Physiologic investigation of primary chronic constipation in children: comparison with the barium enema study

Rectoanal manometry and a rectometrographic study were carried out on 31 control subjects and 63 constipated children. A single contrast barium enema was performed on all constipated children and on 20 children for whom this x-ray study (made for a reason other than constipation) was considered normal. This study allowed the determining of four manometric parameters (rectoanal inhibitory reflex threshold, rectorectal reflex threshold, conscious rectal sensitivity threshold, maximal anal resting closure pressure), of three rectometrographic parameters (maximal rectal tolerable pressure, maximal rectal tolerable volume, maximal rectal compliance), and of one radiologic parameter (rectopelvic ratio). It appeared that the barium enema study was not meaningful. The threshold of the inhibitory reflex and of the rectoanal reflex did not allow for a specific definition of abnormality in constipation. Anal closure pressure was higher in 38% of the constipated patients. The sensitivity threshold was significantly higher in the constipated group. In 79% of the patients an increase in rectal compliance was observed. Finally, in this series of constipated patients who did not have Hirschsprung's disease, organic abnormalities were demonstrated in 97% of the children.

Extended intestinal aganglionosis in siblings

In this paper we report two cases of extended intestinal aganglionosis in siblings, a condition that could be considered a severe variety of Hirschsprung's disease.

[An unusual form of laparoschisis. Contribution to the embryological study of the umbilical region]

The authors report one case of laparoschisis with special anatomic peculiarities: it was not defect on the abdominal wall, the intestinal evisceration go through a cordonnal defect who was distand of the normal abdominal wall and umbilicus. This observation re-opens the whole question of the abdominal wall deformities and all the embryologic theories are discussed.

[Impact of reflux on the kidney]

Description of the reflux nephropathy. Pyelonephritis lesions are undoubtedly linked to the vesico-ureteric reflux. The role of the intra-renal reflux ( Hodson ) and the Big Bang Theory ( Ransley ) are discussed as the data from animal experiments. The role of the sterile reflux and of the segmental hypoplasia is relatively less important. The actual management of vesico-ureteric reflux treatment is questioned.

[Obstruction due to congenital tracheal and bronchial stenosis]

Report of seven cases of congenital tracheal and bronchial stenosis in infants, successfully treated by endo-resection (2 cases), tracheoplasty (1 case) and resection with anastomosis (4 cases). The review of several cases of literature let to emphasize some points: the frequency of severe manifestations since neonatal period and during the first months leading to repeated hospitalisations with the treatening of broncho-pulmonar infections; the necessity of early diagnosis and complete anatomic evaluation of stenosis, which sometimes requires to be promptly treated in front of a sudden recurrence of respiratory distress; at last, improvements of reconstructive surgical technique, tracheoplasty for diffuse stenosis, endo-resection or resection with anastomosis for segmental lesions, which the results point out the possibilities and indications of that surgery in the infants.

Technique of end-to-side portacaval shunt in fish (scyliorhinus canicula: small dogfish)

The authors describe a technique of portacaval shunt in a fish (small dogfish) using microsurgery. The techniques of anaesthesia and surgery are described and the results of eight operations are given, which show the problems of this kind of surgery, particularly with healing.

[Multiple vascular thromboses in severe acute autoimmune hemolytic anemia with Mycoplasma pneumoniae serology treated by plasma exchange and immunosuppressive agents]

A 5,9 year old girl presented a severe and acute auto-immune hemolytic anemia, unresponsive to steroids, treated by 10 plasma exchanges, immunosuppressive agents and splenectomy. Despite an anticoagulant treatment, occurrence of multiple thrombosis. Unusual evolution of Mycoplasma serological tests.

[Sigmoid volvulus in children. About 6 cases (author's transl)]

About six of sigmoid volvulus m children, the authors underline the rarity of this etiology in large bowel obstruction. Two cases happened during neonate and four cases are associated with other pathologic diseases (2 neurologic ans 2 Hirschsprung diseases). Diagnosis is based on baryum enema and the best surgical management in emergency is resection and derivation with secondary anastomosis.

[Morphometry of the femoral head in the rabbit. Surface appearance of the acetabulum after femoral prosthesis]

An anatomical study has been achieved on 42 upper extremities of adult rabbit's thigh bones. Three types of prostheses have been perfected in order to analyse the reactions of the cartilage and of the subchondral bone when confronted with these implants. The animals were sacrificed at different intervals. The state of the acetabulum surface has been studied according to macroscopic and microscopic criteria. Three methods converge and agree in showing an arthrosis type of reaction with regard to the non operated controlateral articulation.