Abstract:
BACKGROUND:Ultrasound (US) evaluation of some fetal anomalies provides limited information. Anatomic details that affect prognosis and selection for fetal therapy, such as liver herniation and pulmonary hypoplasia in congenital diaphragmatic hernia (CDH) and airway patency in giant neck masses, may be difficult to delineate using conventional sonographic methods. The authors evaluated the utility of prenatal magnetic resonance imaging (MRI) with new ultrafast imaging sequences in the diagnosis and management of fetal anomalies. METHODS:From April 1996 to April 1997 45 MRI scans were performed in 31 pregnant women with an US diagnosis of a fetal anomaly. The US diagnoses included CDH, giant neck masses, lung masses, abdominal and pelvic abnormalities, twin anomalies, and central nervous system (CNS) anomalies. The fetuses ranged in age from 18 to 39 weeks' gestation (mean, 28.7 weeks). Using a 1.5-T magnet, a variety of ultrafast imaging sequences were performed including fast gradient-echo, half-fourier single shot turbo spin-echo (Haste) and echo-planar imaging yielding images with T1 to T2 type weighting. RESULTS:With CDH, MRI demonstrated liver herniation into the chest in 11 of 14 cases. In four cases, US findings had not been definitive. In two cases of CDH detected by MRI, the primary diagnosis by US had been congenital cystic adenomatoid malformation (CCAM). With lung masses, MRI accurately distinguished between CCAM and bronchopulmonary sequestration (BPS). For giant neck masses with potential airway obstruction, MRI scans permitted differentiation of teratoma from cystic hygroma and allowed delineation of fetal airway involvement. The accurate anatomic evaluation facilitated planning for the ex utero intrapartum treatment (EXIT) procedure, a technique for securing the airway while the term fetus is still on placental support. With huge abdominal masses such as enterogenous cyst and lymphangioma, MRI scanning clarified the diagnosis. Fourteen of the 31 (45%) patients underwent fetal treatment after US and MRI evaluation. CONCLUSIONS:Prenatal MRI enhances fetal anatomic evaluation and facilitates perinatal management and family counseling. Ultrafast imaging sequence MRI is helpful to corroborate and refine US diagnoses. Fetal MRI is a valuable adjunct to US for prenatal diagnosis before fetal surgical intervention for selected life-threatening birth defects.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Quinn TM,Hubbard AM,Adzick NSdoi
10.1016/s0022-3468(98)90315-3subject
Has Abstractpub_date
1998-04-01 00:00:00pages
553-8issue
4eissn
0022-3468issn
1531-5037pii
S0022-3468(98)90315-3journal_volume
33pub_type
杂志文章abstract::The informed consent process for emergency surgery in children poses a challenge for pediatric surgeons because the child and his/her surrogates (usually parents) must make medical decisions in a relatively short period. The unique circumstances of a surgical emergency create potential barriers to achieving the centra...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2005.05.019
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Minimally invasive surgery has broad applicability to pediatric diseases, including pediatric cancer resection. Neuroblastic tumors of childhood are highly variable in presentation, and so careful selection of appropriate candidates for minimally invasive resection is paramount to achieving safe and durable ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2020.02.019
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND/PURPOSE:Pleuropulmonary blastoma (PPB) is a rare primary neoplasm of pleuropulmonary mesenchyme. Fewer than 170 children have been reported, and few single institutions have reported more than several cases. Treatment for this condition is primarily surgical resection; however, increasing experience suggests...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.10.074
更新日期:2006-01-01 00:00:00
abstract::End-to-end anastomosis has become the standard technique for repair of esophageal atresia with distal tracheoesophageal fistula. End-to-side anastomosis with ligation of the fistula in continuity has also been advocated. For over 25 years both methods have been used in this hospital. The purpose of this report is to c...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(91)90998-9
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND/PURPOSE:Failure of the gut barrier and endotoxemia have been implicated in sepsis and multiple organ failure (MOF) syndromes in adults. The contributions of endotoxin (ETX) and proinflammatory cytokines (CKs) to the pathophysiology of disease and the outcomes of infants in the neonatal intensive care unit (N...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.10.038
更新日期:2007-03-01 00:00:00
abstract::Pilomatrixoma is a benign tumor of hair follicles that usually occurs as a single tumor and appears in the head and neck region, extremities, and trunk. The authors present a case of pilomatrixoma with multifocal localization. Simple excision of lesions is the recommended procedure, and recurrence usually is rare. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.34496
