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The Bishop-Koop anastomosis-a find in pediatric surgery.

A technique of intestinal anastomosis, developed for the treatment of meconium ileus, was used by the authors in the treatment of neonates suffering from various other intestinal anomalies such as atresia, volvulus and apple-peel syndrome. This technique was used in 6 neonates to make a safe intestinal reconstruction.

Female↗

Prenatal diagnosis of gastrointestinal tract obstruction.

The diagnosis of possible duodenal atresia was made in a near-term fetus. The mother had developed polyhydramnios, and the fetus was found on sonography to have two communicating upper abdominal masses. It also failed to ingest contrast media after injection of radiopaque material into the amniotic sac. An esophageal atresia was found after delivery, in addition to the prenatally diagnosed duodenal atresia. The infant had a surgical repair 16 hours after delivery and survived.

Amnion↗

A group study for the classification of anorectal anomalies in Japan with comments to the International Classification (1970).

A study group was formed to undertake further investigation of the problems involved in the classification of anorectal anomalies. At first, a registration form including standardized techniques for clinical and roentogenologic investigation was defined, and then 254 cases were collected and analyzed by referring these materials to the International Classification by the Melbourne group in 1970. Our analysis disclosed: (1) It is imperative to establish a registration form with footnotes describing standardized techniques for clinical and roentogenologic investigations; (2) The rectourethral fistula has been classified simply as high type under the present International Classification, but differences in the levels of the rectal pouch and of the point of fistula, as observed in the collected materials, tends to show that further subdivision of this anomaly may be indicated; (3) An abnormal skin fold at the anal and/or perineal sites is not always diagnostic of low type, specifically of covered anus-complete. Conversely, some infants with high type anomaly had abnormal skin folds; and (4) Two types of anomaly, which have not been well described in the present classification, were detected. They were "rectal membraneous atresia" and "recto-penile fistula."

Anal Canal↗

Morbidity and mortality in small bowel atresia. Jejuno-ileal atresia.

One hundred and one babies were admitted to the Hospital for Sick Children, Great Ormond Street, London, between 1967 and 1981, suffering from small bowel atresia. The overall mortality in this period was 23%, although in the years 1974-81 this fell to 12%. Mortality was considerably higher in jejunal atresia than in ileal atresia. The improved survival in the second half of the series was related to more frequent use of parenteral nutrition. Morbidity and mortality following the Bishop-Koop procedure was high and this operation is inappropriate for the treatment of small bowel atresia.

Humans↗