Journal of pediatric surgery
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All-terrain vehicle (ATV)-related injuries continued to increase in recent years. We aimed to analyze the ATV injury patterns at our institution to help structure public awareness campaign and encourage governmental regulation, with the ultimate goal of injury prevention. ⋯ Both the incidence and severity of ATV-related injuries are increasing in a regional pediatric trauma center. There is a lack of regulation enforcement and public awareness of the danger of ATV use in children. Efforts to ensure helmet use and limit operator age are urgently needed to reduce childhood ATV-related injuries.
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Children with esophageal foreign bodies are frequently seen by pediatric surgeons. Choking and dysphagia are common presentations; however, esophageal perforation has been reported. Historically, rigid esophagoscopy with extraction of the foreign body has been the recommended treatment. Alternatively, Foley balloon extraction is a safe and effective approach. ⋯ Balloon extraction of pediatric esophageal foreign bodies is a safe and cost-effective procedure. This technique is applicable for infants, children, and adolescents. Experienced practitioners should be able to achieve greater than 80% success rate.
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We report a term male neonate who was born with a large, red, tubular, mucosa-lined umbilical mass containing a patent lumen. Prenatal ultrasonographic screening at 20 to 28 weeks of gestation revealed a large cyst at the umbilicus, communicating with the urinary bladder. ⋯ The dome was resected, and the bladder was repaired in 2 layers after identification of the ureteral orifices. Bladder prolapse through a patent urachus can be predicted by prenatal ultrasound and has a distinct neonatal appearance.
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Nonoperative management of blunt pediatric liver injuries has become the standard of care in the absence of hemodynamic instability. However, associated bile duct injuries remain as difficult challenges. Few case reports have demonstrated the benefits of conservative approaches, but others have found better outcomes with surgical intervention. In this study, we report on our experience with interventional endoscopic and radiologic management of 5 pediatric patients with bile duct injuries who underwent unsuccessful surgical interventions. ⋯ With the current advancement in endoscopic retrograde cholangiopancreatography and intervention radiology techniques, we believe that interventional endoscopic and radiologic management of bile duct injuries caused by blunt trauma in children is successful and efficacious even after multiple laparotomies.
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Extracorporeal membrane oxygenation (ECMO) is a means of respiratory and hemodynamic support for patients failing conventional therapies. Children requiring hematopoietic stem cell transplantation who develop complications during therapy may require ECMO. Such patients pose medical and ethical challenges for clinicians considering initiation of ECMO. The authors review the outcomes of these patients and propose recommendations. ⋯ Patients who require ECMO for cardiopulmonary support after hematopoietic stem cell transplantation have a poor prognosis. Clinicians must be cautious in presenting this option to parents and present them with appropriate expectations in this high-risk population.