Journal of pediatric surgery
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Pneumatosis intestinalis of the foregut is a very rare finding. It may represent emphysematous gastritis secondary to inflammatory conditions or gastric emphysema secondary to proximal foregut obstruction and high intragastric pressure. We present a case of gastroduodenal pneumatosis secondary to partial duodenal obstruction in an infant with Down's syndrome.
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Tracheal agenesis is a rare and usually lethal congenital malformation of the forgut. Although some infants can be resuscitated with an intra-esophageal intubation temporarily, long-term airway management is difficult because of the collapsing airway. ⋯ Our procedure has a potential to establish a long-term steady airway in patients with tracheal agenesis. The detail of the procedure is presented and the related literature is reviewed.
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The aim of the study is to review the safety and efficacy of partial fistulectomy with 3-layered primary closure without postoperative intubation for persistent tracheocutaneous fistula (TCF). ⋯ Partial excision and primary closure of persistent TCF is safe and effective. Drain placement and overnight observation are imperative. Careful patient selection is important. Routine postoperative intubation is not necessary.
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This study evaluated the Trap-door button use (Cook Medical, Bloomington, IL) for antegrade enemas in children. ⋯ Percutaneous placement of a cecostomy button under laparoscopic control is an easy and major complication-free procedure. The use of the Trap-door device by the patients or with the help of the parents for antegrade enemas is effective and satisfactory. It improves the quality of life and is reversible.
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Case Reports
Liver transplantation for pulmonary vascular complications of pediatric end-stage liver disease.
Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPH) are poorly understood pulmonary complications of end-stage liver disease (ESLD). We present a case series of children with HPS and PPH. ⋯ Hepatopulmonary syndrome and PPH are uncommon complications of ESLD in children. Epoprostenol can bridge PPH patients to OLT. OLT leads to rapid resolution of HPS and PPH and currently represents the only successful treatment for these children.