Abstract:
:Iatrogenic esophageal perforations in children are rare. To evaluate patterns of injury, clinical presentation, and treatment options for such patients, the authors reviewed the case records of 11 children who had sustained transmural injury to the esophagus during a dilatation procedure at their institution between 1967 and 1994. Strictures requiring dilatation were attributable to caustic ingestion in eight, esophageal atresia repair in two, and congenital stenosis in one. Eight were penetrating injuries, and three were disruptions. Two involved the cervical esophagus; and nine involved the thoracic esophagus. Pain, pyrexia, and tachycardia were early signs. Proximal thoracic perforations led to signs in the left chest region (effusion/pneumothorax); with distal perforation the signs were on the right side. Treatment along conventional lines (local drainage, gastrostomy, primary repair after early recognition, and antibiotic therapy) was successful, with two major complications, both empyemas. The most recent case, a disruption of a tracheoesophageal fistula stricture, was successfully treated with oral water irrigation and antibiotics only. Six had colonic interposition (all caustic ingestion), one required endoesophageal resection of a distal stricture, and four had resolution of the stricture, three without additional dilatation. The majority of children with iatrogenic injuries of the esophagus can be managed successfully by conservative measures and pleural drainage, with surgical procedures reserved for large disruptions of the esophagus, intraabdominal perforations, and cases that do not respond to appropriate conservative measures. Patients with caustic injury to the esophagus have a greater risk for the development of penetrating injury, and this may be one indicator of the severity of scarring. There are distinct clinical patterns of presentation, which depend on the level at which the esophagus is perforated. Dilatation disruption of a localized stricture has a good long-term prognosis for the esophagus and may even cure the stricture. The role of oral irrigation still must be fully evaluated where disruption has occurred as distinct from a penetrating injury.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Panieri E,Millar AJ,Rode H,Brown RA,Cywes Sdoi
10.1016/s0022-3468(96)90404-2subject
Has Abstractpub_date
1996-07-01 00:00:00pages
890-5issue
7eissn
0022-3468issn
1531-5037pii
S0022-3468(96)90404-2journal_volume
31pub_type
杂志文章abstract::The records of eight patients treated for intestinal obstruction resulting from bands that have no identifiable embryologic or acquired basis were reviewed retrospectively. All patients presented with symptoms and signs indicative of intestinal obstruction. Patients older than 2 years of age additionally had a history...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90340-d
更新日期:1992-04-01 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...
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journal_title:Journal of pediatric surgery
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doi:10.1016/0022-3468(92)90302-n
更新日期:1992-02-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
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abstract:BACKGROUND/PURPOSE:The U.S. has an alarming rate of firearm injuries. Racial disparities among victims and predictors of outcomes are not well established. Our objective was to assess costs, length of stay (LOS), and inpatient mortality among nonfatal and fatal pediatric firearm injuries that required hospitalization. ...
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pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90328-7
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journal_title:Journal of pediatric surgery
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doi:10.1016/j.jpedsurg.2018.10.053
更新日期:2019-09-01 00:00:00
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journal_title:Journal of pediatric surgery
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pub_type: 杂志文章
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journal_title:Journal of pediatric surgery
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doi:10.1016/s0022-3468(99)90071-4
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doi:10.1016/s0022-3468(79)80022-6
更新日期:1979-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.11.005
更新日期:2005-03-01 00:00:00
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更新日期:1985-10-01 00:00:00
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journal_title:Journal of pediatric surgery
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更新日期:1987-03-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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更新日期:2003-12-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
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更新日期:2013-01-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.03.038
更新日期:2007-08-01 00:00:00
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pub_type: 杂志文章
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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更新日期:1992-12-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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更新日期:1993-02-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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