William Edwards Ladd

Biography

• Born 8 September 1880 in Massachusetts as the sixth of seven children
• Graduated with an MD from Harvard Medical School in 1906
• 1910-1913 Assistant Visiting Surgeon to the Boston City Hospital, Infant’s Hospital, Children’s Hospital and Milton Hospital
• 1912 – Assistant in Surgery at Harvard Medical School
• 1927 – Surgeon-in-Chief at Boston Children’s Hospital
• 1941 – co-authored the first modern American paediatric surgical textbook (Abdominal Surgery of Infancy and Childhood) with Robert E. Gross (1905-1988)
• Died 15 April 1967

Medical Eponyms

• Ladd’s bands – anomalous congenital peritoneal bands attaching the caecum to the posterior abdominal wall in cases of intestinal malrotation
• Ladd’s operation (1932) – Incision of Ladd’s bands to relieve duodenal obstruction in malrotation of the intestine
• Ladd-Gross syndrome – Icterus neonatorum associated with atresia of the bile ducts. 
• Ladd’s syndrome (1932) – Congenital obstruction of the duodenum secondary to peritoneal bands (Ladd’s bands) resulting from a malrotated caecum.

Key Medical Attributions:

• December 6, 1917, in Halifax harbour, Canada, the French cargo ship the S.S. Mont-Blanc, filled with wartime explosives, collided with the S.S. Nimo, a Norwegian ship. The detonation resulted in 2,000 deaths and 9,000 injured. Ladd arrived on scene within 24-hours in charge of a Red Cross Unit with enough equipment for a 500-bed hospital. He treated thousands of the injured, including hundreds of children with burns and lacerations.
• On returning to Boston, Ladd devoted himself entirely to the surgical care of infants and children
• From 1911, published multiple papers regarding his experience of intussusception and its management [Boston Med Surg J 1911, Boston Med Surg J 1913, Arch. Surg 1934]
• Ladd pioneered the surgical management of Wilm’s tumour, including promoting the abdominal surgical approach over the posterior approach.  ‘Embryoma of the kidney (Wilm’s tumour)‘
• Made key contributions in the surgical management of cleft palate and bladder exstrophy [N Eng J Med 1940]
• Also contributed to the surgical management of biliary atresia, tracheoesophageal fistulas/atresias, and anorectal malformations [American Journal of Surgery 1934]
• A number of Ladd’s trainees went on to achieve notable milestones in paediatric surgery including;
  • Orvar Swenson – best known for his work with Hirschsprung disease
  • Robert E. Gross – credited for being one of the first to report successful closure of a Patent Ductus Arteriosus (1939) and pioneering treatment of aortic coarctation, co-author of Ladd’s Paediatric Surgery textbook mentioned above, and Ladd’s successor as Chair of Surgery at Boston Children’s Hospital (1945)

Major Publications

• Ladd WE, Gross RE. Abdominal Surgery of Infancy and Childhood. 1941 Saunders
• Ladd WE. Congenital obstruction of the duodenum in children. 
  New England Journal of Medicine 1932; 206: 277-283. [Ladd’s syndrome]
• Ladd WE. Surgical disease of the alimentary tract in infants. New England Journal of Medicine 1936;215:705–8.

References

• Bill H. William E. Ladd, M.D.: great pioneer of North American pediatric surgery. Progress in pediatric surgery 1986;20:52–9. [PMID 3095882]
• Wiedemann HR. William E. Ladd. European Journal of Pediatrics, 1990;149(10):669
• Harvard Alumni Association. Harvard Men at the Halifax Disaster. Harvard alumni bulletin. 1917;20:337-338
• Nakayama DK. William Ladd before the Halifax explosion. J Pediatr Surg. 2017 Sep 5. [PMID 28927980]
• Xydas. S, Widmann. W, Hardy. M. William E. Ladd: Father of Pediatric Surgery. Curr Surg. 2003 Jan-Feb; 60 (1):47-50 [PMID 14972312]