Pediatric surgery international
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Pediatr. Surg. Int. · Feb 1997
Congenital pyloric stenosis: a modified umbilical incision for pyloromyotomy.
Thirty-two patients underwent a pyloromyotomy via an umbilical incision; in 11 a modified umbilical approach was used to facilitate delivery of the pyloric mass. Incisions are made in the skin fold of the upper half of the umbilicus and at the midline, joining the two at the top. ⋯ This incision allows easy access to the pylorus and provides more convenient exposure. The absence of traction on the retractors avoids tissue ischemia, which leads to wound abscess development.
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A 6-day-old female presented with vomiting and an abdominal mass. At laparotomy, a pyloroduodenal duplication cyst was enucleated from the pyloric region. Of the diagnostic studies performed, IV cholangiography with spiral computed tomography and an upper gastrointestinal barium study were useful in the preoperative differential diagnosis.
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Pediatr. Surg. Int. · Feb 1997
Bronchial foreign body: should bronchoscopy be performed in all patients with a choking crisis?
The aspiration of a bronchial foreign body (FB) remains a common pediatric problem with serious and sometimes fatal sequelae. The diagnosis is often delayed or overlooked. ⋯ The clinical and radiologic data were compared with the bronchoscopy findings, which revealed that the history of a choking crisis was the clinical parameter that showed the highest sensitivity (97%) with high specificity (63%), and that other symptoms and radiology, even those with high sensitivity (88% and 85%, respectively), had low specificity (9%). We conclude that bronchoscopy should be performed in all patients with a history of a choking crisis even if they have normal radiologic findings and few symptoms.