Peutz-Jeghers' syndrome--juvenile intestinal polyposis--review of five cases.

During the past 30 years, authors observed and followed 5 patients with Peutz-Jeghers' syndrome. Four of them had diffuse polyposis of stomach, small bowel and colon. They also had severe clinical presentation of the disease, with recurring colicky pain, haemorrhage, anaemia and intussusception, all of which necessitated frequent surgical treatment. Excised polyps presented as benign hamartomas, without malignant alteration. Mucocutaneous pigmentations were present in 4 patients. Family history was revealing in only 2 cases. One patient, a girl aged 2 years, died due to the complications of the surgical intervention (intestinal obstruction). She has had the most severe form of the disease with diffuse polyposis.

[Osteomyelitic pseudarthrosis of the tibia with loss of substance treated with a graft of the opposite fibula]. / Pseudarthrose ostéo-myélitique du tibia avec perte de substance traitée par greffon du péroné opposé.

Dragan Dj./Re. No. 2755/76, 5,5-year-old boy, referred to this hospital with signs of bipolar osteomyelitis, destruction and fistulisation of the left tibia and talocrural arthritis. Staphylococcus albus and streptococcus haemoliticus were isolated from the fistula. Osteomyelitis was treated with an adequate therapy including long usage of Lincocin. In Feb. and Oct. of 1977 a sequestrotomy of the mid portion of the tibia and transmedular fixation using Ratschmann's nail were performed. The process resulted in pseudarthrosis of the mid portion of the tibia with loss of bone substance in the length of 2.5 cm and talocrural arthrosis and deformed foot. The boy walking support. In July 1980, in the stage of "ripe" pseudarthrosis a complete resection of pseudoarthrosis with sclerotic portions of tibia to healthy bone was performed. The mid part of the right tibia was resected subperiostally and was grafted centromedularlly into the upper and lower medular channel of the left tibia. Two Kirschner's needles were implanted centromedularlly so as to strengthen the bone osteosynthesis. Complete union of the grafted fibula with treppassage of the medular channel occurred with its tibilisation and growth in length and width. In July 1982, the concave foot was corrected using Bertrand's method. The present difference in the length between the two legs is 4.5 cm which is corrected by the use of padded shoes. Lengthening of the leg is planned to be performed before he reaches the age of 14.

[Chronic granulomatous disease (in a 2-month-old infant)]. / Hronicna granulomatozna bolest (u odojceta od 2 meseca).

The paper describes a severe form of chronic granulomatous disease with onset in the neonatal period; the case presented is a 2-month-old male infant, coming from a family in which hid older brother died with signs of the same illness. The disease is rare. This is the second report in our literature. The clinical picture showing various severity confirms the heterogenity of the disease and difference in the gene expressivity. Further investigation involving the function of granulocytes in children with recurrent infections might help us to reveal this disease characterized by disfunction of granulocytes, more frequently.

[Osteoarticular tuberculosis in children (author's transl)]. / La tuberculose ostéoarticulaire chez les enfants.

A group of sixteen children suffering from osteoarticular tuberculosis were seen over the past five years in the Belgrade Paediatric Surgery Clinic. This disease is now extremely rare and effects chiefly children born outside maternity departments and not receiving BCG vaccination at birth for different reasons. The osteoarticular tuberculosis rate in the Socialist Republic of Serbia over this period was thus one in 500,000 children. The disease is three times as common in male children, most often affecting the hip and presenting above all at about the age of nine. At the time of admission, eight children had tuberculosis lesions affecting the lungs, visible and active or latent, partially or completely. In five children, one of the parents was receiving treatment for active pulmonary tuberculosis at the time of onset of the disease. Conservative treatment (immobilisation, tuberculous bacteriostatic therapy and general measures) was used in fifteen children and only one underwent surgery, in addition to the standard treatment described. In only one child, there was ankylosis of the hip and the end of treatment, the others having less sequelae of returning completely to normal. In one girl, osteoarticular tuberculosis was complicated by exsudative tuberculosis pericarditis.