Journal of pediatric surgery
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Review Case Reports
Foregut duplication cyst of the hypopharynx: a rare cause of upper airway obstruction.
Foregut duplication cysts of the hypopharynx are extremely rare, and only 6 cases, all of which have been described as solid lesions and contained heterotopic gastric epithelium, could be found during our literature review. We present a unique case of a hypopharyngeal foregut duplication cyst that was grossly cystic and had no heterotopic epithelium microscopically. ⋯ Congenital laryngeal cysts can appear similar to this lesion. However, the hypopharyngeal location of a cyst is a clue for the diagnosis of duplication on endoscopic examination.
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Comparative Study
Adhesive small bowel obstruction after appendectomy in children: comparison between the laparoscopic and open approach.
Adhesive small bowel obstruction (SBO) is a common postoperative complication. Published data in the pediatric literature characterizing SBO are scant. Furthermore, the relationship between the risk of SBO for a given procedure is not well described. To evaluate these parameters, we reviewed the incidence of SBO after laparoscopic appendectomy (LA) and open appendectomy (OA) performed at our institution. ⋯ The overall risk of SBO after appendectomy in children is low (0.7%) and is significantly related to perforated appendicitis. Small bowel obstruction after LA appears statistically less common than OA. Laparoscopic appendectomy remains our preferred approach for both perforated and nonperforated appendectomy.
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Gastroesophageal reflux disease (GERD) is cited by many to be a common cause of apparent life-threatening events (ALTEs). However, there are few reports in the literature regarding the surgical treatment of GERD to prevent a recurrent ALTE. ⋯ Our data suggest that among patients who had an ALTE and are found to have GERD, fundoplication appears to be an effective method for preventing recurrent ALTE.
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Unadjusted abuse-related mortality has been demonstrated to be nearly 4-fold higher for African American (AA) children. Little is known about the etiology of this disparity. This study examines the importance of injury severity and initial presentation in explaining the observed disparity. ⋯ Despite attempts to control for the clinical presentation and injury severity of abused children, significant differences in mortality persist between AA and white children.
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The purpose of this study was to determine the outcome of "minor resuscitation" trauma patients managed without the immediate presence of a surgeon. ⋯ Pediatric emergency medicine physicians discharged more patients than the surgeons, but also upgraded more to level 1 status. Level 2 trauma patients can be safely managed without immediate surgeon presence.