Appendicitis in the pediatric age group.

A retrospective analysis of 35 patients aged 2 to 20 years who were seen at the District of Columbia General Hospital and Howard University Hospital over a three-year period (1984 to 1986) was performed. All patients were operated on with a preoperative diagnosis of acute appendicitis. A normal appendix was found in 17 percent of patients, of which the majority was adolescent girls. Of those patients with acute appendicitis, 41 percent had perforated appendices, and one half of these were judged to be complicated.At diagnosis or at reoperation, one half of the patients were maintained on single-antibiotic therapy, the other half were maintained on triple-antibiotic therapy. The average hospital stay was 26.6 days, with no significant difference between those patients on single- or triple-antibiotic coverage. The average hospital stay for patients with uncomplicated appendicitis was six days.

Partial splenectomy for a splenic pseudocyst.

Based on the principles and techniques of partial splenectomy and splenorrhaphy, the feasibility of removing a splenic cyst while preserving normal functioning splenic tissue is demonstrated. This approach avoided the potential catastrophe of overwhelming postsplenectomy sepsis in a 16-year-old girl.

Ultrasound contribution to the diagnosis of neonatal hydrometrocolpos with proximal vaginal atresia.

The value of ultrasound examination in a case of neonatal hydrometrocolpos is presented. Ultrasound proved the pelvic origin and the cystic nature of the mass, determinations essential to a correct diagnosis.

Computed tomography of testicular feminization.

Testicular feminization is a rare genetic disease characterized by an XY karyotype, bilateral functional testes, female external genitalia, blind vagina, and absence of müllerian derivatives. The presurgical localization of the testes is critical and is particularly well suited to the cross-sectional imaging capability of CT.

Duodenal atresia in utero in association with Down's syndrome and annular pancreas.

A 28-weeks' gestational trisomic-21 male, with duodenal atresia due to annular pancreas, is presented. The atresia was diagnosed in utero by sonographic techniques. A review of the pertinent literature and discussion of management are presented.

Ultrastructure of the gonads in the testicular feminization syndrome.

The testicular feminization syndrome is a form of familial male pseudohermaphroditism transmitted by an X-linked gene. The karyotype is 46XY. Affected patients resemble normal females phenotypically. To date, only eight cases of this syndrome have been studied by electron microscope. This study reports the ultrastructural appearance of the gonads in two additional patients. The presence of mature interstitial cells with a rich endoplasmic reticulum suggests that the pathologic defect is not due to a lack of androgenic hormone production by the testes but is caused by peripheral end-organ resistance.

Spontaneous neonatal gastric perforation.

Sixteen cases of spontaneous neonatal gastric perforation seen between January 1969 and March 1979 are reported. There were 13 surgically treated patients and three autopsy cases. This study provides information relative to the incidence among black populations, an incidence 1 per 2,900 live births. The entity is at least four times more common in males than females. All perforations occurred within the first week of life (average 72 hr). All perforations were on the greater curvature of the fundus. The operative mortality of this series is 7.5% (1 of 13) with an overall mortality of 25% (4 of 16). A gastrostomy was routinely done. No peritoneal cavity drainage or segmental gastric resection was necessary.