Orvar Swenson (7 February 1909 – 13 April 2012) was a Swedish-born American
pediatric surgeon
Pediatric surgery is a medical specialty, subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults.
History
Pediatric surgery arose in the middle of the 1879 century as the surgical care of birt ...
. He discovered the cause of
Hirschsprung's disease
Hirschsprung's disease (HD or HSCR) is a birth defect in which nerves are missing from parts of the intestine. The most prominent symptom is constipation. Other symptoms may include vomiting, abdominal pain, diarrhea and slow growth. Symptoms usu ...
and in 1948, with Alexander Bill, performed the first pull-through operation in a child with
megacolon
Megacolon is an abnormal dilation of the colon (also called the large intestine). This leads to hypertrophy of the colon. The dilation is often accompanied by a paralysis of the peristaltic movements of the bowel. In more extreme cases, the feces ...
, which then became a treatment for the disease.
Initially a resident in
pathology
Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...
, he soon became an assistant professor of
pediatric surgery
Pediatric surgery is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults.
History
Pediatric surgery arose in the middle of the 1879 century as the surgical care of birth defects required ...
at Harvard and later moved to Boston's
Floating Hospital for Children
Tufts Children's Hospital (formerly Floating Hospital for Children) in Boston, Massachusetts was a downtown Boston pediatric hospital owned by Tufts Medical Center, occupying the space between Chinatown and the Boston Theater District, which c ...
as surgeon-in-chief, where he was the first pediatric surgeon on the staff at the hospital and where he began his research in Hirschsprung's disease. Subsequently he became surgeon-in-chief of
Children's Memorial Hospital
Ann & Robert H. Lurie Children's Hospital of Chicago, formerly Children's Memorial Hospital and commonly known as Lurie Children's, is a nationally ranked pediatric acute care children's hospital located in Chicago, Illinois. The hospital has 3 ...
, where he remained until his retirement in 1973.
In 1973, Swenson was elected president of the
American Pediatric Surgical Association. He authored ''Swenson's Pediatric Surgery'', which ran into five editions and he was the recipient of a number of awards including the
E. Mead Johnson Award
The E. Mead Johnson Award, given by the Society for Pediatric Research, was established in 1939 to honor clinical and laboratory research achievements in pediatrics. The awards are funded by Mead Johnson, Mead Johnson Nutritionals, a subsidiary of ...
, the
William E. Ladd
William Edwards Ladd (September 8, 1880 – April 15, 1967) was an American surgeon, and is commonly regarded as one of the founders of pediatric surgery.
Family and education
William Edwards Ladd was born on September 8, 1880, in Milton, Massach ...
Medal and the
Denis Browne Gold Medal.
Early life
Swenson was born in
Helsingborg
Helsingborg (, , , ) is a city and the seat of Helsingborg Municipality, Scania (Skåne), Sweden. It is the second-largest city in Scania (after Malmö) and ninth-largest in Sweden, with a population of 113,816 (2020). Helsingborg is the cent ...
, Sweden, in 1909.
[ ] His parents, Amanda and Carl Albert Swenson, were missionaries for the
Community of Christ
The Community of Christ, known from 1872 to 2001 as the Reorganized Church of Jesus Christ of Latter Day Saints (RLDS), is an American-based international church, and is the second-largest denomination in the Latter Day Saint movement. The churc ...
and relocated their family to
Independence
Independence is a condition of a person, nation, country, or state in which residents and population, or some portion thereof, exercise self-government, and usually sovereignty, over its territory. The opposite of independence is the statu ...
, Missouri, in 1917.
Both parents died when Orvar was a teenager, and he and his brother Alvin lived in a boarding house where they started a business, Woodcraft, which sold fire-by-friction sets, bows and arrows, and field hockey sticks.
Orvar graduated from
William Chrisman High School
William Chrisman High School is a high school located in Independence, Missouri, United States, as part of the Independence School District.
History
The school was founded in 1888 and was known as Independence High School. The first building wa ...
in 1929 and
William Jewell College
William Jewell College is a private liberal arts college in Liberty, Missouri. It was founded in 1849 by members of the Missouri Baptist Convention and endowed with $10,000 by William Jewell. It was associated with the Missouri Baptist Conventi ...
in 1933.
The same year, Orvar and Alvin were admitted to
Harvard Medical School
Harvard Medical School (HMS) is the graduate medical school of Harvard University and is located in the Longwood Medical Area of Boston, Massachusetts. Founded in 1782, HMS is one of the oldest medical schools in the United States and is consi ...
