Biomedical subjects
Publications and source records attributed to G Weisgerber.
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Hamartomatos inverted polyps of the rectum were observed in a 12 years-old boy suffering from recurrent rectal discharges of mucus. Diagnosis was made on examination of rectal specimens obtained by local excisions and finally by recto-sigmoïdectomy, showing ectopic lobulated glandular structures deep to the muscularis mucosae. This histological aspect must be differentiated from adenocarcinoma, but in the paediatric age, prognosis depends on the degree of diffusion of the hamartomatous tissue, which may lead to extensive surgery such as recto-sigmoïdectomy. Whether this lesion is dysgenetic or acquired is discussed, and what relation can be presumed with solitary ulcer of the rectum is not clear.
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Surgery for post-traumatic recto-vesicle fistulae involves two major risks : recurrence and residual sphincter disturbances. It would appear that a solution may be offered in the form of transanal pre-rectal colonic lowering. This technique, which is easy to perform, and which involves no suture, has been used successfully in an 11 and a half year old child.
A case of Steiner type neuroapudomatosis presented with a pseudo-Hirschsprung disease in an infant. Secondarily, the facies became typical, while hyperthyrocalcitoninaemia led to the discovery at the age of 2 years and 8 months of a medullary carcinoma of the thyroid. Despite early surgery in the absence of any clinical signs, it was not possible to avoid cervical lymphatic spread.
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The syndrome known as the Multiple Endocrine Neoplasia type III or type IIb presents a particular histological intestinal lesion: hyperplasia of the myenteric plexus. The electron microscopic study of the plexus of Auerbach in our observation suggests a disequilibrium of the different types of individual axonal sheaths compared to the descriptions of a normal plexus. The possible role of this anomaly in the genesis of intestinal manifestations in this syndrome is here discussed.
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A child is described who developed acute ischaemic necrosis of the oesophagus complicating an otherwise typical case of anaphylactoid purpura. This episode was preceded by a necrotising ileitis requiring intestinal resection and ileostomy. The histological similarities of the lesions in the oesophagus and the ileum suggest a common cause connected with the anaphylactoid purpura.
This study is an evaluation of the infectious risk related to neonatal surgery in 300 patients between 1968 and 1978, and its consequences to mortality and morbidity. Bacteriological species, circumstances, chronology of infection, related to each type of surgical pathology prove the endogenous way of contamination to be usual and predominant. When intestinal obstruction occurs, the risk of hematogenous diffusion is directly dependent from local stasis and bacterial pullulation which can be evaulated with duodenal, jejunal or fecal samples. Both mechanical factors and antibiotictherapy can induce qualitative and quantitative changes in bacterial flora of the bowel, and then increase the incidence of endogenous septicemia.
Involvement of the ureters (rigid and segmented) and bladder was seen in a 6-year-old child whose clinical lesions were typical of Henoch-Schoenlein purpura. Infrapelvic left uretic stenosis developed secondarily whilst the other lesions disappeared. Histological study and in particular cutaneous and renal immunofluorescence made it possible to eliminate the possible diagnosis of polyarteritis nodosa, and to confirm that of Henoch-Schoenlein purpura. An ischaemic vasculitis was the cause of the ureteric and bladder lesions, and of the progression to stenosis. The existence of this possibility should lead to routine examination to detect such lesions. Sequential radiological studies are necessary whenever such lesions are recognised.
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Chronic haemorrhagic ascites in an infant is reported. After much hesitation without a definite diagnosis the first laparotomy was carried out and the estimation of amylase, lipase and proteolytic enzyme activities in the ascitic fluid suggested a pancreatic origin for the ascites. This was conformed at a second laparotomy when the condition was correted. This emphasises the importance of the estimation of pancreatic enzymes in unexplained ascites in children.
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