[Effectiveness of piperacillin in the antibacterial treatment of intra-abdominal infections in children]. / Efficacité de la pipéracilline dans le traitement antibactérien des infections intra-abdominales de l'enfant.

The effectiveness of piperacillin was investigated in 30 children operated upon for peritonitis: 13 had acute appendicitis with puriform peritoneal reaction, or a recently perforated appendix; 5 had generalized peritonitis of appendicular origin, and 13 had intraperitoneal abscess. In the 12 children who underwent right iliac appendicectomy (with post-operative drainage in 3), piperacillin was administered alone during 5 days; clinical and bacteriological cure was obtained in all cases; the mean duration of stay in hospital was 7 days. The 5 cases of generalized peritonitis required drainage; piperacillin was given alone in 4 of them and combined with an aminoglycoside and metronidazole in one who was in poor general condition. Bacteriology showed a predominance of Escherichia coli alone or associated with other organisms. Clinical and bacteriological cure was obtained in 3 patients; the mean duration of stay in hospital was 12 days. Seven of the 13 cases of intraperitoneal abscess needed drainage. Piperacillin was administered alone for 7 days on average in 10 cases and combined with an aminoglycoside and metronidazole in 2 cases. Eight patients had a favourable course, 5 developed complications. In all 3 groups piperacillin was tell tolerated. A patch of urticaria was noted in 2 cases and a transient skin rash in 2 other cases. No neutropenia was observed in these children whose treatment never exceeded 10 days.

[The surgical form of the hemolytic-uremic syndrome]. / Forme chirurgicale d'un syndrome hémolytique et urémique.

The hemolytic-uremic syndrome consist of micro-angiopathic hemolytic anemia, acute renal failure, and thrombocytopenia following a prodromal illness of gastroenteritis. The syndrome can present in dramatic fashion with severe abdominal pain and signs of peritonitis suggesting an acute surgical crisis. In some cases, laparotomy is necessary, and we report a case with colectomy.