Abstract:
:Traumatic solid organ injuries are easily recognizable on computed tomography (CT) scans and usually are treated nonoperatively. Small bowel injuries may be difficult to diagnose and require prompt operation. This study was done to assess the role of clinical examination versus diagnostic tests in evaluating these injuries. The medical records of all pediatric (< or = 18 years old) patients treated at a pediatric trauma center from 1984 to 1995 were reviewed. Statistical analysis was performed using SAS software, with P values of less than .05 considered significant. Small bowel injury occurred in 48 patients (21 blunt, 27 penetrating). Most blunt injuries were automobile-related (11 patients) or attributable to recreational activities (4) or bicycle accidents (2). Penetrating injuries were primarily caused by assaults with guns (21) or knives (4). All conscious patients with small bowel injury had abnormal physical examination findings at the time of presentation. Nineteen patients had generalized peritonitis, and 14 had localized abdominal tenderness. The serum amylase level was abnormal in 2 of 18 cases. Abdominal CT scans were obtained in six patients and showed the injury in only three. Peritoneal lavage (DPL), performed in 10 patients, led to the diagnosis in five. There was no significant difference in the complication rate (30%) between patients operated on immediately because of a diagnostic test result and those operated on later, after a period of clinical observation (P = 1.0, Fisher's Exact test). Associated injuries were common (60%) among both blunt and penetrating cases. In this nonoperative era of pediatric trauma care, small bowel injury is best diagnosed clinically. The physical examination is 100% sensitive in the conscious patient, and specificity is achieved by serial examination. Serum amylase, CT scan, and DPL are not reliable diagnostic tests to exclude these injuries. Patients can be observed until physical findings suggest bowel injury without increased morbidity. Associated injuries are common; thus, patients are best treated where multidisciplinary support is available.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Moss RL,Musemeche CAdoi
10.1016/s0022-3468(96)90113-xsubject
Has Abstractpub_date
1996-08-01 00:00:00pages
1178-81; discussion 1181-2issue
8eissn
0022-3468issn
1531-5037pii
S0022-3468(96)90113-Xjournal_volume
31pub_type
杂志文章abstract:PURPOSE:To determine if there is a role for routine pouchogram before ileostomy reversal after IPAA in pediatric patients. METHODS:The medical records of pediatric patients who underwent pouchogram between 2007 and 2017 prior to ileostomy reversal after IPAA at two affiliated hospitals were reviewed for concordance be...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.09.031
更新日期:2020-08-01 00:00:00
abstract::A 13-year-old girl with multiple genitourinary malformations, incomplete bladder exstrophy, urethral duplication with single bladder, septate vagina, and total urinary incontinence is presented. Prior to admission she had undergone surgery for teratoma and calculi of the bladder and partial fecal incontinence. A conti...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90534-g
更新日期:1990-12-01 00:00:00
abstract::Nissen fundoplication results in closure of the tracheoesophageal fistula (TEF) without the necessity for a thoracic operation by preventing both the reflux of gastric contents into the lungs through the distal TEF, and leakage of air into the stomach of less than 30 cm H2O intrapulmonary pressure. This procedure can ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(86)80375-x
更新日期:1986-09-01 00:00:00
abstract:PURPOSE:In pediatric endoscopic surgery, a limited view and lack of tactile sensation restrict the surgeon's abilities. Moreover, in pediatric oncology, it is sometimes difficult to detect and resect tumors due to the adhesion and degeneration of tumors treated with multimodality therapies. We developed an augmented re...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.08.025
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:Delivery of local anesthesia for surgical office procedures for pediatric patients can be difficult. Injections are painful and often lead to patient anxiety, and topical anesthetics frequently provide incomplete anesthesia. The authors prospectively studied the efficacy of iontophoresis, a needle-fr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90765-0
更新日期:1999-06-01 00:00:00
abstract:INTRODUCTION:Currarino syndrome is a type of caudal regression syndrome characterized by the association of hemisacrum, anorectal malformation and presacral mass. Only few studies on small series report the incidence of urinary dysfunction in Currarino syndrome. Our aim was to evaluate the urological outcome in patient...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.05.038
更新日期:2014-11-01 00:00:00
abstract:PURPOSE:Nissen fundoplication is the most commonly performed operation to treat gastroesophageal reflux disease and vomiting in children with neurologic impairment. However, failure rates of Nissen fundoplication in this population are higher, and alternatives to Nissen fundoplication have technical and functional disa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.10.024
更新日期:2012-01-01 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:PURPOSE:Indomethacin, a nonselective prostaglandin inhibitor used to treat patent ductus arteriosus, is associated with intestinal perforation inducing an NEC-like illness. We sought to define the contribution of prostaglandin E2 (PG E2) and its receptor EP4 to intestinal blood flow regulation in premature neonates wit...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.01.029
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Investigation of the value of scrotal Doppler ultrasound (DUS) in the diagnosis of acute scrotum and its impact on the treatment strategy was undertaken. METHOD:Seventy-nine children (mean age, 9.2 years) with acute scrotum were prospectively studied. The protocol included history, clinical examination, scr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.04.026
更新日期:2006-08-01 00:00:00
abstract::Neural tube closure is a complex spatio-temporal process. Multiple neural tube defects (NTDs) in a single patient are extremely rare. Only a few cases of multiple NTDs have been reported in the world literature, including less than 20 cases of double NTDs and 3 cases of triple NTDs. We report a fourth case of triple N...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.09.103
更新日期:2011-02-01 00:00:00
abstract::A lateral skin-flap perineoplasty has been used in 15 patients born with an absent anal canal. The aim behind the introduction of this modification was the prevention of mucosal prolapse. On early assessment, this has been achieved in 11 of the cases. This represents a 50% improvement on our previous results. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(84)80108-6
