Pediatric surgery international
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Pediatr. Surg. Int. · Dec 2007
Case ReportsMagnetic attraction leading to a small bowel obstruction in a child.
Foreign body ingestion in small children is common yet only 1% of cases require operative management of associated complications (Arana et al. in Eur J Pediatr 160:468-472, 2001). A 6-year-old boy was referred to our institution with a 12 h history of abdominal pain. This pain was diffuse and crampy in nature and associated with multiple episodes of non-bilious, non-bloody emesis. ⋯ The patient had an uneventful post-operative course and was discharged to home on the second post-operative day. This case demonstrates the complications that may occur with multiple magnet ingestion. It highlights the need for close observation and early surgical intervention in children with a suspected history of foreign body ingestion, a clinical picture of gastrointestinal distress, and radiographic evidence of a radio-opaque foreign object.
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Pediatr. Surg. Int. · Nov 2007
Multicenter Study Comparative StudyGastroschisis and exomphalos in Ireland 1998-2004. Does antenatal diagnosis impact on outcome?
Antenatal detection of anterior abdominal wall defects (gastroschisis and exomphalos) enables detailed prenatal planning and counselling with appropriate intrauterine transfer, delivery in a tertiary referral centre with prompt access to paediatric surgery and early surgical intervention. The authors believed that there was a relatively low rate of antenatal detection in Ireland and that an improved antenatal screening program would allow increased detection thus avoiding emergency retrievals from peripheral obstetric centres. Our hypothesis was that there was a significant difference in management and outcome in children with anterior abdominal wall defects detected antenatally and those detected at birth. ⋯ The demographics and the presence of associated anomalies did not differ between the groups. The hypothesis that antenatal diagnosis in anterior abdominal wall defects improves outcome has been demonstrated to be false. Despite this result, the importance of antenatal screening and prenatal management of complex foetal conditions with consultation with experienced paediatric and neonatal staff is without doubt.
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Pediatr. Surg. Int. · Nov 2007
Case ReportsA sewing needle migrating into the liver in a child: case report and review of the literature.
Swallowing foreign bodies is a common problem in children. Although most objects pass through the gastrointestinal tract with no untoward effect; long, sharp-pointed, or slender objects can perforate the gut. ⋯ A survey of the literature over the period from 1971 to 2006 revealed a total of five cases of childhood hepatic sewing needle together with our case. The practical lesson illustrated by this report is that the surgeon must carefully evaluate the liver when foreign body was not found in gastrointestinal system and also perforation site was found anywhere.
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In the pediatric population, rectal injuries usually occur as a result of motor vehicle collisions. There has been an increased interest in selective diversion of rectal injuries in adults and increased utilization of laparoscopy both as a diagnostic and therapeutic adjunct. The aim of the study was to review our institutional experience with rectal injuries to determine if there was a subset of patients who could be managed with selective diversion. ⋯ Primary repair without a diverting colostomy was performed in 3 patients (2 intraperitoneal and 1 extraperitoneal injury) without complications. Based on the limited sample size, one should avoid making any definitive recommendations but, it appears, primary repair without fecal diversion can be performed safely in select children in spite of a longer time to surgery. Laparoscopy may be used for the immediate management of the penetrating trauma patient to rule out intraperitoneal extension, repair a perforation and guide the colostomy if necessary.