Journal of pediatric surgery
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Various factors can influence the metabolism of surgical neonates. These include prematurity, operative stress, critical illness, and sepsis. The nutritional management of surgical infants with congenital or acquired intestinal abnormalities has improved after the introduction of parenteral nutrition. ⋯ Nutritional support in surgical neonates has a profound impact on outcome. Exogenous glutamine can modulate immune, metabolic, and inflammatory responses. Further investigations are needed to clarify the clinical benefit of parenteral or enteral glutamine administration in surgical neonates.
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Comparative Study Clinical Trial Controlled Clinical Trial
Prospective evaluation of nonsurgical versus surgical management of appendiceal mass.
Prospective evaluation was undertaken of surgical findings, complications, morbidity, and hospital stay between initial nonsurgical management versus early surgical intervention of an appendicular mass. ⋯ Early surgical intervention was beneficial over nonoperative management in this cohort of patients. Interval appendectomy is recommended after nonsurgical management of an appendicular mass.
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Comparative Study Clinical Trial
Neonates with congenital diaphragmatic hernia have smaller neck veins than other neonates-An alternative route for ECMO cannulation.
The aim of this study was to compare the size of the right internal jugular vein between neonates with congenital diaphragmatic hernia (CDH) who need extracorporeal membrane oxygenation (ECMO) and non-CDH neonates. The purpose also was to describe a method for cannulation of the right brachiocephalic vein if the internal jugular vein was too small for ECMO cannulation. ⋯ Severely affected neonates with CDH have significantly smaller right internal jugular veins than other neonates. If the patient needs ECMO and if the internal jugular vein is too small for cannulation, the right brachiocephalic vein can be successfully cannulated from the neck instead.
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Postnatal cystic adenomatoid malformations (CAMs) are managed by surgical excision. Asymptomatic CAMs have decreased in size with initial observation. This is the first reported case of complete resolution of a postnatal CAM. Premature infants with asymptomatic CAMs may benefit from careful observation as their initial treatment.
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A 12-year-old girl presented with lower abdominal pain, nonbilious vomiting, and a severe secretory diarrhea. Infectious and noninfectious etiologies were ruled out, and she was found to have perforated acute appendicitis. It is essential to consider acute appendicitis in the differential diagnosis for secretory diarrhea and abdominal pain in the pediatric population.