Selective catheterization of tracheoesophageal fistula

Selective catheterization of tracheoesophageal fistula

356 good results in clinical or research fields. Indicated for pediatric surgery researchers.--Carlos M. Almoyna Measurement of Digestive Intralumina...

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good results in clinical or research fields. Indicated for pediatric surgery researchers.--Carlos M. Almoyna Measurement of Digestive Intraluminal Pressures. III. Open Tubes. C. Mart~nez-Almoyna and J. Monereo. Rev Quir Esp

6:97, 1979. Open tubes are frequently used as a sensory system for digestive intraluminal pressures, mostly in the esophagus and colon. Catheters present m a n y advantages and a few disadvantages compared to balloons. This unusual topic is largely discussed with a complete bibliographic review (pediatric, adults and research papers, useful for pediatric research).-Carlos M. Almoyna Recurrent Abdominal Pain in Childhood. L l/arsano, M .

Nitzan, Y. Matot. Harefuah 96:593 595, (May), 1979. Of children between the age of 3 to 14 yr, 10% complain of abdominal pains. Less than 10% of these are organic in nature. The most frequent causes of abdominal pains in children in Israel are in the gastrointestinal tract, hiatus hernia, peptic disease, and familial Mediterranean fever. Volvulus and intussusception are rather rare causes of abdominal pain. In 77% of the patients reviewed, the pain was psychogenic in origin. In the younger group, between 3 4 yr of age, the cause was feeding problems and in the 5-7 yr group, the cause was related to problems in school. In 50% of the patients another member of the family suffered from abdominal pain. The authors stressed the point that organic disease can be masked by psychological disturbances. In 31% of the patients who have been followed-up the pains have disappeared and in 14% there was marked improvement. Therefore, the authors came to the conclusion that the prognosis in these children is good if they are properly treated.--Shemuel Nissan latrogenic Perforation of the Esophagus in Premature Infants. H. S. Nagaraj, P. Mullen, D. B. Groff, et al.

Surgery 86:583 589, (October), 1979. Ten premature infants with traumatic perforation of the cervical esophagus were seen in a 2-yr period. All had been vigorously treated for RDS. While 6 infants had blood tinged or excessive secretions and increasing respiratory distress was noted in 7, the diagnosis was first suspected by abnormal position of the nasogastric tube in all 10. Difficulty in nasogastric intubation was only encountered in 4 infants. Pneumothorax occurred in 9 and pneumomediastinum in 4. Esophagoscopy was not helpful in this series. Four infants were treated with fluoroscopically placed soft nasogastric tubes and systemic antibiotics. In 6, cervical mediastinal drainage with gastrostomy in 5 was used. All babies received parenteral nutrition. Three of four babies managed none operatively died in the first week after perforation. Two of six with operative drainage survived. Of these four deaths two were from candidiasis 11 and 44 days after drainage. One died of chronic pulmonary dysplasia after 47 days and 1 died following intracranial bleed 17 days after drainage. Proper suctioning and visualization during intubation should prevent this injury. When it occurs, early diagnosis and aggressive surgical m a n a g e m e n t are r e c o m m e n d e d . Eugene S. Wiener


Selective Catheterization of Tracheoesophageal Fistula. D.

R. Kirks, C. A. Briley, Jr., G. Currarino. A m J Roentgenol 133:763-764, (October), 1979. A 17-mo-old female revealed evidence of a recurrent tracheoesophageal fistula but the fistula could not be found at thoracotomy. Under fluoroscopic control a 3 French catheter was passed through the fistula and a guide wire was passed through the trachea into the mouth and anchored. The catheter and wire allowed identification of the recurrent fistula at subsequent repeat thoracotomy. The technique, described in detail, is recommended for difficult cases as recurrent fistulas or fistulas not definitely demonstrated on barium studies. Randall 14I. Powell Diagnosis and Surgical Treatment of "H-type" Tracheoesophageal Fistulas. C. R. Lain. World J Surg 3:651 657,

(May), 1979. Four patients, ages 1, 6, 12, and 50 yr, form the basis for this report. The first patient presented at 6 wk of age and the diagnosis was made at age 12 yr following 6 operations that included patent ductus ligation, division of an aberrant right subclavian artery, bronchoscopy and tracheostomy, repeat bronchoscopy and tracheostomy, a right upper lobectomy, and a Heller procedure. A film following the ductus ligation revealed a stomach greatly distended with air which in retrospect suggested the correct diagnosis. The second patient was diagnosed at age 1 yr after a negative barium study at age 5 mo. The other two patients had delays in diagnosis also. In the discussion, Dr. Daniel Hays commented on the delay in diagnosis and presented 20 patients from the Children's Hospital of Los Angeles since 1958. Since 1965, 75% have been diagnosed in the first several months of life. Abnormal or absent motility of the distal esophagus is common and should suggest the diagnosis.--Randall HI. Powell Esophageal Replacement in Children: 10 yr Experience. I.

Wolfstein, M. Y. Rabau, L. Avigad, et al. Israel J Med Sci 15:742-745, (September), 1979. Between 1969 and 1978, 11 children underwent esophageal reconstruction. Their ages at operation ranged from 1 to 16 yr. All the operations were performed in one stage. The right colon was used in 7 children and reversed gastric tube in 4. There were no postoperative deaths. Temporary salivary fistula and cervical anastomotic stricture were the most common operation-related complications. On the follow-up visit, at least 6 mo after surgery, all the children were able to eat a normal diet.--Shemuel Nissan Patterns of Postcibal Gastroesophageal Reflux in Symptomatic Infants. S. J. Jolley, J. J. Herbst, D. G. Johnson, et

al. A m J Surg 138:946 950, (December), 1979. There were 35 boys and 13 girls less than 2 yr of age with a history of recurrent vomiting or regurgitation of feeding studied for gastroesophageal reflex by extended pH monitoring. All children also had a barium upper GI series and nine had lower esophageal sphincter pressure studies. Symptomatic infants displayed three patterns of gastroesophageal reflux after a clear fluid meal, more easily detected in the