summer and fall months. The median age at presentation was 7 years. The most frequent presenting symptom, in addition to urethrorrhagia, was dysuria. Laboratory and radiographic studies were frequently normal although red blood cells were seen microscopically in 57%. Bacterial cultures were always negative. Symptoms persisted for as long as 8 years (median between 6 and 12 months). The etiology of this symptom complex in these cases is unknown but is thought to be an infectious agent. Strictures developed in three patients, all of whom had had prior endoscopy. In none of the six patients in whom cystoscopy was omitted did a stricture devel0p. Inasmuch as endoscopy is unnecessary to rule out serious lesions that might mimic idiopathic urethrorrhagia, its use on a routine basis in these patients does not seem warranted to these autbors.--George Holcomb, Jr.
525 Surgical Treatment of Balanic and Distal Penile Hypospadia.
G. L. Zigiotti and N. Pappalepore. Rass It Chir Ped 22:335343, (October-December), 1980. The authors have applied Van der Meulen's technique in 17 patients from 1975 to 1978. The average age was 6.7 years. There were six mental stenoses, two patients presented a slight curvature, and two had maldescended testis. Two of the 17 patients had already been operated with the technique of GilVernet and Mathieu. One of the 17 patients operated with Van der Meulen's technique required reoperation for an inexplicable stenosis of the bulbar urethra. With the use of Van der Meulen's technique the authors had no fistula or stenosis; one patient, however, has a spraying urinary stream, three had slight rotation of the penis to the right, and in three there is an excess of preputial skin. The authors found this a valuable technique; the only disadvantage was a preputial edema in the first postoperative weeks.--Paolo Magillo The Repair of Urethral Fistulas Occurring After Hypospa-
dins Repair. M. A. Dennis and R. D. Walker, III. J Urol 128:1004-1005, (November), 1982. A successful method for repair of urethral fistulas following hypospadias correction and utilizing the technique of "pants over vest" has been developed by the authors. This repair was accomplished in 14 patients with no fistula recurrence. The average hospitalization was 2.7 days. Only 7 of 14 patients required urinary diversion which averaged 3.7 days.--George Holcomb, Jr. Posterior Urethral Valves, Unilateral Reflux and Renal Dysplasia: A Syndrome. D. L. Hoover and J. IV. Duckett, Jr. J
Urol 128:994-997, (November), 1982. Infants with posterior urethral valves and persistent unilateral reflux after valve resection often have an associated nonfunctioning dysplastic kidney. Spurious function of the unit with reflux may be apparent on the delayed films of the excretory urogram. Misinterpretation of the initial radiographic studies performed without coincident bladder drainage results in the missed diagnosis of this syndrome and misguided surgical management. Of 82 patients with urethral valves, 17 (21%) had persistent unilateral reflux. A renal scan was useful in determining nonfunction in 11 (65%) of those patients with persistent unilateral reflux and in one with bilateral reflux. The functionless kidney was on the left side in 11 of 12 cases (92%). Early nephroureterectomy is advocated to improve voiding dynamics. The prognosis is generally excellent. The embryogenesis of the syndrome is discussed as it relates to the "bud theory" of renal dysplasia and posterior urethral valves.--George Holcomb, Jr. Ureterovascular Hydronephrosis and the "Aberrant" Renal Vessels. F. D. Stephens. J Urol 128:984-987, (November),
1982. The pelvis, an angulated upper segment of the ureter, and the lower anterior renal segmental vessels entangle to produce hydronephrosis. However, which of the three structures provokes obstruction is conjectural. The structural relations in this anomaly were compared to those of normal kidneys, hydronephroses from other causes, and nonrotated kidneys.