Pediatric surgery international
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Pediatr. Surg. Int. · Sep 2005
Comparative StudyReduction of incarcerated inguinal hernia in infants using caudal epidural anaesthesia.
Incarcerated inguinal hernias in infants are commonly encountered. Reduction with intravenous sedation using morphine and related drugs carries risks of apnoea and/or respiratory arrest, especially in small, ex-premature babies who have an increased incidence of incarceration and thus opiate use is best avoided. Caudal epidural anaesthesia is widely used as pre- and post-operative analgesia in elective inguinal herniotomy in infants. ⋯ Ages at presentation ranged from 2 to 17 weeks with a median gestational age of 36 weeks (range 29-39 weeks). Caudal epidural anaesthesia is a safe, feasible and effective method of achieving reduction of irreducible, incarcerated inguinal hernias. It is especially useful in low-birth weight, premature infants where intravenous opiate sedation is best avoided.
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Pediatr. Surg. Int. · Sep 2005
Case ReportsEpidural emphysema associated with subcutaneous emphysema following foreign body in the airway.
Epidural emphysema is a rare condition and usually accompanies pneumothorax, subcutaneous emphysema (SCE), or pneumomediastinum. We report a child who presented with epidural emphysema (pneumorachis) and SCE. The child was subsequently found to have a foreign body obstructing the airway, which was the likely cause of the pneumorachis. Thus, foreign body aspiration should be considered in an infant with SCE, and early intervention in the form of bronchoscopy should to be done to arrest the condition's progressive nature.
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Pediatr. Surg. Int. · Sep 2005
Comparative StudyIntercellular adhesion molecule (ICAM-1) response after major neonatal surgery.
Surgical stress induces systemic endocrine-metabolic responses that influence the function of endothelial cells (EC) to cause various systemic reactions. Intercellular adhesion molecule (ICAM)-1 is an adhesion molecule that plays an important role in inflammation, and increased expression of ICAM-1 on EC is a reflection of EC activation. In this study, we investigated the ICAM-1 response to surgical stress in neonates undergoing major surgery. ⋯ We found that ICAM-1 increases in response to surgical stress in neonates, although there was no significant difference in levels. However, surgical stress as represented by serum ICAM-1 would appear to last longer with intestinal surgery than with non-intestinal surgery. Further research is required to establish the usefulness of ICAM-1 as an easily detectable substance associated with endothelial damage that reflects the host's response to major surgical stress.
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Foreign body ingestion is a common problem encountered in the pediatric age group. The swallowed object is often passed with little or no morbidity. ⋯ The magnet and the steel ball were attracted to each other, forming a composite unit. The disc battery and the magnet were attracted to each other across a loop of ileum, causing necrosis and perforation of the ileum.