Abstract:
:Esophageal achalasia (EA) has been historically treated by esophageal dilatation or myotomy with or without fundoplication. Botulinum toxin (Botox-Allergan) use in pediatric EA has not been previously described. The authors' objective was to observe the efficacy of botulinum toxin injection into the lower esophageal sphincter (LES) for EA. An 11-year-old boy presented with a 9-month history of frequent pneumonia, productive cough, and a 1-year history of chest discomfort and odynophagia. Chest radiograph showed changes compatible with aspiration. Upper gastrointestinal (UGI) series showed typical narrowing of the LES, and 24-hour pH study showed no reflux. Esophageal manometry showed classic findings of achalasia. An upper gastrointestinal endoscopy was performed showing a huge volume of retained food. A direct four-quadrant injection was performed with a total of 100 U of botulinum toxin into the LES. UGI series showed improvement in esophageal emptying. Esophageal manometry showed impressive improvement in LES pressure (preinjection, 44.1 mm Hg to postinjection mean of 16.6 mm Hg), percent relaxation (preinjection, 30% to postinjection, 58.8%), and duration of relaxation (preinjection, 1.9 seconds to postinjection, 11 seconds). The patient has not had any further respiratory symptoms, chest pain, or odynophagia in 8 months of follow-up. Botulinum toxin injection is simple and effective for EA and merits its study in a prospective manner in the pediatric population.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Walton JM,Tougas Gdoi
10.1016/s0022-3468(97)90650-3subject
Has Abstractpub_date
1997-06-01 00:00:00pages
916-7issue
6eissn
0022-3468issn
1531-5037pii
S0022-3468(97)90650-3journal_volume
32pub_type
杂志文章abstract:PURPOSE:Initial Children's Oncology Group (COG) management for Wilms' tumor (WT) consists of primary nephroureterectomy with lymph node sampling. While this provides accurate staging to define further treatment, it may result in intraoperative spill (IOS), which is associated with higher recurrence rates and therefore ...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2012.10.015
更新日期:2013-01-01 00:00:00
abstract::Short lengths of small intestine may be resected without significantly affecting the digestive and absorptive capacity; however, extensive resection produces varying degrees of malnutrition. This study was undertaken to define the adaptive changes in the remaining small intestine of two of the jejunal and ileal mucosa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90329-1
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Our objective was to evaluate the accuracy of acoustic radiation force impulse (ARFI) elastography in determining extent of liver fibrosis in pediatric patients with short bowel syndrome (SBS). METHODS:This prospective cohort study included pediatric patients with SBS who underwent ultrasound with ARFI meas...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.03.016
更新日期:2017-06-01 00:00:00
abstract::It is necessary to consider catheter-related events when a previously stable patient has an acute change in cardiopulmonary status, regardless of the duration of catheter use; and to recognize that hydrothorax from vein perforation may be bilateral, necessitating bilateral drainage procedures. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80008-9
更新日期:1989-03-01 00:00:00
abstract::Reduced-size liver transplantation has been recognized as a powerful modality in alleviating the global donor shortage in pediatric liver transplantation. We describe, for the first time, a technique for revascularizing reduced-size grafts which has not been patterned after adult revascularization techniques. This rev...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90698-k
更新日期:1993-07-01 00:00:00
abstract::This report described a patient with multiple injuries in whom a major bronchial tear was not diagnosed early because the lung reexpanded initially. When pulmonary sepsis intervened and the bronchial injury was discovered, repair could not be accomplished because of continuing sepsis. The case emphasizes the need for ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(77)90187-7
更新日期:1977-08-01 00:00:00
abstract::The long-term effect of dividing the genitofemoral nerve supply to the undescended testis in naturally cryptorchid rats is reported. 20 male Buffalo rats with an undescended right testis, noted at the age of 30 days, were used for the investigation. 20 healthy animals served as controls. The abdominal division of the ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90382-4
更新日期:1994-06-01 00:00:00
abstract::Inflammatory cloacogenic polyp (ICP) is a rare lesion arising in the region of the anorectal transitional zone. It is likely caused by occult internal prolapse. Most cases reported in the literature are in the adult population. This is a report of ICP in four children. Awareness of this entity in children is important...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90137-x
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND/PURPOSE:Pulmonary injury from mechanical ventilation has been attributed to application of excess alveolar pressure (barotrauma) or volume (volutrauma). The authors questioned whether partial liquid ventilation (gas ventilation of the perfluorocarbon filled lung, PLV) would reduce ventilator-induced lung inj...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.26361
更新日期:2001-09-01 00:00:00
abstract::The most common site of teratomas in neonates is in the sacrococcygeal region. Herein the authors describe a congenital teratoma, and to their knowledge it is the first reported case of vulvar site in a newborn. Tumor was removed on the fourth day of life, and she was completely normal 18 months after the operation. B...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.22302
更新日期:2001-04-01 00:00:00
abstract::An infant presented with abdominal distension and failure to thrive. This patient was a 3.5-month-old, ex-26-week premature infant at the time of presentation who required supplemental parenteral nutrition until day 9 of life. Workup found ascites and a complex cystic mass in the porta hepatis. A perforated gallbladde...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.35029
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:The preferred treatment for children with major pancreatic ductal injury remains controversial. This report compares our results using early operation with previously reported series using both operative and nonoperative management. METHODS:This is a retrospective analysis of all children with pancr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.20711
