100 years of pediatric surgery in Stockholm, with personal memories from the last 50 years.

Abstract

The first children's hospital in Sweden (Kronprinsessan Lovisa's Children's Hospital) was established in Stockholm in 1854. In 1885 it was divided into a medical and a surgical department. This constituted the birth of pediatric surgery in Sweden. Pediatric surgery has been included in undergraduate teaching programs since 1945. A personal Associate Professorate in Pediatric Urology was instituted at the Karolinska Medical School in Stockholm for N. O. Ericsson in the late fifties. Upon his retirement in 1976 this personal chair was converted into an established Professorship in Pediatric Surgery. Pediatric surgery has been recognized as a specialty by our Medical Association since 1947. A survey of the Annual Reports from the Lovisa Hospital from 1885 to 1969 shows three phases in the development of our specialty in Sweden. The first stage extends from 1885 to 1932. During this period the disease pattern was dominated by septic and tuberculous infections, by empyemas, and by ENT diseases. Few cases of congenital malformations were reported. The bulk of general surgery in childhood was performed in the departments of general surgery. The second stage (1932-1945) was characterized by a decreasing incidence of tuberculous infections, by a successive transfer of orthopedic and ENT patients to the Departments of Orthopedic and ENT surgery respectively. During this period, a marked increase occurred in the volume of malformation surgery. This was due to the centralized treatment of congenital anomalies. The third stage started in 1945. The war had ended and we became acquainted with the dramatic development of pediatric surgery in other countries, in particular in the USA. The main advance was the possibility of opening the chest for repair of congenital anomalies of the heart and the great vessels, of the esophagus, and of the diaphragm. Soon afterwards, rectosigmoidectomy was introduced for the treatment of Hirschsprung's disease. In 1952, a second department of pediatric surgery was opened in Stockholm as a part of a new Children's Clinic at the Karolinska University Hospital. The major part of general surgery from the Stockholm area and all of the cardiovascular surgery stayed with the "Lovisa Hospital", while the major part of neonatal surgery and specific abdominal surgery was performed at the Karolinska Hospital. In order to improve the rather underdeveloped situation of pediatric urology, N. O. Ericsson was appointed to the post of Associate Head of the Karolinska Department, soon bringing this field to the frontlines of international standards. This historical review ends with some of the author's personal memories from the last 50 years.