Journal of pediatric surgery
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Tension gastrothorax develops when the stomach herniated through a congenital diaphragmatic defect into the thorax is massively distended by trapped air. The authors present 5 cases and discuss the diagnostic and therapeutic management. ⋯ Tension gastrothorax is a life-threatening condition leading to acute and severe respiratory distress. The condition exhibits distinct radiographic features. Emergency decompression of the distended stomach should first be attempted via nasogastric tube. If this maneuver fails, decompression must be achieved either by needle puncture or by chest tube insertion into the stomach.
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Case Reports
Ovarian torsion associated with appendicitis in a 5-year-old girl: a case report and review of the literature.
Acute ovarian torsion is an uncommon cause of abdominal pain in female children and is often difficult to differentiate from other conditions causing lower abdominal pain. Acute adnexal pathology associated with appendicitis is very rare, with only a handful of reports available in the literature. Reported is a case of ovarian torsion associated with appendicitis in a 5-year-old girl along with a comprehensive literature review.
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Complications of open conversion, hypercarbia, and intestinal injury have plagued minimally invasive approaches to congenital diaphragmatic hernia (CDH) repair in neonates. To safely begin using minimally invasive techniques for neonatal CDH repair, we formulated preoperative selection criteria and operative techniques that would enhance chances for successful thoracoscopic primary diaphragm repair and uncomplicated outcome. ⋯ Neonatal thoracoscopic CDH repair is safe in selected patients who have good preoperative pulmonary function and anatomy amenable to primary diaphragmatic repair. A wider range of neonates may be acceptable for thoracoscopic CDH repair with increasing surgical experience.
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Transient oliguria during laparoscopic surgery is a known phenomenon. Currently, no data on the impact of pneumoperitoneum on renal function in children are available. ⋯ Pneumoperitoneum leads to anuria in most children younger than 1 year and to oliguria in about one third of older children. This is a completely reversible phenomenon. Urine output should not be taken into consideration for calculating intravenous fluid administration during pneumoperitoneum in children.
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The significance of spot urine 5-hydroxyindoleacetic acid (5-HIAA) levels in the early diagnosis of acute appendicitis (AA) is questioned. ⋯ Spot urine 5-HIAA determination may be a practical, objective, and noninvasive method in the early diagnosis of AA. Because other radiological and laboratory tests can be insufficient, especially in the early period of AA, this test may be used effectively instead. Clinical studies are necessary for further conclusions.