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:We compared direct hospital costs and indirect costs to the family associated with immediate appendectomy or initial nonoperative management for perforated appendicitis in children. METHODS:From June 2009 through May 2010, 61 prospectively identified families completed a cost diary, documenting the ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.03.024
更新日期:2012-06-01 00:00:00
abstract::Three children with testicular feminization syndrome have been seen in the past 4 yr. Each presented with at least one large inguinal hernia. The gonad was proven to be a testis by frozen section. Gonadectomy and herniorrhaphy were done. The plan is to remove the second gonad after puberty. The causation and genetics ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(81)80008-5
更新日期:1981-08-01 00:00:00
abstract::Obstructive jaundice is an unusual initial manifestation of non-Hodgkin's lymphoma in children. Two pediatric patients with primary intraabdominal non-Hodgkin's lymphoma causing obstructive jaundice are presented. Although percutaneous transhepatic cholangial drainage (PTCD) is frequently used to treat obstructive jau...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90733-8
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:In the intestine, Wnt proteins are powerful regulators of cell proliferation, differentiation, and adhesion. Mutations of the adenomatous polyposis coli (APC) gene elevate nuclear beta-catenin and provoke intestinal tumor formation. We sought to determine whether Wnt signaling is involved in adaptive respons...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.03.021
更新日期:2005-06-01 00:00:00
abstract::Percutaneous aspiration and tetracycline sclerosis is a safe but temporary therapy of large splenic cysts in children. Between 1985 and 1987, three girls with splenic cysts were seen. Their ages ranged from 5 to 14 years, and the cysts were from 8 to 16 cm in diameter. Despite their large size, all were asymptomatic a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80711-0
更新日期:1989-07-01 00:00:00
abstract:PURPOSE:The purpose of this report is to investigate changes in the myenteric plexus associated with the dilated proximal segment of jejunoileal atresia (JA). Two-dimensional morphologic changes in the myenteric nerve plexuses were investigated using whole-mount preparation. METHODS:Proximal (P) and distal (D) intesti...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.21618
更新日期:2001-03-01 00:00:00
abstract::Intrauterine growth retardation (IUGR) is a leading cause of perinatal morbidity and mortality. Most IUGR is the result of inadequate transfer of nutrients from mother to fetus. Transamniotic fetal feeding (TAFF) has been proposed as a method of treating IUGR in which nutrients, infused into the amniotic fluid, would ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80643-7
更新日期:1987-09-01 00:00:00
abstract::This study was conducted to investigate the newborn's response to surgical trauma. Ten newborns and 10 infants as a control group undergoing similar surgical procedures were studied. All patients had moderate surgical stress, and there was no difference between the groups regarding the degree of surgical trauma. Alter...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90147-7
更新日期:1995-04-01 00:00:00
abstract:PURPOSE:To evaluate the expression of Cold-inducible RNA-binding protein (CIRP) in torsion/detorsion of the testes in different phases and demonstrate the protective effect of CIRP on testicular injury after torsion/detorsion (T/D) in an experimental mouse model. METHODS:Twenty-four male BALB/c mice were divided rando...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.02.065
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:With the advent of more aggressive chemotherapy, the incidence of neutropenic enteropathy is increasing. This review was performed to (1) determine which children are affected, (2) identify predisposing factors, and (3) assess efficacy of treatment. METHODS:A 10-year (1988 to 1997) review identified 33 childre...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90566-3
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Open Ladd's procedure is the gold standard for the correction of intestinal malrotation and laparoscopic approach remains controversial. This study aimed to evaluate our experience in laparoscopic management of malrotation. METHODS:Single center retrospective study including patients who underwent a laparos...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.09.023
更新日期:2019-09-01 00:00:00
abstract::As fetal swallowing is documented in utero, supplementation of the ingested amniotic fluid with nutrients or hormones has been postulated as a potential prenatal treatment for intrauterine growth retardation (IUGR). To study the effect of epidermal growth factor (EGF) on the developing fetal small intestine, 12 pregna...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(05)80305-7
