Undifferentiated (embryonal) sarcoma of the liver in childhood. Successful combined-modality therapy in four patients.

Background: Undifferentiated (embryonal) sarcoma of the liver is a rare, highly malignant, mesenchymal tumor presenting predominantly in late childhood. Four girls, ages 6-13 years, who were treated with combined-modality regimens are reported.

Methods: In the first and second patients, hemihepatectomy resulted in complete removal of the tumor, and multiple-agent chemotherapy was administered postoperatively.

[Acute exacerbation of chronic recurrent appendicitis in childhood].

Retrospective analysis of 324 childhood appendectomies revealed microscopic signs of previous inflammation in 66 out of 111 acute cases and in 162 of 182 cases of "chronic" cases presented with a long history of recurrent abdominal pain. Thus a somewhat liberal indication for appendicectomy in childhood seems justified in the appropriate cases.

[Chronic intermittent duodenal obstruction in childhood].

Chronic intermittent duodenal obstruction caused by stenosis of the distal duodenum is a rare disease. Tight fixation of the ligament of Treitz, compression due to mesenteric lymphomatas or abnormal attachment of the mesocolon can cause intermittent impairment of intestinal passage. It will be necessary to differentiate this against genuine arterio-mesenteric duodenal obstruction as well as nerve motility disorders.

[Routine gastrostomy in esophageal atresia].

Contrary to Kiely and Spitz we have been using gastrostomy in almost all cases of oesophageal atresia treated with primary anastomosis. Gastro-oesophageal reflux has never been a major problem and during 25 years of personal paediatric surgical experience we have never performed any type of antireflux surgery. To confirm this we have followed up 71 out of 77 survivors who underwent primary anastomosis and gastrostomy in 3 Departments of Paediatric Surgery.