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The seventh case of colonic atresia and Hirschsprung's disease association is presented. It is proposed that if vascular accident occurs before the eighth week of intrauterine life, it does not only result in atresia but also associates with Hirschsprung's disease.
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Infants requiring prolonged hyperalimentation for a variety of conditions may experience difficulty in establishing oral feedings. Indeed, active resistance to oral feeding is often observed. We describe an infant who was deprived of normal oral feedings for the first ten months of life. Because subsequent feeding resistance was apparently due to behavioral and developmental factors, we suggest that the approach to such cases should involve particular attention to these areas. The child development literature and our surgical experience with esophageal atresia give supporting evidence.
35-year-old woman developed polyhydramnios during her first pregnancy. Ultrasound confirmed this and showed high bowel obstruction. Delivery was uneventful, the infant was asymtomatic. Abdominal films, however, demonstrated a high jejunal obstruction. At surgery "apple peel" atresia of the small bowel was found. Good outcome.
Although underrepresented compared with infectious diseases, calves' surgical abdomen diseases and abdominal surgery are a part of daily veterinary practice. Clinical presentations may differ from adult cattle and change rapidly. The decision whether to perform abdominal surgery or refer the animal has to take into consideration the condition and its prognosis for the calf. This article discusses clinical presentation of calves and focuses on specific situations with a detailed description of the surgical techniques, atresia coli, and umbilical remnants infection.
Isolated rectal atresia in the girl with a normal anal canal is extremely rare, and its association with a fistula has not been reported in the literature. A 6-year-old girl who had a unique combination of rectal atresia and rectovestibular fistula was treated successfully by a posterior sagittal approach.
UNLABELLED: The aim of this study was to answer the question whether or not, after an operation for duodenal atresia, a transanastomotic feeding tube reduces the time to full preanastomotic feeding. The method used was a retrospective study and a prospective observation. 18 consecutive newborns with duodenal atresia, nine from each of two different centres of paediatric surgery, were studied retrospectively. The patients in one centre received a nasogastric tube and a transanastomotic feeding tube during the operation, while in the other centre only a nasogastric tube was used. Seven control patients with duodenal atresia treated postoperatively with a nasogastric tube and a transanastomotic feeding tube were prospectively observed. The main outcome measure used to compare these two groups was the time required to achieve full preanastomotic feeding. RESULTS: The patients who were treated postoperatively with the transanastomotic feeding tube needed significantly less time to achieve full preanastomotic feeding than those with a nasogastric tube only (P < 0.001, Mann-Whitney U test). CONCLUSION: The use of a transanastomotic feeding tube, after an operation for duodenal atresia, leads to earlier full preanastomotic feeding.
Of 59 infants with jejunoileal atresia, seven presented with absence of mesentery, the main superior mesenteric artery ceasing to exist beyond the origin of the right colic or ileocolic artery, and a helical ileum. This distinctive form of jejunal atresia has been recognized with increasing frequency in recent years. Distal to the atresia, the small bowel receives its blood supply retrograde from an artery derived from the ileocolic or right colic arcades, and the ileum coils around its nutrient artery in an "apple peel" or "Christmas tree" deformity. The first three patients in this report died. The lastion, but they recovered as their malabsorption gradually disappeared. The treatment includes resection of the dilated bowel, as in other atresias. Resection of part of the distal bowel may be required for additional atresias or for poor vascularity with questionable viability. Postoperative malabsorption generally requires intravenous hyperalimentation.
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Polysplenia syndrome has been well described. It is associated with gastrointestinal atresia in patients with situs inversus abdominus; however, it appears that this case represents the first occurrence of polysplenia with jejunal atresia having agenesis of the dorsal mesentery and partial situs inversus abdominus.