Journal of pediatric surgery
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The urinary bladder is the second most commonly injured genitourinary organ. The objective of this study was to describe the management of pediatric traumatic bladder ruptures in the United States and their association with surgical repair and mortality. ⋯ After bladder trauma, pediatric patients demonstrate significantly improved survival when the bladder is surgically repaired. With only 67% of intraperitoneal bladder injuries being repaired, there appears to be underuse of a life-saving procedure.
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Case Reports
An unusual case of small bowel obstruction in a child caused by ingestion of water-storing gel beads.
Foreign body ingestion occurs most commonly in the pediatric population. Small bowel obstruction is a rare complication that can occur, and surgical intervention is required. ⋯ Symptoms resolved after a large bead 3 cm in diameter was retrieved via laparoscopic-assisted excision. This case suggests that water-storing gel beads are particularly dangerous foreign bodies and should be kept out of the reach of children.
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Diagnosis of necrotizing enterocolitis (NEC), prevalent in premature infants, remains challenging. Enterocyte damage in NEC can be assessed by intestinal fatty acid-binding protein (I-FABP), with a sensitivity of 93% and a specificity of 90%. Numerous markers of inflammation are known, such as serum amyloid A (SAA) and fecal calprotectin. ⋯ The combination of noninvasive measurement of I-FABP and fecal calprotectin seems promising for diagnosing NEC at an early time point. Prospective analysis is required to confirm this finding and to evaluate better treatment strategies based on noninvasive measurement of I-FABP and calprotectin.
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Review
Long-term review of sutureless ward reduction in neonates with gastroschisis in the neonatal unit.
A sutureless ward reduction (SWR) protocol was implemented in the neonatal intensive care unit of a tertiary level hospital in 1999. Although the short-term outcomes associated with SWR have been documented, the long-term outcomes are unknown. ⋯ Most patients with SWR exhibited normal growth with minimal bowel complications. Despite the high incidence of umbilical hernia, the majority resolved spontaneously and did not require subsequent herniotomy.
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Review Case Reports
Ureteral injury after percutaneous iliosacral fixation: a case report and literature review.
We report a case of right ureter injury in an 11-year-old girl after a percutaneous iliosacral screwing with non-computer-assisted fluoroscopic guidance. The indication was a pelvic ring fracture, C1-1 in the Tile modified AO classification (J Am Acad Orthop Surg. 1996;4:143-151). ⋯ Twelve days after the initial trauma, a right ureter tear was highlighted, just opposite the fourth lumbar vertebra. Uneventful spontaneous healing of the ureteral injury site occurred following double J-stent catheterization.