Journal of pediatric surgery
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Five patients with tracheobronchial injuries secondary to blunt thoracic trauma were reviewed over a 9-year period. Bronchial disruption occurred in four cases and tracheal disruption in one. Of the four patients with bronchial disruption, a major airway injury was suspected early because of a large air leak or persistent pulmonary atelectasis. ⋯ The child with a blowout perforation of the trachea was diagnosed early by bronchoscopy and was successfully managed without surgery. Tracheobronchial injury is one of the most severe injuries caused by blunt trauma and requires a high index of suspicion for early diagnosis and surgery. Bronchial repair is successful in most instances.
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Review Case Reports
Congenital pyloric atresia and junctional epidermolysis bullosa: a report of long-term survival and a review of the literature.
The coexistence of congenital pyloric atresia (PA) and epidermolysis bullosa (EB) in newborns is a rare but distinct association. Mortality is high. In particular, a universally fatal outcome has been reported in neonates born with the junctional type of EB and PA. ⋯ Presently, these lesions are mild and require little therapy. Their nails, initially normal at birth, have become discoloured, thickened, and dystrophic. The management of pitted, carious, and yellow teeth is currently the major problem.(ABSTRACT TRUNCATED AT 250 WORDS)
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The majority of life-threatening injuries secondary to the placement of central venous catheters, such as bleeding and pneumothorax, occur at the time of initial insertion. When a catheter extravasates in the neck, edema of the neck wall or chest is usually seen, and the pump indicates occlusion. ⋯ In reviewing these cases, all showed both a change in catheter location on a subsequent x-ray and poor or no blood return on aspiration; paradoxically, the infusion pump in each case did not sense a catheter malposition or occlusion. We conclude that, although the success of central line placement may be documented on insertion, a continual reappraisal of both the function and location of the line is necessary.
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A case of isolated rupture of the thoracic trachea due to blunt trauma in a 4-year-old child is presented. The rarity of this injury and its initial presentation as massive subcutaneous emphysema and bilateral pneumothoraces warrant its description. This child was diagnosed as having a tracheal injury by computed tomography scan. ⋯ Rigid bronchoscopy done 2 months later showed no abnormality. This case demonstrates that computed tomography is helpful in the diagnosis of tracheal injuries. The treatment may require early operative intervention and closure of the defect.