Pediatric surgery international
-
Pediatr. Surg. Int. · Nov 2005
Case ReportsGastroschisis reduction using "Applied Alexis", a wound protector and retractor.
We used an Applied Alexis (Applied Medical Resources Corp, USA) wound protector and retractor (WPAR) instead of a "spring loaded silo" (SLS) for gastroschisis reduction because SLS is currently unavailable in Japan. Our patient was a 1,707 g female diagnosed prenatally with gastroschisis born at 35 weeks gestation by spontaneous vaginal delivery. Attempted primary closure failed and a WPAR was used as a silo. ⋯ Operating time was 20 minutes. Three days later, all eviscerated organs had been reduced into the peritoneal cavity, the silo was removed, and the gastroschisis defect closed without difficulty. Postoperative recovery was uneventful and the WPAR was an excellent alternative for making a silo.
-
Pediatr. Surg. Int. · Nov 2005
Case ReportsLethal gastric rupture caused by acute gastric ulcer in a 6-year-old girl.
Gastric rupture is extremely rare in childhood beyond the neonatal period. We describe a previously healthy 6-year-old girl with a large laceration along the greater curvature on the posterior wall of the stomach. The patient was admitted to a neighboring hospital because of vertigo with 1-day history of intractable vomiting and epigastric pain. ⋯ Pathology of the gastric wall showed mucosal necrosis while the musculature remained intact consistent with an acute gastric ulcer. Since clinical condition of gastric rupture deteriorates rapidly, early diagnosis and appropriate treatment is essential for good prognosis. One should consider that ulcer formation might cause gastric rupture in childhood.