Pediatrics : the hygienic and medical treatment of children . on. TREATMENT.—None is required in uncomplicated cases. Whenthe lesion is associated with pulmonary stenosis, the treatment isthat of the latter disease. PATENT DUCTUS ARTERIOSUS BOTALLI If post-mortem records be taken as a criterion, this lesion is muchless common than either pulmonary stenosis or defect of the inter-ventricular septum. I am convinced, however, from clinical experi- 26 Diseases of Heart, Pericardium and Blood Vessels ence, that open ductus arteriosus is not necessarily a permanentlesion, and that in many cases in w
Pediatrics : the hygienic and medical treatment of children . on. TREATMENT.—None is required in uncomplicated cases. Whenthe lesion is associated with pulmonary stenosis, the treatment isthat of the latter disease. PATENT DUCTUS ARTERIOSUS BOTALLI If post-mortem records be taken as a criterion, this lesion is muchless common than either pulmonary stenosis or defect of the inter-ventricular septum. I am convinced, however, from clinical experi- 26 Diseases of Heart, Pericardium and Blood Vessels ence, that open ductus arteriosus is not necessarily a permanentlesion, and that in many cases in which all the clinical evidences ofits existence are present, complete recovery takes place. As a result,I believe that the lesion is far more common than is generally statedin the literature. PATHOLOGICAL ANATOMY.—The lesion represents the per-sistence of a condition which is normal only in fetal life. The normalclosure of the ductus through thrombus organization and obliteratingendarteritis does not take place. Instead of an impervious fibrous Fig. 217. D, open ductus arteriosus. Male, 16 days old. Warren Museum, Harvard University cord or a bit of fibrous tissue connecting the pulmonary artery withthe beginning of the descending aorta, there is an open blood ductus may be found widely patulous, lined with normal endo-thelium, or there may be evidences of a certain amount of endarteritis,causing a narrowing of the open lumen. ETIOLOGY.—The lesion is developmental in origin. I believethat it represents, not always arrested development, but often merelydelayed development. My reasons for this belief are, first, that Ihave seen at autopsy in infants in the second year, evidences of arecent obliterating endarteritis in open ductus arteriosus; second,that I have seen a number of cases showing the typical clinical pic-ture of this lesion, in which all the signs disappeared in later life. Open Ductus Arteriosus 27 The cause of the disturbance of development is not de
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatr, bookyear1917
