Pediatric surgery international
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Pediatr. Surg. Int. · Mar 2009
Review Case ReportsStroma-predominant Wilms tumor with teratoid features: report of a rare case and review of the literature.
We describe the case of a 4-year-old boy with a unilateral right-sided Wilms tumor with stromal predominance and teratoid features, which was localized to the kidney and hence, was completely resected. The pediatric surgeon and pathologist, both should be aware of this rare appearance of nephroblastoma so as to avoid the highly toxic chemotherapy and radiotherapy in such patients.
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Pediatr. Surg. Int. · Mar 2009
Do not rush into operating and just observe actively if you are not sure about the diagnosis of appendicitis.
The aim of this study was to determine whether the admission and active observation of children where the diagnosis of acute appendicitis is uncertain is a safe and effective way to improve the diagnostic accuracy of appendicitis and safely reduce the incidence of negative laparotomies without increasing complications. ⋯ Both the features and results and the complication rates and costs of the group operated on after observation were the same as the directly operated on group. However, patients undergoing a negative appendectomy stayed as inpatients longer than only observation patients with higher treatment charges. We could therefore decrease the negative appendectomy rate, the associated cost and duration of hospitalization without causing extra complications if we observe and investigate patients with right lower quadrant pain with a doubtful diagnosis and did not operate on them directly.