更新日期:2001-02-01 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::Kaposiform hemangioendothelioma is a rare locally aggressive vascular tumor that usually manifests during early childhood. Typically the lesion presents with skin, soft tissue and bone involvement and is characterized histologically by ill-defined nodularity and the presence of spindle cells with resemblance to Kaposi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.03.014
更新日期:2016-06-01 00:00:00
abstract::Focal hepatic lesions in the pediatric population are rare and are usually found on incidental imaging of the abdomen. The most common lesions are focal nodular hyperplasia and hemangioma, but the differential diagnosis is quite broad. We present a case of an adolescent male who was found to have a large pseudorheumat...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.04.036
更新日期:2006-08-01 00:00:00
abstract::A 4-year-old well boy was seen because of an asymptomatic left testicle undescended since birth; the testis was not palpable and the right side was normal. After an episode of left lower quadrant and left hip area pain, with some bladder symptoms and left leg limping, a work-up including a CAT scan showed a calcified ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80637-1
更新日期:1987-09-01 00:00:00
abstract::The authors report an unusual case of bilateral short term acute orchitis in a patient with recurrent polyserositis (familial Mediterranean fever). ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90428-x
更新日期:1995-10-01 00:00:00
abstract::A simple technical detail in placing the upper pouch holding suture to facilitate proximal segment mobilization in esophageal atresia is described. The suture is passed through both walls of the upper segment and the tip of the Foley catheter. If circular myotomy is needed, the Foley catheter balloon is inflated to fi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80422-0
更新日期:1987-02-01 00:00:00
abstract:PURPOSE:The aim of this study was to define clinical features and determine the best therapy for patients with rhabdomyosarcoma (RMS) of the abdominal wall. METHODS:We examined the demographic, clinical features, therapy (especially surgical), and outcome of 34 patients. Patients received combination chemotherapy afte...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90352-4
更新日期:1999-05-01 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::Negative pressure wound therapy (NPWT) is described as it is used in the treatment of an infant burn victim. This case highlights the ability and techniques used to maintain an airtight dressing seal in the perirectal region. Use of this dressing type post-skin grafting allowed for 100% graft adhesion and no bacterial...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.09.022
更新日期:2009-12-01 00:00:00
abstract::Innervation patterns in normal and aganglionic colon were studied using a panel of antineuronal cell antibodies. One antibody, D7, which recognizes a subset of neuronal cells of the peripheral and central nervous system reacted strongly with nerve fibers in the circular muscle of the normal colon. Immunohistochemical ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80339-1
更新日期:1987-03-01 00:00:00
abstract:PURPOSE:Previous single-center studies have reported favorable outcomes when preformed silos (PFS) are used for the staged reduction of gastroschisis. The aim of this study was to assess the frequency and nature of complications associated with PFS in a large population and provide an insight into the practicalities of...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.06.006
更新日期:2009-11-01 00:00:00
abstract::The ideal surgical closure for large omphaloceles remains controversial. Most techniques described advocate removal of the amniotic sac prior to repair of the abdominal wall defect. Herein, the authors describe a surgical technique preserving the amniotic sac, which has distinct advantages in achieving safe and rapid ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(86)90013-8
更新日期:1986-12-01 00:00:00
abstract::The clinical and radiographic presentation of infants with type III posterior urethral valves help to distinguish them from patients with the more common type I valves. The diaphragmatic valvular obstruction may make catheterization impossible. Percutaneous cystography can confirm the diagnosis and allow for short-ter...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/0022-3468(94)90530-4
更新日期:1994-01-01 00:00:00
abstract::Traumatic splanchnic artery pseudo-aneurysms are uncommon; only two cases have been reported among the pediatric population. The authors describe their experience with four patients in whom splanchnic artery pseudoaneurysms developed after blunt abdominal trauma. Splenic artery pseudo-aneurysms were found in a 6-year-...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90140-2
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:A large cohort of Hodgkin lymphoma (HL) survivors exist. With patients transitioning from pediatric to adult care, practitioners should be aware of potential complications. The aim of this study was to describe the long-term complications of patients who had staging laparotomy for the treatment of HL. METHO...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.11.047
更新日期:2017-09-01 00:00:00
abstract::Pancreatic pseudocysts have not been reported to occur in the fetus or newborn. The authors report two cases of histologically proven pancreatic pseudocysts in neonates, which were detected using prenatal ultrasonography. Surgical management included external marsupialization followed by internal drainage in one case,...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90185-2
更新日期:1996-11-01 00:00:00
abstract::Over a 6-year period, 14 infants with a total of 16 inguinal hernias (IH) underwent transperitoneal closure of the internal ring (TPIR). This was performed through a minilaparotomy, using a purse-string suture placed around the internal ring from within. A difficult inguinal dissection of an edematous and friable sper...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/0022-3468(95)90619-3
更新日期:1995-01-01 00:00:00
abstract::Vascular anomalies are an uncommon cause of gastrointestinal bleeding in childhood. Confusing nomenclature has made objective comparisons of published cases difficult and has interfered with an established consensus regarding diagnosis and therapeutic modalities. The purpose of this study was to clarify the situation ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90640-0
更新日期:1997-06-01 00:00:00