During a 3-year period, 258 infants and children underwent rectal biopsy to exclude Hirschsprung's disease (HD) and related disorders; 32 (12%) were found to have HD. Major morbidity occurred in 3 (2%) of 148 patients undergoing rectal suction biopsy (RSB) and 22 (13%) of 168 suction biopsies were inadequate for diagnosis. In 102 children over 6 months of age, Storz rectal cup biopsy forceps were used with no significant morbidity and adequate biopsies were obtained in 96% of cases. Open rectal biopsy was performed in 8 patients. The RSB tube is safe and reliable, but attention to technique is important. For children over 6 months of age undergoing rectal biopsy for HD, the Storz rectal cup biopsy forceps yields superior results.
Phimosis, defined as scarring of the tip of the prepuce, was studied prospectively in a series of 23 boys aged 4 to 11 years. There was little to support the contention that the condition is caused by trauma, or by ammoniacal or bacterial inflammation of the prepuce, nor could any other aetiological factor be identified. Histological examination of the foreskin showed the appearances of Balanitis Xerotica Obliterans in 20 of 21 specimens submitted for study.
A 27-year-old patient contracted a Coxsackie virus A9 meningitis at 33 weeks gestational age. Two weeks later a macerated female stillborn infant was delivered. The placenta showed a diffuse perivillous fibrin deposition with villous necrosis and inflammatory cell infiltration and yielded Coxsackie virus A9 on culture. Post-mortem examination of the fetus showed only minimal inflammatory changes in the cardiac connective tissue and the subarachnoid space.
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