[Primary experiences with laparoscopic appendectomy]. / Primaere erfaringer med laparoskopisk appendektomi.

The material comprises 77 patients with suspected appendicitis seen in a district community hospital. In the presence of a surgeon with laparoscopic experience laparoscopy was performed in 23 patients. In two patients the laparoscopy was only diagnostic, and in two patients adhesions or friable gangrenous appendicitis necessitated conversion to conventional appendicectomy. Nineteen patients thus had a laparoscopic appendicectomy performed with a median operation time of 63 minutes and a median hospital stay of two days. One patient with gangrenous appendicitis and a periappendicular abscess was readmitted after three weeks because of deep infection, which resolved after antibiotic treatment. The remaining 54 patients had a conventional appendicectomy performed, with a median operation time of 40 minutes and a median hospital stay of three days. There were six complications in this group. We conclude that laparoscopic appendicectomy is a safe alternative to open operation with benefits for the patient in form of lesser pain, shorter hospital stay, fewer complications, better cosmetic outcome, and shorter time to normal activity.

[Early amnion rupture or amniotic band syndrome]. / Tidlig amnionruptursekvens eller amnionbåndsyndromet.

Early rupture of the amnion with resultant oligohydramnios and subsequent development of mesodermal bands between the chorion and the fetus can cause various deformities. The degree of deformity depending on the extent of the band formation and the gestational age at which this occurs. The condition may involve all parts of the fetus and comprizes a spectrum ranging from clinically insignificant small constricting bands on the extremities to large craniofacial and visceral defects which may be fatal and cause abortion. Prenatal diagnosis relies mainly on ultrasonic investigation, and the treatment--quo ad vitam--consists mainly of reconstructive surgery. A case is reported.

[Gastroesophageal reflux in children. An overlooked disease]. / Gastro-øsofageal refluks hos børn. En overset sygdom.

In a material of 25 patients with gastro-oesophageal reflux (GER), 11 had cerebral damage, 15 had symptoms of oesophagitis and 18 had respiratory problems including here six cases of apnoea with cyanosis and bradycardia resembling near-miss sudden infant death syndrome (SIDS). Only two of the children recovered acceptably on conservative treatment and the remainder were submitted to operation. Operation had insufficient effect in 30%. Cerebral damage or atresia of the oesophagus were present in all of the patients in whom operation was without effect. All children with symptom-producing GER should first be submitted to conservative treatment for at least three months and operation should be offered in cases where this treatment fails. Children with chronic or recurrent respiratory symptoms without other explanation and all children with episodes of apnoea and near-miss SIDS should be examined for the presence of GER.