Pediatric surgery international
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Pediatr. Surg. Int. · Jan 2007
Case ReportsOesophageal substitution with free and pedicled jejunum: short- and long-term outcomes.
In children, the indications for oesophageal substitution are principally, long gap oesophageal atresia (OA), severe anastomotic disruption following primary repair of OA and severe caustic or peptic strictures. We present an outcome review of eight cases who underwent oesophageal substitution with jejunum at our institution between 1986 and 2001. The purpose of this study was to evaluate our experience with free/pedicled jejunal grafts and its long-term outcome as an oesophageal substitute. ⋯ There were two late deaths, one from aspiration and the other from a severe asthmatic attack (5 and 7 months postoperatively, respectively). Our results indicate that there are significant complications related to the use of free jejunal grafts. Early recognition and treatment are of paramount importance in the ultimate achievement of a successful technical outcome.
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Bochdalek hernias are usually congenital and are seen with much greater frequency on the left side. Intrathoracic kidney is a very rare congenital anomaly, with only about 50 cases reported in the world literature. The incidence of intrathoracic kidney with Bochdalek hernias was reported to be less than 0.25%. ⋯ Under a thoracotomy, a direct closure of the hernia was performed after the colon and kidney were returned to the abdomen. We report the second case, which has a diagnosis of a right Bochdalek hernia with intrathoracic kidney. Clinical correlations among this unusual combination are discussed.
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Pediatr. Surg. Int. · Oct 2006
Case ReportsIngestion of unusual foreign bodies and malrotation: a "perfect storm".
Management of foreign body ingestion is usually nonsurgical unless atypical foreign bodies or anatomical variants are suspected. The present article illustrates a case of atypical foreign bodies ingestion in the presence of intestinal malrotation. The patient required surgical treatment and had an uneventful postoperative recovery. The article also reviews the cases reported in the literature of magnetic ingestion and the possible complications associated with it.
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Pediatr. Surg. Int. · Oct 2006
A prospective study into the demographics and treatment of paediatric facial lacerations.
To evaluate the demographics and treatment of facial lacerations occurring in a paediatric patient cohort. We undertook a prospective study of 106 children who sustained a soft tissue facial injury and who presented to an Accident and Emergency department in a UK district general hospital supporting a population of 750,000. Approximately 31,000 are dependent children between the age of 0-12 years. ⋯ The pattern of facial lacerations in our study supports the results of previous studies. Our data has provided further insight into the presentation of these injuries. These studies are valuable in targeted injury prevention programmes aimed at potentially reducing the nature, incidence and severity of facial soft tissue trauma in children in the UK.
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Pediatr. Surg. Int. · Oct 2006
Case ReportsCongenital intrathoracic kidney with right Bochdalek defect.
Intrathoracic kidney is a rare congenital anomaly. Since most reported cases are asymptomatic, it is extremely rare for this ectopia to be diagnosed in the neonatal period. We report a male infant with right intrathoracic kidney associated with Bochdalek defect. ⋯ The intrathoracic kidney with attached adrenal gland was located at the level of the carina and was covered with protruded retroperitoneum. The kidney was thought to have been pushed this high by the small intestine and left lobe of the liver, which had also herniated through the defect. Postoperative hemodynamics and renal function were normal.