Portal venous deprivation in patients with portosystemic shunts and its effect on liver tumors.


AIMS:To outline the use of radiological investigations in patients with congenital portosystemic shunts (CPS) and to assess the degree of portal venous deprivation in relation to the development of liver tumors. METHODS:Single center retrospective cohort study of all patients with CPS referred from 1990 to 2016. Radiological investigations were reviewed for the presence of intrahepatic portal veins. Two groups were defined: Group 1 - without evidence of preservation of an intrahepatic portal venous system and, Group 2 - with evidence of intrahepatic portal venous flow. These groups were compared for the development of liver tumors, serum ammonia, and nature of subsequent surgical intervention. The ratio of infraceliac to supraceliac aortic diameter and hepatic enhancement in biphasic CT scans were also used to infer hepatic arterial in-flow and compared to age matched controls. Nonparametric tests were used throughout. A P value of 0.05 was considered significant. Data are quoted as median (IQR). RESULTS:45 patients (Group 1, n = 12: Group 2, n = 33) were investigated for CPS at a median age of 8 months (1 month-14 years). Liver tumors were more common in Group 1 than Group 2 [11/12 (92%) versus 10/33 (29%); P < 0.001]. Aortic ratio was significantly lower in patients with CPS compared to control (0.82 versus 0.96; P < 0.001), but there was no difference between patients with or without tumors (0.82 versus 0.82; P = 0.52). Enhancement of the liver parenchyma was greater in portal venous rather than arterial phases by a median difference of 28 (15-50) Hounsfield units in controls, compared to 15 (8.5-23.5) in CPS patients (P = 0.04). A single stage closure was possible in 2/6 (33%) operated patients in Group 1 and 14/20 (70%) in Group 2 (P = 0.32). CONCLUSIONS:Patients without radiological evidence of intrahepatic portal venous flow were significantly more likely to have associated hepatic tumors with a relative risk 3.1. LEVELS OF EVIDENCE:This manuscript includes data that are III and IV Levels-of-Evidence.


J Pediatr Surg


Tyraskis A,Deganello A,Sellars M,De Vito C,Thompson R,Quaglia A,Heaton N,Davenport M




Has Abstract


2020-04-01 00:00:00














  • Morbidity and mortality among "big" babies who develop necrotizing enterocolitis: A prospective multicenter cohort analysis.

    abstract:BACKGROUND:Necrotizing enterocolitis (NEC) is classically a disease of prematurity, with less reported regarding morbidity and mortality of this disease among other infants. METHODS:Data were prospectively collected from 2009 to 2015 at 252 Vermont Oxford Network member centers on neonates with birth weight>2500g admi...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Velazco CS,Fullerton BS,Hong CR,Morrow KA,Edwards EM,Soll RF,Jaksic T,Horbar JD,Modi BP

    更新日期:2017-10-12 00:00:00

  • Update on Wilms tumor.

    abstract::This article reviews of the current evidence-based treatment standards for children with Wilms tumor. In this article, a summary of recently completed clinical trials by the Children's Oncology Group is provided, the current diagnostic evaluation and surgical standards are discussed, and the surgical impact on current...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章,评审


    authors: Aldrink JH,Heaton TE,Dasgupta R,Lautz TB,Malek MM,Abdessalam SF,Weil BR,Rhee DS,Baertschiger R,Ehrlich PF,American Pediatric Surgical Association Cancer Committee.

    更新日期:2019-03-01 00:00:00

  • Immune thrombocytopenia: surgical therapy and predictors of response.

    abstract::We have reviewed 40 patients with immune thrombocytopenia purpura (ITP) to assess current methods of preparation for surgery and to evaluate perioperative complications and response to splenectomy. Twenty-one patients had chronic ITP (greater than 1 year duration) and 19 patients had severe acute thrombocytopenia (pla...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Davis PW,Williams DA,Shamberger RC

    更新日期:1991-04-01 00:00:00

  • Trends in common surgical procedures at children's and nonchildren's hospitals between 2000 and 2009.

    abstract:PURPOSE:Though growth in children's surgical expenditures has been documented, procedure-specific differences in volume and costs at children's hospitals (CH) and non-hildren's hospitals (NCH) have not been explored. Our purpose was to compare trends in volume and costs of common pediatric surgical procedures between C...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Short HL,Sarda S,Travers C,Hockenberry JM,McCarthy I,Raval MV

    更新日期:2018-08-01 00:00:00

  • A new surgical complication related to corticosteroids in a patient with Henoch-Schönlein purpura.

