Pediatric surgery international
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Pediatr. Surg. Int. · Apr 2008
Case ReportsPediatric penetrating cardiac injury from abuse: a case report.
While cardiac foreign bodies after trauma have been described in the literature, we report the first case of intentional injury in an infant with an intracardiac needle. We review the literature and stress the need for a high degree of vigilance in evaluating children for potential child abuse.
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Pediatr. Surg. Int. · Apr 2008
Mortality in micro-premature infants with necrotizing enterocolitis treated by primary laparotomy is independent of gestational age and birth weight.
Previous reports indicate that mortality in micro-premature infants with surgical necrotizing enterocolitis (NEC) is inversely proportional to gestational age and birth weight. We have observed that patterns of survival in micro-premature infants with NEC appear to be changing and may be influenced by the use of primary laparotomy (PL). Thirty-one infants <1,500 g who underwent surgery for NEC were classified into two subgroups: extremely low birth weight infants <1,000 g (ELBW, N = 17) and very low birth weight infants 1,000-1,500 g (VLBW, N = 14) and the groups were compared. ⋯ The only variables associated with increased mortality were pannecrosis and longer segment of necrotic bowel (P = 0.005). In our neonatal unit, the mortality of micro-premature infants less than 1,500 g with surgical NEC appears to be independent of gestational age and birth weight. Although the small sample size may mitigate the validity of this study, we found that the most important determinants of mortality were pannecrosis and longer length of necrotic bowel.
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Though various approaches to the thoracic inlet have been described in adults, currently no guidelines exist in children. Reports in the literature of resection of thoracic inlet tumours in children are only anecdotal. ⋯ Experience with a 3.5-year-old boy having a thoracic inlet ganglioneuroma, using the anterior cervico-thoracic trap door incision demonstrated excellent access and minimal morbidity. We recommend the trap door incision as the preferable route for exploring thoracic inlet tumours in children.