Journal of pediatric surgery
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Comparative Study
Nonaccidental trauma is a major cause of morbidity and mortality among patients at a regional level 1 pediatric trauma center.
Traumatic injuries are a major cause of morbidity and mortality in children. The purpose of the present study was to determine the incidence of nonaccidental trauma (NAT) and to compare the outcomes of accidental trauma (AT) patients with NAT patients at a large pediatric trauma center. ⋯ The surgeon caring for children must appreciate the high incidence of NAT with its increased morbidity and mortality relative to AT patients. A surgical evaluation should be performed promptly in NAT patients because of their frequent need for emergent intervention.
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Comparative Study
Is contralateral exploration necessary in preterm infants with unilateral inguinal hernia?
Contralateral inguinal exploration has been the preferred approach to preterm infants with unilateral inguinal hernia. There is no literature evidence to justify this. The aim of this prospective study is to analyze the incidence and to determine any risk factors for the development of contralateral metachronous hernia (MH) in the preterm when compared with term infants. ⋯ There is no significant difference between the occurrence of MH in preterm when compared with term infants. Routine contralateral exploration in preterm infants with its associated risks is therefore not justified in unilateral hernia.
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Review Case Reports
Congenital teratoma of the tongue: a case report and review of the literature.
Teratomas of the head and neck are rare. They develop in neonates and are associated with feeding difficulty, airway obstruction, and difficulty in swallowing (which may cause polyhydramnios). ⋯ He exhibited respiratory arrest immediately after birth and underwent intubation. The mass, which was completely excised, was histologically identified as a mature teratoma.
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Comparative Study
Experience of bedside preformed silo staged reduction and closure for gastroschisis.
The purpose of this study was to assess the effectiveness of routine staged reduction and closure at the bedside, using preformed silos with no general anesthesia (PSnoGA), compared to emergency operative fascial closure (OFC) under general anesthesia for gastroschisis (GS). ⋯ PSnoGA has outcomes statistically similar to OFC, although days on ventilator are significantly reduced. Slow reduction of the bowel avoids abdominal compartment syndrome and closure may be achieved without fascial sutures. PSnoGA is performed at the bedside and aims to avoid general anesthesia, a period of ventilation, and out-of-hours operating, thereby reducing costs. A prospective, multicenter, randomized control trial is needed to evaluate the effectiveness of PSnoGA.
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Case Reports
Formation of a calcified "cast" in a long-term indwelling central venous catheter: a case report.
Catheter-related central venous thrombosis is a complication seen with long-term indwelling central venous catheters. The uses of total parenteral nutrition, catheter location, and duration of catheter use have been shown to increase the risk of thrombus formation. However, organized calcification of such a thrombus is a rare occurrence and, to our knowledge, has never been reported in a patient unexposed to total parenteral nutrition. We report a patient with an extensive, organized, calcified "cast" surrounding a central venous catheter used solely for chemotherapy administration.