    abstract::In this case presentation of a 4-year-old boy with histopathologically proven Henoch-Schönlein purpura the authors report a surgical complication that occurred under corticosteroids; this had not been described previously. Relief of abdominal pain was dramatic and the hematemesis disappeared, but an entero-enteral fis...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: van den Broek RW,van Rossum MA,van Duinen CM

    更新日期:1995-09-01 00:00:00

  • Gastrointestinal function after surgical correction of Hirschsprung's disease: long-term follow-up in 135 patients.

    abstract::This study is a retrospective review of all children treated for Hirschsprung's disease over the past 22 years at a single pediatric institution. During this time 177 patients had definitive surgical reconstruction. Five children died of causes unrelated to Hirschsprung's disease, and five children died from enterocol...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Marty TL,Seo T,Matlak ME,Sullivan JJ,Black RE,Johnson DG

    更新日期:1995-05-01 00:00:00

  • Interplay between collagenase and undescended testes in Adamts16 knockout rats.

    abstract:BACKGROUND:The inguinoscrotal stage of testicular descent is characterized by an increase in cell density and collagen fibers as the gubernaculum undergoes cell division and increases Extracellular Matrix (ECM) activity. Rats that lack the enzyme Adamts16, a known ECM proteinase, develop cryptorchidism postnatally and ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Sarila G,Bao T,Abeydeera SA,Li R,Mell B,Joe B,Catubig A,Hutson J

    更新日期:2020-09-01 00:00:00

  • From where did the BAPS emerge?

    abstract::This is a personal account of the emergence of the British Association of Paediatric Surgeons (BAPS), one of the oldest of the specialty associations. It was formed in 1953 by like-minded professionals from around the UK, and its first meeting was held in and around the Hospital for Sick Children, London, in the summe...

    journal_title:Journal of pediatric surgery

    pub_type: 历史文章,杂志文章,评审


    authors: Young DG

    更新日期:2014-02-01 00:00:00

  • Pediatric trauma-associated acute respiratory distress syndrome: Incidence, risk factors, and outcomes.

    abstract:BACKGROUND/PURPOSE:Acute Respiratory Distress Syndrome (ARDS) results in significant morbidity and mortality in pediatric trauma victims. The objective of this study was to determine risk factors and outcomes specifically related to pediatric trauma-associated ARDS (PT-ARDS). METHODS:A retrospective cohort (2007-2014)...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: de Roulet A,Burke RV,Lim J,Papillon S,Bliss DW,Ford HR,Upperman JS,Inaba K,Jensen AR

    更新日期:2019-07-01 00:00:00

  • Long-term review of sutureless ward reduction in neonates with gastroschisis in the neonatal unit.

    abstract:BACKGROUND:A sutureless ward reduction (SWR) protocol was implemented in the neonatal intensive care unit of a tertiary level hospital in 1999. Although the short-term outcomes associated with SWR have been documented, the long-term outcomes are unknown. METHODS:Retrospective data were collected from the medical recor...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章,评审


    authors: Choi WW,McBride CA,Bourke C,Borzi P,Choo K,Walker R,Nguyen T,Davies M,Donovan T,Cartwright D,Kimble RM

    更新日期:2012-08-01 00:00:00

  • Leiomyoma of small bowel: a case report.

    abstract::Benign small bowel tumors are rare and usually present in late adult life. Because of its raity, a case of benign leiomyoma of the small bowel presenting with distal small bowel obstruction in childhood is reported, with a discussion of the principles of management. ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Freeman J

    更新日期:1979-08-01 00:00:00

  • Avulsion of wandering spleen after traumatic torsion.

    abstract::Wandering spleen usually causes clinical symptoms by torsion. Cases of torsion or hemorrhage after blunt trauma are reported. The authors experienced avulsion of wandering spleen after traumatic torsion in the victim of pedestrian injury. The spleen had been located in the left upper quadrant on the time of torsion, b...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Kim SC,Kim DY,Kim IK

    更新日期:2003-04-01 00:00:00

  • Prenatal diagnosis of orbital heterotopic brain tissue.

