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Report about a rare complication of gastroschisis by early volvalus. Following this occasionally the prenatal diagnosis there was a very ultrasonogram of a mostly solid tumour before the abdominal wall. The postpartal operative therapy with resection and later doubling according to Bianchi B described.
Radiological terminology includes a number of interesting and often amusing terms intended to help us understand and remember the pathological abnormality being described. What radiological sign is illustrated in Fig. 1 and what condition does it represent?
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An analysis of findings of clinical and ++roentgenological examinations of 55 patients with ectopy of the anal canal prior to operation and 68 patients after correction of the defect has shown that secondary megacolon developed in proportion with the age and degree of the outlet opening stenosis and there appeared injuries of elements of the normally formed anal canal. The authors described their original many-steps operation of the formation of the anus which allows all elements of retaining feces to be preserved. The amount of good long-term results increased from 22-26% up to 75% as compared with those of operations after Stone.
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Twenty cases of meconium peritonitis were found between September 1980 and March 1988 at Mackay Memorial Hospital. The male to female ratio was 1.5 to 1. Six of the 20 cases involved premature babies. The great majority presented symptoms and signs before 5 days old, but one case was not diagnosed until 13 months of age. Polyhydramnios of the mother was found in six cases (30%). Abdominal distension was the universal symptom in all 20 cases. Hydrocele was noticed in 8 of the 12 male babies. In seven cases (35%) radiological examination showed abdominal calcifications. All patients underwent surgical intervention. Peritonitis was of cystic type in seven cases (35%); fibroadhesive in nine cases (45%); generalized in four cases (20%). Evident intestinal perforation was noted in 13 patients, and a mechanical obstructive lesion was found in 9 cases (45%) including intestinal diaphragm, atresia, volvulus, and Hirschsprung's disease. In only two patients (10%) was neither evident perforation nor obstructive lesion. The overall mortality rate was 30% (6/20), with no mortality after 1986 (0/6). The mortality seemed increased in those associated with perforation (4/13) and midgut volvulus (2/2) in particular, compared with non-perforation cases (1/7). It appears that early aggressive operation, and meticulous postoperative care, have contributed to the higher survival rate in recent years.
The authors presented various data with respect to the frequency (431 cases) of anorectal malformations associated to urogenital abnormalities (26 to 56%). They also indicated the frequent association of these anomalies with a lumbosacral vertebral malformation (28%). The higher the anomaly, the more serious the condition.
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On the basis of the analysis of 98 major colonic resections in children with Hirschsprung's disease, anorectal developmental defects, diffuse colonic polyposis, the problems of mobilization of bringing down the different portions of the intestine are considered.
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Fetal urine output was evaluated in 12 pregnancies complicated by hydramnios. Six of these pregnancies were twin gestations with markedly elevated fetal urine output of the hyperperfused fetus. All six fetuses had urine output greater than the 95th percentile for their gestational age. These six patients were evaluated prior to and during the 29th week of pregnancy. Three singleton gestations had upper gastrointestinal obstruction and normal fetal urine output of 18.7, 18.0, and 12.3 mL/hour at 35, 35, and 31 weeks' gestation, respectively. Markedly elevated fetal urine output of 18 mL/hour (tenth to 95th percentile at 26 weeks, 4-7 mL/hour) was present in one fetus that was subsequently found to have diabetes insipidus. The remaining two singleton pregnancies with idiopathic hydramnios had upper limits of normal fetal urine output of 10 and 13 mL/hour at 31 and 32 weeks, respectively. It appears that hydramnios may be the result of polyuria of the hyperperfused twin in cases of twin-twin transfusion or diabetes insipidus. In upper gastrointestinal obstruction or idiopathic hydramnios, increased fetal urination does not appear to be present.
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