, where they successfully petitioned the dean to be placed in the same class so that they could share textbooks in order to save money.
They graduated from Harvard in 1937.
Career
Swenson began his medical career as an intern at
Ohio State University
The Ohio State University, commonly called Ohio State or OSU, is a public land-grant research university in Columbus, Ohio. A member of the University System of Ohio, it has been ranked by major institutional rankings among the best publ ...
. After a year, he returned to Boston to work at
Boston Children's Hospital
Boston Children's Hospital formerly known as Children's Hospital Boston until 2012 is a nationally ranked, freestanding acute care children's hospital located in Boston, Massachusetts, adjacent both to its teaching affiliate, Harvard Medical Scho ...
and
Peter Bent Brigham Hospital
Brigham and Women's Hospital (BWH) is the second largest teaching hospital of Harvard Medical School and the largest hospital in the Longwood Medical Area in Boston, Massachusetts. Along with Massachusetts General Hospital, it is one of the two fo ...
. Initially a resident in
pathology
Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in ...
, he took a residency in surgery from 1939 to 1945,
[ after which he became an assistant professor of ]pediatric surgery
Pediatric surgery is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults.
History
Pediatric surgery arose in the middle of the 1879 century as the surgical care of birth defects required ...
at Harvard while working on the pediatric surgical staff at Boston Children's Hospital.[ In 1949 he moved to Boston's ]Floating Hospital for Children
Tufts Children's Hospital (formerly Floating Hospital for Children) in Boston, Massachusetts was a downtown Boston pediatric hospital owned by Tufts Medical Center, occupying the space between Chinatown and the Boston Theater District, which c ...
as surgeon-in-chief, making him the first pediatric surgeon on the staff at the hospital.[ Subsequently he moved to Chicago in 1960 to become the surgeon-in-chief of ]Children's Memorial Hospital
Ann & Robert H. Lurie Children's Hospital of Chicago, formerly Children's Memorial Hospital and commonly known as Lurie Children's, is a nationally ranked pediatric acute care children's hospital located in Chicago, Illinois. The hospital has 3 ...
, where he remained until his retirement in 1973.[ After his retirement from clinical practice, he moved to Miami and taught at the ]University of Miami
The University of Miami (UM, UMiami, Miami, U of M, and The U) is a private research university in Coral Gables, Florida. , the university enrolled 19,096 students in 12 colleges and schools across nearly 350 academic majors and programs, incl ...
until 1980.[
]
Hirschsprung's disease
Swenson's main contributions to pediatric surgery focused on Hirschsprung's disease
Hirschsprung's disease (HD or HSCR) is a birth defect in which nerves are missing from parts of the intestine. The most prominent symptom is constipation. Other symptoms may include vomiting, abdominal pain, diarrhea and slow growth. Symptoms usu ...
, a congenital disease
A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can r ...
in which nerves are absent from part of the colon, causing constipation and megacolon
Megacolon is an abnormal dilation of the colon (also called the large intestine). This leads to hypertrophy of the colon. The dilation is often accompanied by a paralysis of the peristaltic movements of the bowel. In more extreme cases, the feces ...
(abnormal dilation of the colon). He began his research on the condition while he was a surgical resident in Boston.[ He discovered that the disease was caused by an absence of ]ganglion cell
{{stack,
A ganglion cell is a cell found in a ganglion. Examples of ganglion cells include:
* Retinal ganglion cell (RGC) found in the ganglion cell layer of the retina
* Cells that reside in the adrenal medulla, where they are involved in the s ...
s in the rectum
The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...
, but before clarity on the cause of the disease, with Alexander Bill, they designed a surgical procedure to remove the abnormal section of the bowel, pull-through the normal bowel and join Join may refer to:
* Join (law), to include additional counts or additional defendants on an indictment
*In mathematics:
** Join (mathematics), a least upper bound of sets orders in lattice theory
** Join (topology), an operation combining two topo ...
it to the remaining parts of the normal bowel.
When Swenson performed the procedure in 1948, it was the first successful surgical correction of megacolon.[ It was not however a real Hirschsprung's, as Swenson clarified later in an interview when Bill had said to him that "this is just a weird case; it's not a real Hirschsprung's disease".]
This operation, however, became the only procedure that treated Hirschsprung's disease and became known as the " Swenson pull-through". He described the hallmark clinical and radiological markers of Hirschsprung's disease in newborns and showed that the only way to make a definitive diagnosis was to perform a full-thickness rectal biopsy
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a diseas ...
