Abstract:
:Evolution of the present-day policy of conservative management of ruptured spleen has been hailed as one of the most notable advances in pediatric surgery. Until 1971, routine splenectomy used to be the sacrosanct treatment for splenic trauma. It was universally believed that non-operative management carried a high mortality of 90 to 100%. Sporadic reports of successful conservative treatment appeared in the early twentieth century, but regrettably, these were ignored. Likewise, experimental studies pointing to the danger of post-splenectomy sepsis were also disregarded. Dominant surgical opinion continued to practice removal of the injured spleen. In 1968, Upadhyaya and Simpson, based on a well-designed clinical analysis of 52 children made a convincing plea for conservative management. In 1971, Upadhyaya et al. presented results of a corroborative experimental study, which provided the conclusive evidence that isolated splenic tears are well tolerated and heal spontaneously by first intention. Seeing the surge of publications that followed this presentation, it becomes apparent that this study constituted the real turning point that changed the world opinion in favour of salvage of the ruptured spleen. By 1979, numerous authors had reported the safety of non-operative management in hundreds of children all over the world. Currently, the policy of routine splenectomy has been universally abandoned; and the reported salvage rate of ruptured spleen is more than 90%. This paper traces the historical perspectives in the management of injured spleen from the times of Aristotle to the present day.
journal_name
Pediatr Surg Intjournal_title
Pediatric surgery internationalauthors
Upadhyaya Pdoi
10.1007/s00383-003-0972-ysubject
Has Abstractpub_date
2003-11-01 00:00:00pages
617-27issue
9-10eissn
0179-0358issn
1437-9813journal_volume
19pub_type
历史文章,杂志文章,评审abstract::Premature male ischiopagus tetrapus twins weighing 2.2 kg were born unexpectedly. They required initial ventilation for respiratory distress syndrome and an emergency laparotomy for intestinal obstruction at 10 days of age. At 8 months of age, formal separation was carried out. Primary skin closure was possible withou...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/BF01372144
更新日期:1997-04-01 00:00:00
abstract::Multiple endocrine neoplasia (MEN) 2B is a hereditary syndrome including medullary thyroid carcinoma (MTC), pheochromocytoma, gastrointestinal (GI) disorders, marfanoid facies, and multiple ganglioneuromas. MTC is the major cause of mortality, and often appears during the 1st decade of life. RET proto-oncogene mutatio...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-002-0824-1
更新日期:2002-09-01 00:00:00
abstract::Accessory hepatic tissue, unlike accessory splenic and pancreatic tissue, is rare and has a limited and almost exclusively sub diaphragmatic distribution. Fewer than ten cases of intrathoracic ectopic liver have been reported so far in the literature. This paper reports a case that caused a diagnostic dilemma. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s003830000520
更新日期:2001-07-01 00:00:00
abstract::Internal anal sphincter achalasia (IASA) is a condition with a clinical presentation similar to Hirschsprung's disease, but with the presence of ganglion cells on rectal biopsy. The diagnosis of IASA is made on anorectal manometry, which demonstrates the absence of a rectosphincteric reflux on rectal balloon inflation...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050552
更新日期:1999-01-01 00:00:00
abstract::Adrenal cysts (AC) are rare, particularly in the newborn period. Almost all ACs in newborns were diagnosed on exploratory laparotomy or at autopsy. We report a newborn with an AC that was diagnosed after an exploratory laparotomy due to its rare presentation. This case shows that ACs should be considered in the differ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-002-0759-6
更新日期:2003-06-01 00:00:00
abstract::With widespread use of antenatal ultrasound, an increasing number of urinary-tract lesions are being detected, and the clinician is called upon to make management decisions. Parenchymal lesions of the kidney pose a special challenge because of the associated risk of the occurrence of malignancy. A case of an antenatal...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-002-0833-0
更新日期:2003-04-01 00:00:00
abstract::In a retrospective study, intraoperative photos and video documentations of 884 children demonstrate that inguinal hernias and their recurrences are aspects of a full spectrum, which ranges from fully closed internal inguinal rings (IIR) and small openings to all-the way-down-into-the-scrotum open processus; 92% of th...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-007-2018-3
