Chronic duodenal ulcer in children and response to highly selective vagotomy.

The effectiveness of highly selective vagotomy (HSV) in adult duodenal ulcer surgery is confirmed by absence of peroperative mortality or postoperative morbidity and by ulcer healing in the majority of cases. Whether it could be used in children with the same result was the subject of our study in 13 successive cases of complicated duodenal ulcer treated between 1974 and 1987. There was complete ulcer healing in 4 cases. Pain relapsed in 5 cases and there was recurrence of hemorrhage in 2 cases. Although immediate good results lasted for at least 3 years, 2 patients were lost to follow-up. Still, we consider HSV as a safe procedure available for children as it does not "queer the pitch" for a subsequent treatment if it fails.

[Skin sutures in pediatric surgery. Use of a fast-resorption synthetic thread]. / Sutures cutanées en chirurgie pédiatrique. Utilisation d'un fil synthétique à résorption rapide.

Vicryl Rapide is a new, fast absorption skin suture material. Its spontaneous elimination avoids the conventional stitch removal. The tolerability of this material and the cosmetic results obtained were tested in a paediatric surgery department in elective surgery and in emergency surface wound sutures. Provided certain precautions are taken (tense sutures and sutures of the face must be avoided, since the thread passages are visible in 25 percent of the cases), the material is well tolerated; the cosmetic results and child comfort it provides and the absence of stitch removal makes Vicryl Rapide a first-choice material in paediatric surgery.

Xanthogranulomatous pyelonephritis in children. Report of 7 cases and one associated with nephroblastoma.

8 cases of XGP in children are reported. The presence of urolithiasis together with xanthogranulomatous lesion in 7 cases and of nephroblastoma in one may be of help in understanding the aetiopathogenesis. In all the cases the involved kidney did not function thus necessitating subcapsular nephrectomy via retroperitoneal approach.

[Urethral injuries caused by hair strangulation]. / Plaies de l'urètre par cheveu étrangleur.

Fifteen urethral injuries by hair strangulation gave to the authors the opportunity to search the meaning of such a practice. The observed damages of urethra are not the result of some overzealous ritualistic circumcision as the child or his family say. A patient tedious investigation establishes that this strange practice finds its assessment probably in a mythic belief or in an unrevealed erotic purpose. The authors emphasize the best results of a two stage repair procedure.

[Segmental dilatation of the ileum associated with an omphalocele and a common mesentery. Discussion around 2 cases : chance or morphogenically "related"? (author's transl)]. / Dilatations segmentaires iléales associées à une omphalocèle et à un mésentère commun réflexions à propos de 2 cas : hasard ou "instantané" de morphogénèse pathologique?

Segmental dilatation of the ileum is the subject of this report which concerns two cases. Both cases were associated with omphalocele and intestinal malrotation, an observation already noticed by some authors. Is it still a hazardous coincidence or rather a real opportunity which throws light over the explanation of this malformation?

[Future of the remaining rectum after treatment of familial polyposis (author's transl)]. / Devenir du rectum restant dans la polypose recto colique familliale.

In the treatment of familial polyposis the conservation of the rectum is essential to assure a convenient control and rhythm of defecation. Meanwhile the future of resting polyps deserves the attention of the surgeon. Certain authors are optimistic and claim that spontaneous regression of the polyps is possible. Our experience illustrates that the rectal mucosa tends to fabricate new crops of polyps. The prolonged post operative observation of more than 4 years of polyposis in one family has permitted us to follow the evolution of the rectal mucosa and to deduce that gravity of the lesion is quite variable. The polypotique character of the rectal mucosa must influence the choice of certain surgical technic specially that nine of them achieve entire satisfaction yet.