[Bacterial cervical lymphadenitis--surgical aspects]. / Bakterielle Lymphadenitis colli im Kindesalter--kinderchirurgische Aspekte.

In a retrospective study we evaluated clinical features and diagnostic impact of sonography, white blood cell count, C-reactive protein as well as bacterial etiology of children treated surgically for bacterial cervical lymphadenitis. We report on 38 children at the age between 2.5 months and 14 years who were admitted in our departments between 1990 and June 2002. Leukocytosis (median 16.5 Gpt/l) and/or elevated concentrations of C-reactive protein (median 27 mg/l) occurred in the majority of patients. Clinical appearance and the result of ultrasound examination were relevant for diagnosis of suppurative inflammation. Treatment included incision and drainage in 29 cases, aspiration was performed in 4 children and in 5 cases the affected lymph nodes were removed. We found a predominance of infections due to S. aureus (37%) and group A streptococci (16%). A mixed aerobic-anaerobic infection was observed in 2 (5%) children and atypical mycobacteriosis in 3 (8%) cases. In conclusion, suppurative cervical adenitis has to be taken into account in children with cervical lymph node enlargement. In these cases surgical drainage is a key to appropriate resolution.

Benign symmetric lipomatosis with myelomeningocele in an adolescent: An uncommon association-case report.

The authors report an unusual localization of symmetric adipose tumors associated with spinal dysraphism. Initially, the patient underwent a closure of the lumbosacral myelomeningocele. At that time, the tumors were not evident and remained undiscovered up until puberty. However, during puberty, the symmetric lipomatous masses grew at the perineal region. Except the patient's age, all findings and the clinical picture supported the diagnosis of a benign symmetric lipomatosis (BSL). To the authors' knowledge, the following case has not been described previously.

Chondromatosis of the ankle joint (Reichel syndrome).

A case of chondromatosis of the upper ankle joint in childhood is described. It is a monoarticular disease with a good prognosis, frequently without known prior trauma or inflammation, although often free fragments of cartilage are seen in the joint cavities. It originates from the synovium of the joint, and is known in the literature as Reichel syndrome.

Laparoscopy-assisted abdominal shunt revisions in children with hydrocephalus.

Abdominal shunt revisions are frequently necessary for ventriculoperitoneal shunt systems in children with hydrocephalus internus. There are many well-known problems related to abdominal shunt revisions such as difficulties in reaching the abdominal cavity, intra-abdominal adhesions, cerebrospinal fluid pseudocyst, or problems in retrieving dislocated catheters. From 6/1996 to 12/1997 we operated on twenty (20) children aged from 2-15 years (body weight 4.8-68 kg) with abdominal shunt insufficiency using the laparoscopy assisted technique. In only one case was it impossible to reach the abdominal cavity laparoscopically and conventional open surgery was necessary. We had no complications such as injured vessels or bowel and saw a complete recovery in all patients. In comparison to conventional surgery, we found handling simple, minor trauma to the patients, good intra-abdominal view, short operation times and good cosmetic results to be the advantages of laparoscopy-assisted abdominal shunt revision. In addition hospitalisation time can be reduced.

[Preventive orchidopexy of the contralateral testis after testicular torsion in childhood?]. / Prophylaktische Orchidopexie des kontralateralen Hodens nach Hodentorsion im Kindesalter?

Follow-up examinations following testicular torsion did not reveal any differences in the development of contralateral testicles preventively fixed compared with those which were not. It is thus concluded that criteria other than testicular development must be taken into account when deciding on mandatory contralateral orchiopexy in testicular torsion.

[The clinical relevance of the dynamics of ventricular changes in surgically treated hydrocephalus of children with myelomeningocele]. / Zur klinischen Relevanz der Dynamik der Ventrikelveränderungen beim operierten Hydrozephalus von Kindern mit Myelomeningozele.

The normalisation of head circumference and ventricular dilatation are aims of the therapy of hydrocephalus. Sonographic follow-up after ventriculo-peritoneal shunt demonstrates a changed ventricular morphology and inform about clinical relevant questions in regard of effectivity and complications of the shunt. The different morphological development of liquor systems in spite of comparable premises is discussed on the base of 47 children with myelomeningoceles.

[Results of cerebral sonography in children with myelomeningoceles]. / Ergebnisse der zerebralen Sonografie bei Kindern mit Myelomeningozelen.

47 infants with myelomeningocele were investigated by ultrasound after the surgical closure of the cele and followed up to 12 months. The aim was the early diagnosis of hydrocephalus and the recording of morphological features of the ventricular system in comparison with hydrocephali of other origins, especially of Chiari-Syndrome. 31 infants needed a shunt due to rapid progress of the ventricular dilatation and clinical signs of a raised intracranial pressure: in 25 of this group (81%) the ultrasound investigation demonstrated a Chiari-Syndrome. Of 16 further infants who definitely did not need a shunt, only 5 (31%) had a Chiari-Syndrome. Therefore, the first sonographic examination seems to provide a certain prognostic evidence for the development of a hydrocephalus.

[Is phonoenterography suitable for determining postoperative intestinal motility?]. / Eignet sich die Phonoenterographie zur Erfassung der postoperativen Darmmotilität?

The electrico-acoustical auscultation of intestinal sounds permits a continuous recording, documentation and evaluation of the intestinal motility to be made. Temporal course and duration of the sounds as well as their amplitude as a measure of their intensity are criteria for the diagnosis. The frequency-analysis of sound-patterns may be used for differential diagnosis of different forms of ileus.

[Juvenile bone cysts (author's translation)]. / Erfahrungen in der Behandlung juveniler Knochenzysten.

37 young persons suffering from juvenile bone bone cysts underwent surgery. The operative treatment consisted of meticulous excochleation and refilling of the cavity with homologous or autologous cancellous bone chips. Relapses occurred in 14 cases twice. Allogenous material suits best for primary treatment. In case of relapse autogenous bone chips sould be used.