Journal of pediatric surgery
-
Comparative Study
Presence of pneumomediastinum after blunt trauma in children: what does it really mean?
Pneumomediastinum after blunt thoracic trauma is often considered a marker of serious aerodigestive injury that leads to invasive testing. However, the efficacy of such testing in otherwise stable children remains unknown. We hypothesize that pneumomediastinum after blunt trauma in clinically stable children is rarely associated with significant underlying injury. ⋯ Children with pneumomediastinum from blunt trauma often receive invasive and expensive testing with low yield, especially those with isolated thoracic trauma.
-
Comparative Study
Follow-up of surgical correction of aortic arch anomalies causing tracheoesophageal compression: a 38-year single institution experience.
Anomalies of the aortic arch (vascular rings) are uncommon anomalies in which preferred strategies for diagnosis and treatment may vary among institutions. In this study, we report a description of our approach and review of our 38-year experience in patients surgically treated for vascular rings. ⋯ Vascular anomalies with/without tracheoesophageal compression present symptomatically in a variety of ways, and noninvasive methods are used to identify the specific lesion and associated cardiac defects. Surgical repair is associated with low or no mortality in patients with uncomplicated complex of vascular anomalies.
-
Persistent respiratory symptoms often occur after double aortic arch (DAA) repair but rarely require a second operation. We report 4 children with severe respiratory problems (failure to extubate, 2; severe respiratory distress, 2) caused by severe tracheomalacia and tracheal compression after DAA repair, treated by anterior aortopexy. Aortopexy proved effective and safe in improving symptoms and provides a simple treatment option for children with severe malacia or tracheal compression after DAA repair.
-
Slide tracheoplasty can be applied successfully to all types of long segment congenital tracheal stenosis. In case of short segment tracheal stenosis, direct resection and anastomosis is often preferred. We report a case illustrating a new side benefit of the slide tracheoplasty in a patient presenting a relatively short hypoplastic tracheal segment coexisting with tracheomalacia after EA with TEF repair.
-
Clinical Trial
A prospective study of methicillin-resistant Staphylococcus aureus colonization in children scheduled for elective surgery.
Staphylococcus aureus is a major cause of surgical wound infections. To obtain contemporary data on S aureus, we performed a prospective study of colonization and infection in children scheduled for elective surgical procedures. ⋯ Methicillin-resistant S aureus colonization was common in asymptomatic children. Most strains appeared to be health care-associated and resistant to clindamycin. Wound infection rate remained low despite the high prevalence of staphylococcal colonization.