Obstructive jaundice causes depression of immune system function but it is unclear at present how rapidly immune function recovers after relief of biliary obstruction. To address this issue, we studied 218 Sprague-Dawley rats with common bile duct obstruction. Mononuclear phagocyte function, cell mediated immune function, portal-systemic shunt fraction, liver function tests, and liver histology were evaluated in normal (sham) rats, obstructed rats, and at weekly intervals after relief of biliary obstruction. Hepatic uptake of radiolabelled bacteria was 82 per cent in sham rats and 66 per cent in rats 21 days after CBD obstruction (P less than 0.05). Phagocytic activity returned to normal within 7 days after choledochoduodenostomy. Cell mediated immunity, measured by skin graft rejection, was significantly prolonged in the obstructed group (P less than 0.05) but had returned to normal 7 days after biliary diversion. Return of hepatocellular function, as measured by liver function tests, paralleled recovery of immune function. This study demonstrates prompt recovery of the immune system after internal biliary drainage for obstructive jaundice. This finding is in contrast to previous studies that demonstrated persistent immune suppression months after biliary diversion. These data may have implications concerning the usefulness of internal biliary drainage before surgery in patients with obstructive jaundice.
We report a case of cervical teratoma in a term female infant born to a 20-year-old white woman. There are rare tumors in neonates, occurring in approximately 1 in 20,000 to 1 in 40,000 live births. These tumors are accurately defined by ultrasound. Although benign, cervical teratomas cause respiratory compromise. In this case the tumor was removed surgically with no recurrence at the 10-month follow-up.
Case 34.-A white girl aged 14J4 months suddenly mani¬ fested pain, a distended abdomen and bloody diarrhea. Autopsy revealed intussusception of the jejunuum (no anatomic or pathologic cause was demonstrable).1534 Aline Street._ ABSTRACT OF DISCUSSION Dr. David Adlersberg, New York : The paper of Drs. Browne and McHardy proves the increased interest of the gastro-enterologist in lesions of the small bowel and repre¬ sents a valuable contribution to our knowledge. It is impor¬ tant to realize and emphasize that the jejunum is the site of more extensive enzymatic digestion and absorption than any other part of the digestive tract ; thus, pathologic changes of the jejunum are likely to impair the processes of digestion and nutrition to a great extent. It has been also my experi¬ ence that definite periumbilical pain should call attention to the possibility of a lesion of the small intestine. Intubation with the Miller-Abbott tube and careful fluoroscopic and roentgenographic examination are time-consuming procedures but of essential diagnostic importance. It is agreed that organic lesions of the jejunum such as intussusception, diverticulosis and diverticulitis, primary jejunal ulcer, granuloma of the jejunum (regional jejunitis) and neoplasms (carcinoid, carci¬ noma, sarcoma and lymphosarcoma) are rare diseases in com¬ parison with other pathologic changes of the gastrointestinal
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