. Swenson subsequently followed his patients for a number of years. Over his career, he traveled to India, Australia, South America, Europe and Canada to demonstrate his procedure.[
]
Other surgical work
As well as Hirschsprung's disease, Swenson worked on the treatment of other birth defects. He performed esophageal anastomoses for esophageal atresia Esophageal can refer to:
* The esophagus
* Esophageal arteries
* Esophageal glands
The esophageal glands are glands that are part of the digestive system of various animals, including humans.
In humans
Esophageal glands in humans are a part of a ...
and tracheoesophageal fistula
A tracheoesophageal fistula (TEF, or TOF; see spelling differences) is an abnormal connection (fistula) between the esophagus and the trachea. TEF is a common congenital abnormality, but when occurring late in life is usually the sequela of surgica ...
, and resection and anastomosis in intestinal atresia
Intestinal atresia is any congenital malformation of the structure of the intestine that causes bowel obstruction. The malformation can be a narrowing (stenosis), absence or malrotation of a portion of the intestine. These defects can either occur ...
. He was among the first to advocate performing a pelvic osteotomy
An osteotomy is a surgical operation whereby a bone is cut to shorten or lengthen it or to change its alignment. It is sometimes performed to correct a hallux valgus, or to straighten a bone that has healed crookedly following a fracture. It is ...
when treating bladder exstrophy
Bladder exstrophy is a congenital anomaly that exists along the spectrum of the exstrophy-epispadias complex, and most notably involves protrusion of the urinary bladder through a defect in the abdominal wall. Its presentation is variable, often ...
and for partial nephrectomy
A nephrectomy is the surgical removal of a kidney, performed to treat a number of kidney diseases including kidney cancer. It is also done to remove a normal healthy kidney from a living or deceased donor, which is part of a kidney transplant pro ...
in bilateral Wilms' tumor
Wilms' tumor or Wilms tumor, also known as nephroblastoma, is a cancer of the kidneys that typically occurs in children, rarely in adults.; and occurs most commonly as a renal tumor in child patients. It is named after Max Wilms, the German surg ...
s.[
]
Awards and honors
He served as president of the American Pediatric Surgical Association in 1973–1974,[ and was the author of ''Swenson's Pediatric Surgery'', a textbook that was published in five editions from 1958 to 1990.][ He received the ]E. Mead Johnson Award
The E. Mead Johnson Award, given by the Society for Pediatric Research, was established in 1939 to honor clinical and laboratory research achievements in pediatrics. The awards are funded by Mead Johnson, Mead Johnson Nutritionals, a subsidiary of ...
from the Society for Pediatric Research
A society is a group of individuals involved in persistent social interaction, or a large social group sharing the same spatial or social territory, typically subject to the same political authority and dominant cultural expectations. Socie ...
in 1952, the William E. Ladd
William Edwards Ladd (September 8, 1880 – April 15, 1967) was an American surgeon, and is commonly regarded as one of the founders of pediatric surgery.
Family and education
William Edwards Ladd was born on September 8, 1880, in Milton, Massach ...
Medal from the American Academy of Pediatrics
The American Academy of Pediatrics (AAP) is an American professional association of pediatricians, headquartered in Itasca, Illinois. It maintains its Department of Federal Affairs office in Washington, D.C.
Background
The Academy was founded ...
in 1959, and the Denis Browne Gold Medal from the British Association of Paediatric Surgeons The British Association of Paediatric Surgeons (BAPS) is a registered charity that aims to advance the study and practice of paediatric surgery.
The organisation
The organisation was founded in 1953. The idea for the group came up when a group of f ...
in 1979.[
]
Personal life
Swenson married Melva Elizabeth Criley in 1941; they had three daughters. He died in Charleston, South Carolina
Charleston is the largest city in the U.S. state of South Carolina, the county seat of Charleston County, and the principal city in the Charleston–North Charleston metropolitan area. The city lies just south of the geographical midpoint o ...
, in 2012, aged 103.[
]
Selected publications
*
*
*
*
*
References
{{DEFAULTSORT:Swenson, Orvar
1909 births
2012 deaths
American pediatric surgeons
Swedish emigrants to the United States
Physicians of Brigham and Women's Hospital
Harvard Medical School faculty
Harvard Medical School alumni
William Jewell College alumni
People from Helsingborg
People from Independence, Missouri