Journal of pediatric surgery
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A 1-year-old child developed fatal septic pulmonary embolism upon removal of a central intravenous catheter. Histologically identical material was found in the pulmonary arteries and in the inferior vena cava at the catheter tip site. The pathophysiology of pulmonary embolism occurring during childhood is reviewed.
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Gastrografin was used to relieve subacute intestinal obstruction due to Ascaris lumbricoides in children. This hyperosmolar and wetting agent proved to be highly efficient to achieve this goal. Statistical evaluation of the hospital stay and first bowel action showed a significant difference between the treated "gastrografin group' and the untreated by gastrografin "control group,' in favor of the "gastrografin group.' Our data strongly suggest the use of Gastrografin in subacute intestinal obstruction due to Ascaris lumbricoides. This treatment should be instituted provided the patient has been adequately hydrated prior to administration.
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Gastric replacement of the esophagus using the posterior mediastinal route is reported in four infants with esophageal atresia without tracheoesophageal fistula. The procedure is recommended for the ease with which the operation can be performed and the low incidence of anastomotic complications. Growth and development in the short-term follow-up has been satisfactory and reflux has not been a problem.
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We report a series of four spinal cord-injured children with ventilator dependency who were implanted with radiofrequency phrenic nerve pacers. At injury, their ages ranged from 6 to 9 years. Implantation occurred from 15 to 47 months following injury. ⋯ There have been no complications related to pacer dysfunction in the postoperative course. Selective pacing schedules have been developed to minimize problems related with external mechanical ventilation. Radiofrequency phrenic nerve pacing is of value in the complete rehabilitative management of these severely disabled children.