Splenic artery ligation and vasoligation in the management of bleeding oesophageal varices

The effects of splenic artery ligation combined with vasoligation of the short gastric, left gastric vessels and veins around the abdominal esophagus were studied in 20 patients with bleeding esophageal varices. Follow-up period varied between 18-24 months. The liver pathology was bilharzial fibrosis in 17 [85%], mixed in 2 [10%] and post-hepatic cirrhosis in one [5%]. The patients were classified according to the modified Child's Risk Grading into grade A [20%], B [60%] and C [20%]. The drop in portal pressure varied between 23 and 5 cm/H20 [mean 8.1 cm/H20]. Recurrent bleeding after 20 months occurred in one [5%]. Postoperative ascites developed in four [20%], but was easily controlled medically. All the patients showed improvement in the peripheral blood picture. Deterioration in liver function tests occurred in one patient. None of the patients developed splenic abscess or cysts. Endoscopic follow-up showed that the varices did not disappear, but progressed. There was no operative mortality. One patient [5%] died two months postoperatively from progressive liver failure. The preliminary results of this line of treatment are encouraging, but longer follow-up is still needed

Acetylcholine esterase enzyme study of the myenteric plexus in infantile hypertrophic pyloric stenosis

Phyoric tissues from 13 infants with infantile hypertrophic pyloric stenosis and 4 normal control were studied using acetylcholine esterase enzyme apparent reduction in the number of the cholinergic ganglia in the intermuscular plexus was seen. Increased demand and compression by the hyper-atrophied muscles Lare new meatus was achieved. Only one developed a fistula. In this preliminary study the operation has proven to be technically simple with few complications

Modification of the Mathieu and Horton-Devine urethroplasty in the management of hypospadias

A one-stage urethroplasty based on the Mathieu and Horton-Devine operation is described. The operation was carried out on 10 boys with distal and mid-penile hypospadias. In all of them a terminal position for the new meatus was achieved. Only one developed a fistula. In this preliminary study the operation has proven to be technically simple with few complications

Primary reconstruction of bladder exstrophy: a report on the early results of the operation

Primary reconstruction of bladder extrophy was carried out on five children at Ismailia General Hospital. Successful repair was achieved in four of them. The details of the technique are presented. The early results are encouraging; however, final assessment of the functional results needs longer follow-up and could only be made after attempting correction of the genital aspect off the problem

Congenital and segmental obstructive Emphysema

Our experience with congenital obstructive emphysema is reviewed with special reference to problems in diagnosis and management. A flow chart for the diagnostic approach is presented. Two cases with segmental involvement of the emphysema are documented and the pathogenesis discussed. Treatment of congenital obstructive emphysema in the neonate or infant with respiratory distress is usually lobectomy. However for older children with mild symptoms, a conservative policy of treatment is justified