更新日期:2007-12-01 00:00:00
abstract::Cryptorchidism is a common paediatric complaint and is traditionally managed surgically by orchidopexy. We aimed to prospectively review the success of the Bianchi high scrotal incision technique for performing orchidopexy in boys with palpable non-descended testis. A total of 206 orchidopexies were performed in 85 pa...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-008-2149-1
更新日期:2008-06-01 00:00:00
abstract::Pediatric germ cell tumors comprise 1-3% of all malignant pediatric tumors and are found in variable locations. We present the case of a term 3.7 kg neonate who was found to have a giant liver mass at birth, later determined to be an immature teratoma arising from the hepatoduodenal ligament. This case report and imag...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-017-4123-2
更新日期:2017-09-01 00:00:00
abstract::Perineal-mound (PMD) and genital-fold defects cause anorectal malformations (ARM) in both sexes. They are common in females and usually present as a low anomaly (except rectovestibular fistula). They are rare in males and present as an intermediate anomaly. A common embryological explanation for these defects with var...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s003830050562
更新日期:1999-01-01 00:00:00
abstract:AIM:To determine if follow-up by consultant pediatric surgeons (CPS) affects morbidity due to incarceration (INC) in children with indirect inguinal hernia (IH). METHODS:We educate parents so they can identify possible INC and advise them to attend our emergency department anytime for immediate review by on-call CPS. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章,多中心研究
doi:10.1007/s00383-011-3005-2
更新日期:2012-01-01 00:00:00
abstract::Magnetic resonance cholangiopancreaticography (MRCP) was used to visualize the biliary tract in two children, aged 7 weeks and 10 years, with a choledochal cyst. MRCP was successful in both cases and the findings were confirmed by intraoperative cholangiography. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050667
更新日期:1999-01-01 00:00:00
abstract:PURPOSE:Pediatric patients with intestinal failure need long-term parenteral nutrition (PN), but this nutritional support causes liver dysfunction, such as intestinal failure-associated liver disease (IFALD). Several studies have shown that the lipid emulsion produced by soybean oil (SO) is associated with the occurren...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-017-4190-4
更新日期:2018-02-01 00:00:00
abstract::Congenital mesoblastic nephroma (CMN) is a rare paediatric renal neoplasm. It is a diagnostic challenge to the pathologists due to its close differentials having ominous prognosis. We present three cases of CMN with unusual morphology including evidence of renal dysplasia in one of them. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-008-2279-5
更新日期:2009-01-01 00:00:00
abstract::Gastrointestinal atresia is a major cause of bowel obstruction in the newborn. Experimental models and clinical observations have demonstrated the heterogeneous nature of its pathogenesis. A proportion is due to late intra-uterine vascular insults and some are genetic in nature. Epidemiological studies have found gast...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-008-2138-4
更新日期:2008-06-01 00:00:00
abstract::The management of a critical airway in infants and toddlers with congenital tracheal stenosis (CTS) continues to be an enormous challenge to the surgeon. Until recently, this condition often proved fatal. Improvements in surgical techniques, anesthetic management, and postoperative critical care have resulted in succe...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s003830050028
更新日期:2000-01-01 00:00:00
abstract::Accidental ingestion of corrosive substances remains a major health hazard in children. Most infants and children who ingest caustic substances present with very few symptoms or signs. Approximately 40% of caustic substance ingestions result in esophageal injury, but the optimal management of caustic esophageal burns ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-004-1331-3
更新日期:2005-02-01 00:00:00
abstract::Transanal one-stage endorectal pull-through (TOSEPT) has been presented as the most recent progression in treatment of Hirschsprung's disease (HD), which may be able to replace various previous techniques. This prospective study was designed to compare the efficacy and probable complications of the commonly used open ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-008-2186-9
更新日期:2008-08-01 00:00:00
abstract::Congenital pyloric atresia (CPA) is a very rare condition that was first described by Calder in 1749. Commonly, CPA occurs as an isolated lesion, which has an excellent prognosis, but it can also be seen in association with other malformations, which can have a negative impact on the final outcome. The medical records...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-007-1903-0