    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


    authors: Hingorani M,Mannor G,Vardy SJ,Luthert P,Nicolaides KH,McCartney AC,Rose GE,Aclimandos W

    更新日期:1997-09-01 00:00:00

  • Reduced expression of aquaporin 5 water channel in nitrofen-induced hypoplastic lung with congenital diaphragmatic hernia rat model.

    abstract:PURPOSE:Pulmonary hypoplasia remains the principal cause of high morbidity and mortality in patients with congenital diaphragmatic hernia (CDH). The precise mechanisms causing lung hypoplasia remains unclear. Aquaporins (AQPs) are reported to constitute a family of water channels that facilitate membrane water permeabi...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Takayasu H,Nakazawa N,Montedonico S,Puri P

    更新日期:2007-02-01 00:00:00

  • Long-term analysis of children with esophageal atresia and tracheoesophageal fistula.

    abstract:BACKGROUND/PURPOSE:For children with esophageal atresia (EA) or tracheoesophageal fistula (TEF), the first years of life can be associated with many problems. Little is known about the long-term function of children who underwent repair as neonates. This study evaluates outcome and late sequelae of children with EA/TEF...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Little DC,Rescorla FJ,Grosfeld JL,West KW,Scherer LR,Engum SA

    更新日期:2003-06-01 00:00:00

  • Diagnostic value of rectal suction biopsies using calretinin immunohistochemical staining in Hirschsprung's disease.

    abstract:BACKGROUND:The study investigates the diagnostic value of calretinin immunohistochemical staining (CIS) on rectal suction biopsies (RSB) in Hirschsprung's disease (HD). METHODS:A prospective study was conducted at Children's Hospital 2 in Ho Chi Minh City, Vietnam, from January through December 2015. Patients suspecte...

    journal_title:Journal of pediatric surgery

    pub_type: 临床试验,杂志文章


    authors: Tran VQ,Lam KT,Truong DQ,Dang MH,Doan TT,Segers V,Butler MW,Robert A,Goyens P,Steyaert H

    更新日期:2016-12-01 00:00:00

  • Cumulative sum: An individualized proficiency metric for laparoscopic fundamentals.

    abstract:BACKGROUND:A reliable metric of technical proficiency is indispensable to the training of fellows and residents. The purpose of this study was to determine whether cumulative sum (Cusum) has predictive validity in laparoscopic training. We hypothesized that Cusum would be a better predictor of technical ability in fund...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Hu Y,Warren HL,McMurry TL,Goodrich RN,Choi J,Mahmutovic A,Kim H,Rasmussen SK

    更新日期:2016-04-01 00:00:00

  • New method of surgical delayed closure of giant omphaloceles: Lazaro da Silva's technique.

    abstract:BACKGROUND/PURPOSE:The management of patients with a giant omphalocele remains a difficult problem. In this study, the authors described a new surgical approach for delayed closure of ventral hernia--the Lazaro da Silva's technique--in conservatively treated patients. METHODS:Ventral hernias of 11 conservatively treat...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Pereira RM,Tatsuo ES,Simões e Silva AC,Guimarães JT,Paixão RM,Lanna JC,Miranda ME

    更新日期:2004-07-01 00:00:00

  • Neoappendicostomy in the management of pediatric fecal incontinence.

    abstract:PURPOSE:The Malone appendicostomy, for antegrade enemas, has improved the quality of life for many children with fecal incontinence. In patients whose appendix has been removed, a neo-appendix can be created. We describe our approach and experience with this procedure as an option for surgeons managing children with fe...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Chatoorgoon K,Pena A,Lawal T,Hamrick M,Louden E,Levitt MA

    更新日期:2011-06-01 00:00:00

  • Surgical implications of necrotizing fasciitis in children with chickenpox.

    abstract::Varicella (chickenpox) affects approximately 90,000 children each year. Although most cases resolve, some develop necrotizing soft tissue infections secondary to group A streptococcus and staphylococcus. Delay in diagnosis is common. At the time of initial presentation, the need for surgical intervention is not always...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Waldhausen JH,Holterman MJ,Sawin RS

    更新日期:1996-08-01 00:00:00

  • Prenatal diagnosis and management of abdominal diseases in pediatric surgery.

    abstract:PURPOSE:The aim of this study was to investigate the prenatal courses and management of abdominal surgical diseases. METHODS:Of the 327 patients registered with our fetal treatment board since March 2002, 83 fetuses referred to the surgical department were enrolled for the current study. The prenatal diagnosis, sequen...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Kuroda T,Kitano Y,Honna T,Sago H,Hayashi S,Saeki M

    更新日期:2004-12-01 00:00:00

  • Development of a model for prediction of survival in pediatric trauma patients: comparison of artificial neural networks and logistic regression.