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:Congenital diaphragmatic hernia (CDH) affects 1 in 3000 live births. Modern management strategies include delayed repair of the diaphragm to permit pre-operative optimization of cardiorespiratory status. We describe a cohort of neonates in whom early emergency operative intervention was required for potentia...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.09.012
更新日期:2016-12-01 00:00:00
abstract:INTRODUCTION:The purpose of this study is to evaluate the feasibility of using saline infusion to lengthen small bowel while preserving intestinal enzymatic function. METHODS:Male Sprague-Dawley rats had a 3-cm jejunal segment taken out of continuity. A catheter was inserted in the proximal end, and the distal end was...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.02.017
更新日期:2006-04-01 00:00:00
abstract:PURPOSE:In oncology practice, angioembolization has been reported for tumor reduction before surgery, treatment of life-threatening conditions, and for palliative care. Nevertheless, the overall experience with angioembolization for the treatment of tumors is limited. We report our experience in 7 nonvascular solid ped...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.04.037
更新日期:2009-09-01 00:00:00
abstract::Biopsy of fetal tissues is a relatively new procedure for the diagnosis of congenital malformations. The authors report the first case in which this technique has been applied to an orbital mass, in which heterotopic brain tissue was diagnosed by prenatal biopsy and excised in infancy. The wider implications of such i...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90319-5
更新日期:1997-09-01 00:00:00
abstract::Heterotopic gastric mucosa is rare in children with most cases presenting in association with Meckel's diverticulum. The authors present a 2-year-old boy with gastric heterotopia of the anorectum, who presented with painless, intermittent rectal bleeding. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.35420
更新日期:2002-10-01 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:BACKGROUND/PURPOSE:To date, there are hardly any data on the treatment costs of infantile short bowel syndrome (SBS), despite growing interest in evidence-based and cost-effective medicine. Therefore, the aim of the study was to evaluate resource consumption and costs, next to studying nutritional and growth outcomes, ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.08.009
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to evaluate clinical outcomes in children with asymptomatic congenital lung malformations (CLM) who were initially managed nonoperatively. METHODS:An IRB-approved retrospective review was performed on all CLMs at a single tertiary care referral center (Jan 2006-Dec 2016, n=14...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.02.065
更新日期:2018-06-01 00:00:00
abstract:PURPOSE:The mortality rate for pediatric trauma patients cared for in adult trauma centers has been shown, by means of TRISS methodology, not to differ significantly from that of the Major Trauma Outcome Study (MTOS). The question remains, however, whether the outcome of injured children is better in a designated pedia...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90322-x
更新日期:1996-01-01 00:00:00
abstract::Calcified caval thrombus should be considered in any infant or child where calcifications are noted in the high right retroperitoneal area on plain x-rays of the abdomen. Although typically bullet-shaped in configuration, the calcium distribution in the neonate may be atypical or incompletely developed, suggesting neu...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(78)80471-0
更新日期:1978-08-01 00:00:00
abstract::The purpose of this study was to determine if propranolol (0.5 mg/kg and 1 mg/kg), administered intravenously (IV) at the height of the postburn hypermetabolic response, would decrease myocardial oxygen requirements, without adversely affecting overall oxygen delivery or total body oxygen consumption. To test this hyp...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80541-x
更新日期:1989-08-01 00:00:00
abstract:PURPOSE:The purpose was to study the impact of Down's syndrome (DS) in the diagnosis, management, and outcomes of patients with Morgagni hernia (MH). METHODS:Twenty-two (22) patients with MH treated at a tertiary center were retrospectively studied for history, findings, associated anomalies, referral diagnoses, hospi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.10.001
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND/PURPOSE:Biliary tree cystic malformations (BCM) occur rarely. Current progress in ultrasonography makes it possible to identify them prenatally. The aim of this study was to analyze retrospectively prenatal ultrasound patterns of 5 consecutive subhepatic cysts in an effort to differentiate the BCM before bir...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.34470
更新日期:2002-08-01 00:00:00
abstract::In this report a rare case of mediastinal abscess secondary to purulent tonsilitis is reported. Generally this condition is consequent to systemic, cervical, thoracic, or abdominal infections. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80090-9
更新日期:1989-11-01 00:00:00
abstract::Pneumothorax is a common complication of ventilator therapy and usually responds to tube thoracostomy. Persistent pneumothorax with a large air leak may indicate the presence of a bronchopleural fistula (mean weight 1360 g) with (BPF) required FIO2 of 1.0, a peak inspiratory pressure of 33 cm H2O and were hypoxemic (x...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(80)80746-9
更新日期:1980-08-01 00:00:00
abstract::Two cases of infantile dumping syndrome which developed following Nissen fundoplication for gastroesophageal reflux are described. Both infants were fed postoperatively via a gastrostomy and showed the typical clinical picture of dumping with failure to thrive, intermittent diarrhea, lethargy and pallor postprandially...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(84)80436-4
更新日期:1984-04-01 00:00:00
abstract:BACKGROUND/PURPOSE:There have been few studies documenting the effect of subspecialty training on outcomes after appendectomy in children. Some studies have suggested a better outcome in patients managed by pediatric surgeons as compared with general surgeons. METHODS:We studied the effect of subspecialty training on ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.09.044
更新日期:2007-01-01 00:00:00
abstract::Eight cases of imperforate anus with short colon were seen in our hospital from April 1982 to December 1987. Five were boys, three were girls, and their ages ranged from 2 days to 2 years. The international literature about this kind of disease was reviewed. The disease's name, embryology, diagnoses, differential diag...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/0022-3468(90)90442-c
更新日期:1990-02-01 00:00:00