Journal of pediatric surgery
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Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) has been successful in support of neonates with respiratory failure but requires right common carotid artery ligation. While no short-term neurologic complications have resulted from neonatal carotid ligation, late complications may occur. For both VA ECMO and venovenous (VV) ECMO, blood is drained from the right atrium via a right internal jugular cannula, oxygenated by a membrane lung, and returned to the patient. ⋯ Differences among the patients were related to their primary disease rather than to the mode of ECMO support. The VV patients had cannulation of the femoral vein for perfusion of oxygenated blood. Late complications may occur from femoral vein ligation as well as from carotid ligation so long-term follow-up is needed to assess these two ECMO techniques.
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Acute suppurative thyroiditis is rare in childhood. It presented in two clinically euthyroid children over a 2-year period. Repeated drainage for recurrent abscesses was necessary in one child. ⋯ Administration of antibiotics, which are effective against oral flora, combined with initial drainage of suppuration control infection. Only then can the diagnosis be made by contrast study of the hypopharynx and upper esophagus. Operative excision of the entire epithelial tract and adjacent thyroid tissue is essential to prevent recurrent thyroiditis and abscess.