更新日期:2007-06-01 00:00:00
abstract::The diagnosis of right-sided diaphragmatic rupture (RDR) due to blunt abdominal trauma is often missed in the acute setting, especially in the absence of other thoracoabdominal injuries. We describe two such children. The problems associated with the diagnosis and management of RDR are discussed to emphasize the need ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830100686
更新日期:2002-03-01 00:00:00
abstract:INTRODUCTION:No protocol exists for prophylaxis or therapeutic management of peripherally inserted central catheter (PICC) related deep venous thrombosis (DVT) in children. Currently, very few patients are provided prophylaxis for DVT. In this study, we analyzed our current practice of PICC placement to identify the fr...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-013-3259-y
更新日期:2013-05-01 00:00:00
abstract:PURPOSE:Radiologically inserted gastrojejunal tubes (RGJ) and surgical jejunostomy (SJ) are established modes of jejunal feeding. The aim of the study is to review nutritional outcomes, complications and the practical consideration to enable patients and carers to make informed choice. METHODS:Retrospective review of ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-018-4303-8
更新日期:2018-09-01 00:00:00
abstract:PURPOSE:The RAS association domain family protein 1 (RASSF1A) is known to be frequently inactivated by promoter hypermethylation in cancers. This study investigated the association of RASSF1A methylation with clinical outcomes in hepatoblastoma patients and whether it is correlated with the histological phenotype of he...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-013-3371-z
更新日期:2013-11-01 00:00:00
abstract::Reflux nephropathy (RN) is recognized as a major cause of end-stage renal failure in children and young adults. Inhibition of nitric oxide (NO) exacerbates and enhanced production ameliorates tubulointerstitial fibrosis (TIF) in experimental obstructive uropathy. NO is synthesised by NO synthase (NOS), three distinct ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-002-0858-4
更新日期:2002-10-01 00:00:00
abstract::A small phallus causes great concern regarding genital adequacy. A concealed penis, although of normal size, appears small either because it is buried in prepubic tissues, enclosed in scrotal tissue penis palmatus (PP), or trapped due to phimosis or a scar following circumcision or trauma. From July 1978 to January 20...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-002-0770-y
更新日期:2002-12-01 00:00:00
abstract:PURPOSE:Biliary atresia (BA) is characterized by progressive inflammation of the biliary system. This inflammation persists and causes liver fibrosis, although jaundice disappears after Kasai portoenterostomy (KP). We aimed to confirm whether the oral administration of eicosapentaenoic acid (EPA) suppresses liver fibro...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-018-4313-6
更新日期:2018-10-01 00:00:00
abstract::We present the case of a 14-year-old male with a history of small bowel transplantation for long segment Hirschsprung's disease who underwent Duhamel ileorectal pull-through procedure. In post-transplant, the patient had no restrictions and was not TPN-dependent. To improve his quality of life, he and his family were ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-017-4216-y
更新日期:2018-01-01 00:00:00
abstract::Pediatric osteomyelitis commonly occurs in the long bones and has rarely been reported in small bones such as the vertebrae and ribs. Rib osteomyelitis occurs in approximately 1% or less of all cases of hematogenous osteomyelitis, and is usually caused by Staphylococcus aureus. We present a case of acute osteomyelitis...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-006-1725-5
更新日期:2006-10-01 00:00:00
abstract::Renal and perinephric abscess in children are uncommon. Three basic pathophysiologic mechanisms are involved, namely, hematogenous spread, ascending infection and contamination by proximity to an infected area. Six pediatric patients diagnosed with renal abscess were treated at our institution from 1990-2000. Five pat...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-002-0888-y
更新日期:2003-04-01 00:00:00
abstract:PURPOSE:The aim of this study was to determine the incidence of gastroschisis-related complications (GRCs) after closure of the abdominal wall defect, with a focus on frequency, type and timing of required surgical interventions, and to identify the impact of these on further outcome. METHODS:All gastroschisis patient...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-014-3500-3
更新日期:2014-06-01 00:00:00