Journal of pediatric surgery
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Laparoscopy in children with complicated appendicitis.
Laparoscopic appendectomy is an accepted way of dealing with suspected uncomplicated appendicitis in children. The role of laparoscopy in complicated acute appendicitis is more controversial. The purpose of this trial was to compare laparoscopic appendectomy with open appendectomy in children with complicated appendicitis. ⋯ Laparoscopic appendectomy is an alternative to open procedure in children with complicated appendicitis. Good surgical judgement is necessary in patients with an established appendiceal abscess.
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Synchronous treatment of high imperforate anus with large omphalocele is a challenge for pediatric surgeon. A case of this unusual condition in a male neonate is presented. The high imperforate anus was repaired by primary one-stage posterior sagittal anorectoplasty, and the omphalocele was treated nonoperatively. Recovery was uneventful.
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Case Reports
Abdominal pain and ketonuria in an 11-year-old girl five months after abdominal trauma.
Five months after an abdominal trauma, a 11-year-old girl was admitted for abdominal pain, hyperglycemia, and ketonuria, which led to the diagnosis of left diaphragmatic rupture with gastric necrosis and perforation. The girl died soon after operation.
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Circumcision is the most commonly performed surgical procedure in the United States today. Despite the large number of specialists who perform this procedure, only occasionally are the results unsatisfactory. The purpose of this study is to review the indications for circumcision revision, attempt to identify the specialists who are performing unsatisfactory circumcisions, describe the authors' surgical technique for circumcision revision, and review current coding and billing issues related to this procedure. ⋯ Considering the number of neonatal circumcisions performed in the United States, revision of circumcision uncommonly is required. The most common indication for circumcision revision is redundant foreskin. Although pediatricians were most commonly implicated in this study as the source of unsatisfactory circumcisions, that finding probably is more a reflection of local practices and referral patterns. Our recommended surgical procedure, the conventional sleeve technique, is familiar to pediatric surgeons, produces a satisfactory cosmetic result, and is easy to teach to residents and fellows. The authors do not recommend the use of a gomco clamp for circumcision revision. The authors do not feel that a circumcision revision should be delayed expecting that the child will grow into the redundant foreskin. Appropriate diagnosis codes have been available, but a new and more specific procedure code has just been introduced in 2002.