Journal of pediatric surgery
-
The authors report on a 2-year-old boy in whom pneumatosis intestinalis (PI) and portal vein gas (PVG) resulted from blunt abdominal trauma after child abuse. The presumed pathophysiology of PI and PVG is mechanical in this setting. Its presence establishes mucosal injury but does not necessarily imply intestinal necrosis.
-
Review Case Reports
Impalement and anorectal injuries in childhood: a retrospective study of 12 cases.
Because of the small numbers of impalement and anorectal injuries in childhood, a standardized therapeutic approach is necessary to avoid major complications. On the basis of a retrospective analysis of 12 children with such injuries treated from 1986 to 1996 in our department, the authors tried to establish guidelines for their treatment. ⋯ The current standard principles in the treatment of severe anorectal injuries in children are fecal diversion, wound drainage, and broad spectrum antibiotics. A primary reconstruction in cases of impalement can be recommended only after exclusion of anorectal injury.
-
Intracranial hemorrhage (ICH) is a major concern during extracorporeal membrane oxygenation (ECMO). Daily cranial ultrasonography has been used by many ECMO centers as a diagnostic tool for both detecting and following ICH while infants are on bypass. The purpose of this patient review was to look at the usefulness of performing daily cranial ultrasonography (HUS) in infants on ECMO in detecting intraventricular hemorrhage of a magnitude sufficient to alter patient treatment. ⋯ Almost all ICH occur during the first 5 days of an ECMO course. Unless there is a clinical suspicion, it is not cost effective to perform HUS after the fifth day on ECMO, because subsequent HUS examinations are unlikely to yield information significant enough to alter management.
-
Clinical Trial Controlled Clinical Trial
Swallowing disorders after esophageal atresia evaluated with videomanometry.
Patients with repaired esophageal atresia often show persistent motility disorders of the esophagus. ⋯ UES resting pressure and residual pressure on swallowing, did not differ between the two groups.