Abstract：
OBJECTIVE:Malrotation with midgut volvulus is a time-sensitive pediatric surgical disease that requires emergent operative exploration to avoid bowel loss; however, it also requires specialized pediatric care. The purpose of this study was to identify disparities in bowel resection in children who underwent emergency surgery for malrotation; particularly the role of transfer status. METHODS:The Pediatric Health Information System was used to identify a multicenter cohort of patients who underwent emergency surgical intervention for malrotation. Univariate and multivariable analyses were used to determine factors associated with the primary outcome of bowel resection; secondary outcomes included surgical complications, prolonged length of stay, TPN dependence, and death. RESULTS:Of 3373 patients with malrotation included, 44.8% were transferred in. Younger age, prematurity and other comorbidity, nonwhite race, and public insurance were associated with transfer. Transferred patients were more likely to undergo bowel resection on univariate (30.7 vs 16.4%, p < .001) and multivariable analysis (RR =1.38, p < .010). After adjusting for bowel resection, only patient factors including age and comorbidity were associated with surgical complications, TPN dependence, and death. CONCLUSION:Patients who require hospital-to-hospital transfer for emergent surgical management of malrotation are more likely to require bowel resection which is in turn associated with greater morbidity. Further work is needed to optimize access to prompt surgical care for this condition especially given race and insurance disparities in transfer status. LEVEL OF EVIDENCE:III, prognostic study.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Polites SF,Lautz TB,Jenkins TM,Dasgupta Rdoi
10.1016/j.jpedsurg.2019.01.061subject
Has Abstractpub_date
2019-09-01 00:00:00pages
1848-1853issue
9eissn
0022-3468issn
1531-5037pii
S0022-3468(19)30115-0journal_volume
54pub_type
杂志文章abstract：AIM:The objective of this study is to investigate which central venous catheter dressing is most secure. BACKGROUND:Central venous catheter insertion is a common procedure. A secure dressing is essential to prevent early line displacement. Many different dressings are used, but there is no consensus in choosing an opt...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.10.103
更新日期：2009-02-01 00:00:00
abstract：INTRODUCTION:Appendicitis is the most common pediatric emergent surgical condition, with 77,000 American pediatric admissions costing $680 million US annually. Diagnosing appendicitis can be challenging. The prospective Quality Assurance and performance improvement project for suspected aPPEndicitis (QAPPE) study imple...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2020.09.006
更新日期：2020-09-24 00:00:00
abstract：:Clinicians, as well as embryologists, believe that normally a process of rotation of the midgut takes place that can be hampered at any stage resulting in the different types of "malrotations." However, a "malrotated" gut has never been observed in normal embryos. Therefore all theories on the normal and abnormal deve...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(95)90053-5
更新日期：1995-03-01 00:00:00
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
doi：10.1016/s0022-3468(97)90375-4
更新日期：1997-07-01 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 surgical repair of "very high" undescended testes may bring about testicular atrophy, as a result of impaired vascular supply, whether caused unintentionally by extensive dissection, or deliberately when the Fowler-Stephens operation is employed. In this experimental study, improvement of the vascular supply by me...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90239-0
更新日期：1996-09-01 00:00:00
abstract：:Laparoscopic procedures requiring abdominal CO2 insufflation are applied with increasing frequency to the pediatric age group. Whereas the physiological effects accompanying insufflation have been studied in laboratory and clinical adult subjects, little is known of these effects in the juvenile subject. Young swine (...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(94)90259-3
更新日期：1994-08-01 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：BACKGROUND:Mucosal atrophy and bowel shortening are the hallmark of proximal intestinal diversion for extensive necrotizing enterocolitis (NEC) or Thiry-Vella fistulas (TVF), in which the ends of a defunctionalized loop of intestine are exteriorized as stomas. Recombinant human interleukin-11 (rhIL-11) is a pleiotropic...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2000.7826
更新日期：2000-07-01 00:00:00
abstract：BACKGROUND:Hypertrophic pyloric stenosis (HPS) is the most common diagnosis requiring surgery in infants. Electrolytes are used as a marker of resuscitation for these patients prior to general anesthesia induction. Often multiple fluid boluses and electrolyte panels are needed, delaying operative intervention. We have ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2016.01.013
更新日期：2016-08-01 00:00:00
abstract：PURPOSE:The sphincter muscles in anorectal anomalies, which do not appear in the surgical field, cannot be described adequately. Details of the anal sphincter in low-type anorectal malformations were investigated using 3-dimensional (3D) image analysis. PATIENTS AND METHODS:Thirty patients (10 males and 20 females) wi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.07.073
更新日期：2009-12-01 00:00:00
abstract：:Gastric acid secretion was studied in 30 children with duodenal ulcer and 33 normal children. Both basal (BAO) and maximal (MAO) acid outputs were found to be significantly elevated in patients. In addition, among patients themselves, those with severe disease demonstrated significantly higher MAO than those with mild...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(86)80064-1
更新日期：1986-02-01 00:00:00
abstract：:Esophageal resection or replacement has become the standard therapy for severe esophageal strictures chiefly because less aggressive methods generally have failed. We hereby report our experience with 12 consecutive infants and children who have been managed successfully by means of Stamm gastrostomy and string-guided...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80529-9
更新日期：1989-08-01 00:00:00
