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At least 667 records · Page 37Linked to original sources
PubMed1990

[Necrotizing enterocolitis from the viewpoint of the pediatric surgeon--therapeutic considerations].

In order to define diagnostic and therapeutic guidelines from a paediatric surgical point of view, clinical, laboratory chemical and intraoperative findings from 52 children with necrotising enterocolitis (NEC) were evaluated and correlated with fatality. This analysis produced the following results: 1. The fatality rate for patients with "proven" NEC (n = 28) was 3 = 9%. All 3 of these children who died were so-called "high risk" patients. The fatality rate for patients with "advanced" NEC (n = 24) with intestinal perforation was 6 = 25%. Five of these children who died were so-called "high risk" patients. These 2 patient groups are comparable because the concepts of surgical indication and timing were identical, the technical conditions for surgery were the same, a standardised surgical procedure was employed, and the distribution pattern and extent of intestinal damage were consistent, except for the intestinal perforation in the second group. In addition, the proportion of "high risk" patients was approximately the same in both groups. Therefore, the 2 groups differed only in the attribute of intestinal perforation. Accordingly, the results of comparison cannot be considered to be statistically significant, yet they do indicate a prognostic tendency: Children who cannot receive surgery until after the occurrence of intestinal perforation have a poorer prognosis. 2. The highly indicative diagnostic criterion for proof of developing intestinal gangrene is puncture of the abdominal cavity, enabling detection of migratory peritonitis. 3. With regard to fatality, a comparison of various surgical procedures confirms the special importance of an enterostoma over primary anastomosis. Exceptions only serve to prove the rule here as well.

Anastomosis, Surgical↗
PubMed1993

[Perforated small intestine diverticulum as a cause of acute abdomen in Ehlers-Danlos syndrome].

Based on a rare case of perforated small-bowel diverticulum combined with Ehlers-Danlos syndrome (EDS) we investigated in a retrospective study several swiss hospitals for symptomatic small-bowel diverticulosis aiming at any clue on EDS. We came up with 15 more cases, 5 of them with perforation, yet none showed any sign of EDS. A review of the literature on either small-bowel diverticulosis or the intestinal complications of EDS amounted to 131 cases of perforation and 11 cases of symptomatic small-bowel diverticulosis in combination with EDS, 2 of them suffering from perforation. Regarding the rarity of these diseases the number of patients presenting both is surprising. Although the EDS-specific histopathological changes of the skin could not be shown in the specimen of the intestinum, it seems quite reasonable to suggest an increased incidence of diverticulosis in patients with EDS, since the weakness of the connective tissue allows an easy protrusion of the mucosa through the intestinal wall.

Abdomen, Acute↗
PubMedDate not supplied

Infantile myofibromatosis. A case report.

Infantile myofibromatosis is a rare mesenchymal disorder of infancy characterized by the formation of tumors in the skin, muscle, viscera, bone and subcutaneous tissue. The etiology of the disorder is unknown. We describe here a newborn with multiple infantile myofibromatosis, peritonitis and intestinal perforation. Surgery revealed multiple intestinal obstructions and jejunal perforation due to intestinal tumors; consequently, a jejunostomy was performed. The patient was maintained on total parenteral nutrition and oral semiliquid infant formula for two months, however, he died due to multiple attacks of diarrhea and septicemia.

Gastrointestinal Neoplasms↗