    abstract:BACKGROUND/PURPOSE:There is a paucity of outcome prediction models for injured children. Using the National Pediatric Trauma Registry (NPTR), the authors developed an artificial neural network (ANN) to predict pediatric trauma death and compared it with logistic regression (LR). METHODS:Patients in the NPTR from 1996 ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: DiRusso SM,Chahine AA,Sullivan T,Risucci D,Nealon P,Cuff S,Savino J,Slim M

    更新日期:2002-07-01 00:00:00

  • Thoracoscopy for diagnosis of intrathoracic lesions in children.

    abstract::Disenchantment with available techniques for specific diagnosis of intrathoracic pulmonary lesions in children has led us to explore the usefulness of thoracoscopy. We have performed this technique in nine patients ranging in age from 17 mo to 16 yr. The procedure is performed under intravenous anesthesia with the pat...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Rodgers BM,Talbert JL

    更新日期:1976-10-01 00:00:00

  • Submucosal pressure-air insufflation facilitates endorectal mucosectomy in transanal endorectal pull-through procedure in patients with Hirschsprung's disease.

    abstract:BACKGROUND:Most children with Hirschsprung's disease (HD) can be treated with a transanal endorectal pull-through (TEP) procedure. The authors have developed a simple technique of submucosal pressure-air insufflation (SI) to facilitate the submucosal dissection, which is one of the crucial parts of the operation. METH...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Ergün O,Celik A,Dökümcü Z,Balik E

    更新日期:2003-02-01 00:00:00

  • Pumpless arteriovenous extracorporeal membrane oxygenation: A novel mode of respiratory support in a lamb model of congenital diaphragmatic hernia.

    abstract:BACKGROUND:Extracorporeal membrane oxygenation (ECMO) is commonly required in neonates with congenital diaphragmatic hernia (CDH) complicated by pulmonary hypertension (PH). ECMO carries significant risk, and is contraindicated in the setting of extreme prematurity or intracranial hemorrhage. Pumpless arteriovenous ECM...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Partridge EA,Davey MG,Hornick M,Dysart KC,Olive A,Caskey R,Connelly JT,Hedrick HL,Peranteau WH,Flake AW

    更新日期:2018-08-01 00:00:00

  • Bleeding gastric ulcer in a newborn infant diagnosed by transumbilical aortography.

    abstract::Transumbilical aortography has been utilized for the first time to diagnose the cause of massive upper gastrointestinal hemorrhage in a newborn infant. We consider it a safe and accurate method in cases that meet the following criteria: massive hemorrhage uncontrollable by blood transfusions and supportive medical the...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Fliegel CP,Herzog B,Signer E,Nars P

    更新日期:1977-08-01 00:00:00

  • Firearm injury among urban youth during the last decade: an escalation in violence.

    abstract:PURPOSE:To better characterize firearm violence in urban youth, the authors investigated the circumstances and outcome of shootings among youths under 17 years of age. METHODS:A retrospective case review was undertaken of all patients under 17 years of age treated for a gunshot wound at two adjoining level I Trauma Ce...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章,多中心研究


    authors: Nance ML,Stafford PW,Schwab CW

    更新日期:1997-07-01 00:00:00

  • Predictors of postnatal outcome in neonates with gastroschisis.

    abstract:BACKGROUND/PURPOSE:The optimal management of neonates with gastroschisis is unclear, and there is a significant morbidity. We performed a review of neonates with gastroschisis treated at our center of pediatric surgery over the last 21 years to determine predictive factors of outcome. METHODS:Single-center retrospecti...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Kassa AM,Lilja HE

    更新日期:2011-11-01 00:00:00

  • Corticosteroid therapy in biliary atresia.

    abstract::Sixteen patients with biliary atresia had 44 steroid courses for treatment of cholangitis or diminution of bile flow following Kasai hepatic portoenterostomy operations. A "blast" type (high dose/short duration) steroid administration was employed to potentiate the choleretic and anti-inflammatory effect. There was a ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Karrer FM,Lilly JR

    更新日期:1985-12-01 00:00:00

  • Mixed gonadal dysgenesis, pathogensis, and management.

    abstract::Fourteen patients with Mixed Gonadal Dysgenesis who presented as infants or children are discussed. Gonadal asymmetry, and/or sex chromosomal mosaicism, as well as retained Mullerian Ducts characterize the anomaly. The dysgenetic testis may occur as the result of a cascade of development mishaps stemming from abnormal...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Donahoe PK,Crawford JD,Hendren WH

    更新日期:1979-06-01 00:00:00