Pediatric surgery international
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Pediatr. Surg. Int. · Oct 2010
Comparative StudyIncreased incidence of negative appendectomy in childhood obesity.
In recent years, there has been worldwide increase in childhood obesity. The diagnosis of acute appendicitis in very obese children can sometimes be difficult and challenging. The purpose of this study was to determine the incidence of histologically normal appendix in very obese and non-obese children undergoing emergency appendectomy for the clinical diagnosis of acute appendicitis. ⋯ Suspected appendicitis in childhood obesity is associated with increased incidence of normal appendectomy. Active observation in hospital in very obese children may reduce the rate of normal appendectomy without increasing the incidence of complicated appendicitis.
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Pediatr. Surg. Int. · Oct 2010
Case ReportsTetra-amelia with lung hypoplasia and facial clefts, Roberts-SC syndrome: report of two cases.
Although limb anomalies are a common clinical problem, they are rarely studied. The spectrum of limb anomalies ranges from very mild disorders such as syndactyly to very severe forms such as absent limb (amelia). ⋯ Roberts-SC phocomelia syndrome comprises four limb deficiencies, lung hypoplasia, facial clefts and other anomalies. We describe two cases that presented to us.
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Pediatr. Surg. Int. · Sep 2010
ReviewImplementation of a standardized pain management in a pediatric surgery unit.
Postoperative pain is still a major complication causing discomfort and significant suffering, especially for children. Therefore, every effort should be made to prevent pain and treat it effectively once it arises. ⋯ The fear of side effects mostly prevents the adequate usage of analgesics. Essential is selecting and establishing a simple concept for clinical routine involving a combination of non-pharmacological treatment strategies, non-opioid drugs, opioids and regional anesthesia.
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Pediatr. Surg. Int. · Aug 2010
Ultrasound-guided percutaneous insertion of 2.7 Fr tunnelled Broviac lines in neonates and small infants.
Insertion of permanent central venous access (Broviac line) can be a challenge in neonates especially when sites for peripherally inserted central catheters (PICC) have been exhausted. The landmark technique (LT) has been well described for the percutaneous insertion of central lines in neonates but can be associated with significant complications including death. The use of the ultrasound-guided approach for temporary central line access has been reported but as yet there are no reports of the adaptation of the technique for Broviac line insertion in neonates. ⋯ The ultrasound-guided percutaneous approach for insertion of tunnelled permanent vascular access is safe in neonates with no surgical complications in our series. However, it is a technically demanding procedure to do in neonates and should not be attempted without significant prior experience.