更新日期:1993-10-01 00:00:00
abstract:PURPOSE:Management of postoperative pain following repair of pectus excavatum has traditionally included thoracic epidural analgesia, narcotics, and benzodiazepines. We hypothesized that the use of intercostal or paravertebral regional blocks could result in decreased inpatient length of stay (LOS). METHODS:We conduct...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.10.037
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:We determined the incidence of sensorineural hearing loss (SNHL; >20dB at any frequency) in a contemporary cohort of congenital diaphragmatic hernia (CDH) survivors at a single tertiary care center and identified potential risk factors for SNHL. METHODS:From 2000 through 2011, clinical and audiologi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.01.049
更新日期:2014-06-01 00:00:00
abstract::A newborn infant with aganglionosis of the entire colon and terminal ileum also had congenital lip pits and a submucous cleft palate. These anomalies may be added to the growing list of conditions associated with Hirschsprung's disease. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(79)90010-1
更新日期:1979-04-01 00:00:00
abstract:PURPOSE:We sought to compare the presentation, management, and outcomes in gastric adenocarcinoma cancer for pediatric and adult patients. METHODS:Using the 2004 to 2014 National Cancer Database (NCDB), patients ≤21 years (pediatric) were retrospectively compared to >21 years (adult). Chi-squared tests were used to co...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.01.048
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Severe blunt hepatic injury in children is associated with a high mortality rate. Although nonoperative management has become the treatment of choice for mild to moderate liver trauma, there is no consensus as to the optimal treatment for the most severe hepatic injuries in children. METHODS:A statewide tra...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.24720
更新日期:2001-07-01 00:00:00
abstract:PURPOSE:This study was aimed at comparing the effects of a neutral liquid and a neutral gas used as intraamniotic media on umbilical blood flow, O2 delivery, blood pressure, acid-base status, and electrolytes in the fetus at escalating intraamniotic pressures. METHODS:Eight fetal lambs underwent invasive monitoring of...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90081-7
更新日期:1999-04-01 00:00:00
abstract::Nonoperative treatment of splenic injury is well accepted. Two questions have not been answered. (1) What is the intensity of monitoring required in the hemodynamically stable patient? (2) How long do patients need to be hospitalized? Ninety-one patients having computed tomography (CT) or surgically proven splenic inj...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(05)80336-7
更新日期:1993-10-01 00:00:00
abstract::The distribution of enteric serotonergic neurons was studied in patients with Hirschsprung's disease. Specimens of bowel obtained at surgery were incubated in vitro with tritiated serotonin (3H-5-HT) in the presence of a high concentration of nonradioactive norepinephrine. Sites of high-affinity 3H-5-HT uptake were vi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(78)80102-x
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:The safety of the laparoscopic treatment of intestinal malrotation remains controversial. This study compared the outcomes of laparoscopic and open surgical treatment of intestinal malrotation. METHODS:A multicentric retrospective study included pediatric cases of intestinal malrotation operated on between ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.08.014
更新日期:2020-12-01 00:00:00
abstract:PURPOSE:The physical finding of a thickened spermatic cord as indicator of an inguinal hernia in children is well documented. This thickening has been attributed to the presence of a hernia sac. Based on our clinical observations, cremasteric fibers appeared thickened in the presence of an inguinal hernia. The authors ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90002-7
更新日期:1999-09-01 00:00:00
abstract:PURPOSE:Keloids occur as a result of abnormal wound healing and as many as 70% of keloids and hypertrophic scars affect the pediatric population. Earlobe keloids, similar to lesions elsewhere in the body, remain a challenging problem given the high rates of recurrence and lack of consensus regarding treatment strategy....
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.07.006
更新日期:2020-03-01 00:00:00
abstract::Extrahepatic portal hypertension was induced in rats by portal venous constriction. Portal pressures on the fourth postconstriction day were significantly elevated in PVC rats when compared to control rats. Splenoportograms showed decreased hepatic flow and venous collaterals. Histologic sections showed gastric mucosa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(75)90363-2
更新日期:1975-10-01 00:00:00