abstract：INTRODUCTION:It is generally accepted that there is a risk of hypertension after renal trauma, particularly in high-grade and devascularizing injuries. Hypertension following renal trauma is estimated to occur in five percent of adults, however, the incidence is unknown in the pediatric population. MATERIALS AND METHO...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2015.05.014
更新日期：2015-11-01 00:00:00
abstract：BACKGROUND/PURPOSE:The reported incidence of acute chest syndrome (ACS) in children with sickle cell disease (SCD) is 15% to 20%. Our current objective was to assess risk factors and morbidity associated with ACS. METHODS:The authors reviewed the outcome of children with SCD undergoing abdominal surgery over a 10-year...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2004.02.027
更新日期：2004-06-01 00:00:00
abstract：:A recent case of posttraumatic splenic abscess in a young man following nonoperative management of his splenic rupture is reported. With the recent trend toward nonoperative management of hemodynamically stable splenic rupture, the potential complications of splenic abscess may become more common. In view of the high ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(86)80020-3
更新日期：1986-10-01 00:00:00
abstract：PURPOSE:In an effort to standardize practices and reduce unnecessary hospital resource utilization, we implemented guidelines for management of patients with isolated skull fractures (ISF). We sought to examine the impact of these guidelines. METHODS:Patients with nondisplaced/depressed fracture of the skull vault wit...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2014.09.038
更新日期：2014-12-01 00:00:00
abstract：:In a review of 110 cases of esophageal atresia (EA) and tracheoesophageal fistula (TEF), 15 patients (13.6%) developed anastomotic leakage. All patients had extrapleural surgical exposure and prophylactic extrapleural chest drainage (PEPCD). Despite this precaution, all patients with anastomotic leaks developed a pneu...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90446-e
更新日期：1992-05-01 00:00:00
abstract：BACKGROUND/PURPOSE:Human immunodeficiency virus (HIV) disease is an increasingly common infection in children in sub-Sahara Africa. Rectal fistulation is one such condition with which these patients present to the paediatric surgeon. This appeared to be an exclusively female condition until 2 male patients were treated...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2003.50011
更新日期：2003-01-01 00:00:00
abstract：:Although the survival for infants with abdominal wall defects (AWD) has dramatically improved, agreement on the optimum surgical approach has not been reached. From October 1970 through March 1983, 31 neonates with gastroschisis and 14 neonates with omphalocele were treated. Reduction of the herniated viscera with pri...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(83)80010-4
更新日期：1983-12-01 00:00:00
abstract：BACKGROUND:The organogenesis of esophageal atresia with tracheoesophageal fistula remains unclear. We have previously demonstrated that the fistula tract develops from a trifurcation of the embryonic lung bud and displays pulmonary lineage traits. Unlike the lung, the fistula grows without branching. Bone morphogenetic...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.03.052
更新日期：2006-07-01 00:00:00
abstract：:A rare disease that can mimic acute appendicitis is infarction of accessory spleen. It may occur in children and is difficult to diagnose preoperatively. Greater awareness of this entity may show not only that it is associated with other intraabdominal anomalies but also that it is more common in the tropics than else...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(78)80004-9
更新日期：1978-04-01 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：BACKGROUND:Pancreatic islet cell tumors are rare in adolescents, and most studies published to date focus on older patients. We utilized a national database to describe the histology and clinical pattern of pancreatic islet cell tumors in adolescent and young adult (AYA) patients, and to compare AYAs to older adults. W...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.01.060
更新日期：2019-10-01 00:00:00
abstract：:Recently, interest has been expressed in the correction of diaphragmatic hernia in utero as a solution to the problem of high mortality from this condition. Before such a procedure can be adopted in the human, studies aimed at establishing the contribution such advanced techniques would make in reducing mortality are ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(84)80010-x
更新日期：1984-02-01 00:00:00
abstract：BACKGROUND:Necrotizing fascitis (NF) is a severe infection of the subcutaneous tissue and fascia affecting children and adults. Conventional management includes resuscitation, aggressive debridement of necrotic tissue, and sometimes, additional measures such as hyperbaric oxygen and immunoglobulin therapy. This paper r...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.02.013
更新日期：2006-06-01 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：BACKGROUND/PURPOSE:Abdominoscrotal hydrocele (ASH) is an uncommon entity. Until now, the recommended treatment has been surgical. There is only one successful case of nonoperative management reported in literature. We report the largest series of children with ASH, and provide evidence in support of an initial nonopera...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2016.02.029
更新日期：2016-05-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to investigate our institution's experience with pediatric firearm events. We sought to determine the relationship between a community's level of socioeconomic distress and the incidence of youth gun violence. METHODS:We performed a retrospective review of children <18 years in...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.03.021
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND/PURPOSE:Sentinel lymph node biopsy (SLNB) provides valuable staging information for adult patients presenting with clinically localized cutaneous melanoma. There are little data pertaining to the use of SLNB in the pediatric melanoma population. The objective of this study is to investigate the use of SLNB i...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(03)00193-3
更新日期：2003-07-01 00:00:00
