A Clinicostatistical Study of Congenital Alimentary Tract Obstruction

Clinicostatistical datsa on 314 patients with congenital alimentary tract obstruction at the Department of Pediatrics and Pediatric Surgery of Seoul National University Hospital from January, 1974 to July, 1980 are presented and reviewed. The results are as follows; 1. Congenital megacolon(133 cases) is the most common congenital alimentary tract obstruction, and anorectal malformations(127 cases), congental duodenal obstruction(20 cass), esophageal atresia(12 cases), ileal atresia(9 cases), multiple intestinal atresia(2 cases), and colon atresia(2 cases), in given order of frequency. 2. The 20 cases of congenital duodenal obstruction included 15 male nad 5 female patients. The 10 cases were intrinsic obstruction(diaphragm of web; 4, atresia; 3, stenosis; 2, uncertain; 1) and the 10 cases were extrinsic obstruction(malrotation with or without Ladd's band, midgut volvulus: 9, preduodenal portal vein; 1). Associated anomalies were present in 3(1%) of the total. Operation was carried out in 19 patients and seven of them died. 3. The 22 cases of ileo-jejuno-colon atresia and stenosis included 14 male and 4 female patients. The majority of the patients involved ileum(9 cases), jejunum(9 cases), Jejunoileum(2 cases), and colon aresia was present in 2 cases. Associate anomalies were present in 7(32%) of the total. Operation was performed in 20 patients and seven of them died. 4. The 133 cases of congenital megacolon included 99 male and 34 female patients. The 121 case(91%) were short segment involvement and the remainders were long segment involovement. The 10 cases(8%) were associated with other malformations. In 118 patients operation was performed and the remainders were received conservative treatments, including enema. The 20 cases, 18% of the patients developed complications such as enterocolitis, incontinence, and so on. Three patients died during follow-up.

A Clinicostatistical Study of Congenital Alimentary Tract Obstruction

Clinicostatistical datsa on 314 patients with congenital alimentary tract obstruction at the Department of Pediatrics and Pediatric Surgery of Seoul National University Hospital from January, 1974 to July, 1980 are presented and reviewed. The results are as follows; 1. Congenital megacolon(133 cases) is the most common congenital alimentary tract obstruction, and anorectal malformations(127 cases), congental duodenal obstruction(20 cass), esophageal atresia(12 cases), ileal atresia(9 cases), multiple intestinal atresia(2 cases), and colon atresia(2 cases), in given order of frequency. 2. The 20 cases of congenital duodenal obstruction included 15 male nad 5 female patients. The 10 cases were intrinsic obstruction(diaphragm of web; 4, atresia; 3, stenosis; 2, uncertain; 1) and the 10 cases were extrinsic obstruction(malrotation with or without Ladd's band, midgut volvulus: 9, preduodenal portal vein; 1). Associated anomalies were present in 3(1%) of the total. Operation was carried out in 19 patients and seven of them died. 3. The 22 cases of ileo-jejuno-colon atresia and stenosis included 14 male and 4 female patients. The majority of the patients involved ileum(9 cases), jejunum(9 cases), Jejunoileum(2 cases), and colon aresia was present in 2 cases. Associate anomalies were present in 7(32%) of the total. Operation was performed in 20 patients and seven of them died. 4. The 133 cases of congenital megacolon included 99 male and 34 female patients. The 121 case(91%) were short segment involvement and the remainders were long segment involovement. The 10 cases(8%) were associated with other malformations. In 118 patients operation was performed and the remainders were received conservative treatments, including enema. The 20 cases, 18% of the patients developed complications such as enterocolitis, incontinence, and so on. Three patients died during follow-up.

Two cases of Cryptococcosis in Children

Cryptococcosis is a subacute or chronic mycotic infection caused by cryptococcus neoformans with a special predilection for the lung, skin and central nervous system, but rarely involving the lymphatic system. Recently the authors have experienced two patients with cryptococcosis in volving the liver and lymph nodes. One was 31/4year old male and the other was 11 year old male. The former had suffered from severe abdominal pain since about 1 month ago and high fever developed 10days before admission. On physical examination, jaundice and hepatomegaly were noted with enlarged and tender lymph nodes in the neck and inguinal region. Bone marrow aspiration revealed increased cellularity with eosinophilia. Lymph node and liver biopsy specimens showed mand granulomas including epithelioid cells and Langhan's type giant cells containing numerous cryptococci. The budding cryptococci were also found in the cerebrospinal fluid prepared with India ink. The latter patient was admitted with the chief complaint of high fever and neck mass which had developed one week ago. On physical examination, enlarged lymph nodes were noted in the neck. But hepatomegaly or splenomegaly was not found. Lymph node bisopsy specimen revealed the same findings with the former case. They were treated with Amphotericin B with some improvement, but as the wre discharged because of poor economic condition the were not sufficiently followed up.