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 esophageal dilatation, coupled with endoscopically guided four-quadrant intralesional steroid injection, protected by Nissen fundoplication when gastroesophageal reflux has been demonstrated. In six patients, the stricture(s) were caused by ingestion of lye. In five, they were associated with repair of esophageal atresia. In one, the etiology was never determined. The strictures averaged 3.5 cm in length (range, 1 to 10 cm); the severity of the lesions was indicated by the fact that, in all instances, patients were completely intolerant of solids, and was confirmed fluoroscopically by demonstration of significant luminal narrowing. A mean of 4.3 steroid injections (range, 1 to 8) was required to obtain complete remission of symptoms; there have been no complications except in one lye ingestion patient who developed a tiny perforation following the initial dilatation, which responded to antibiotics alone. All patients remain symptom-free; the mean length of follow-up is 6.2 years (range, 1 to 11 years). We conclude that string-guided esophageal dilatation, when coupled with endoscopically guided steroid injection, is a safe and reliable method for treatment of severe esophageal strictures, which should obviate the need for esophageal resection or replacement in most patients. Moreover, even if treatment should ultimately fail, a procedure of lesser magnitude than esophageal replacement will likely be possible.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Gandhi RP,Cooper A,Barlow BAdoi
10.1016/s0022-3468(89)80529-9subject
Has Abstractpub_date
1989-08-01 00:00:00pages
745-9; discussion 749-50issue
8eissn
0022-3468issn
1531-5037pii
S0022346889002769journal_volume
24pub_type
杂志文章abstract：:The plan for cervical lymph node biopsy should include special maneuvers for recognition of patients with lymphadenitis due to atypical mycobacteria, since these children need extensive operations. The diagnosis should be suspected in children less than 3 yr old with lymphadenopathy present for several months and no e...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(82)80116-4
更新日期：1982-10-01 00:00:00
abstract：:Abdominoscrotal hydrocele is a very rare finding, especially in infants. The authors describe the case of a 7-month-old boy presenting an abdominoscrotal mass, the diagnosis of which was made by sonography and which was excised totally through an extensive inguinal incision. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(86)80118-x
更新日期：1986-11-01 00:00:00
abstract：:Lambert-Eaton myasthenic syndrome is a paraneoplastic syndrome that may reveal a primitive tumor. Neuroblastoma in children and small cell lung carcinoma in adults are the leading tumors revealed or expressed by paraneoplastic phenomena. The clinical neurologic manifestations of Lambert-Eaton myasthenic syndrome are m...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.04.023
更新日期：2009-08-01 00:00:00
abstract：BACKGROUND/PURPOSE:Laparoscopic Appendectomy (LA) is a safe procedure in adults resulting in shorter hospitalization and sooner return to activity. The relative merits of LA and open appendectomy (OA) are evaluated in this first prospective and randomized study in children. METHODS:A total of 129 children with appendi...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1053/jpsu.2002.30841
更新日期：2002-03-01 00:00:00
abstract：:The fifteenth case of neonatal adrenal abscess is reported. It is the first case successfully diagnosed with needle aspiration and treated with percutaneous drainage. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80026-5
更新日期：1988-11-01 00:00:00
abstract：:Thoracic outlet syndrome (TOS) is extremely rare in children. Only several pediatric cases have been reported, and all presented with neurologic symptoms. The authors report on a 6-year-old boy with an asymptomatic left subclavian artery aneurysm caused by compression of the subclavian artery by an anomalous first rib...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2002.34483
更新日期：2002-08-01 00:00:00
abstract：:It is well known that the persistence of alterations in the normal embryological development of branchial arches can lead to preauricular and cervical fistulas within a family. However, until 1970, there were no reports of dysplasia affecting the branchial, otic, and renal systems (BOR syndrome) with dominant autosomi...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(93)90086-z
更新日期：1993-12-01 00:00:00
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 inj...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90113-x
更新日期：1996-08-01 00:00:00
abstract：OBJECTIVE:To characterize referrals to a vascular anomalies center to determine which lesions should be treated by specialists. STUDY DESIGN:Patients sent to our center between 1999 and 2010 were reviewed. Type of anomaly, anatomical location, sex, accuracy of referral diagnosis, and the geographic origin of the refer...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.05.006
更新日期：2011-09-01 00:00:00
abstract：PURPOSE:Our aim was to determine incidence, severity, and outcome, as well as predisposing factors and underlying diagnoses, of intestinal failure-associated liver disease (IFALD) in surgical infants requiring long-term parenteral nutrition (PN). METHODS:We retrospectively studied surgical infants receiving PN for at ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.11.032
更新日期：2012-02-01 00:00:00
abstract：:Twenty-four children with postoperative chylothorax were encountered among 1,264 consecutive thoracic operations over a 7-year period and form the basis of this study. Chylothorax was caused by direct lesion to the thoracic duct or lymphatic vessels in 17 patients and was associated with superior vena cava (SVC) obstr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(91)90696-q
更新日期：1991-05-01 00:00:00
abstract：:Intestinal obstruction in a 2-year-old girl with a histologically proven diagnosis of retroperitoneal yolk sac carcinoma developed after the second course of anticancer chemotherapy. Nonoperative treatment was not effective. Because the patient had fallen into a state of chemotherapy-induced myelosuppression, surgery ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90494-8
更新日期：1998-10-01 00:00:00
abstract：:We report our initial experience and describe the operative technique used in three patients who underwent laparoscopic splenectomy for hematologic disorders between September 1991 and February 1992. No early or late complications have been found at an average follow-up of 9 months. All have remained asymptomatic and ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(93)90033-h
更新日期：1993-05-01 00:00:00
abstract：:Thromboembolic events in the pediatric age group occur most commonly in neonates, and newborns of diabetic mothers are particularly at risk. We report a newborn with right renal vein and inferior vena cava thrombosis who apparently embolized across the foramen ovale antenatally with resultant right brachial artery occ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(91)90024-n
更新日期：1991-06-01 00:00:00
abstract：:In Gaucher disease, partial splenectomy has been suggested for alleviating the complications of splenomegaly as well as for avoiding the immunologic compromise and potential acceleration of bony and hepatic involvement that may follow total splenic resection. However, the fate of the splenic remnant has been reported ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80520-2
更新日期：1989-06-01 00:00:00
abstract：OBJECTIVE:To review the role of various ultrasound (US) modalities in their ability to determine testicular viability in prepubertal testes following Fowler-Stephens orchiopexy (FSO). MATERIAL & METHODS:Our prospective study included all patients from the year 2012 to 2017 with intra-abdominal testes (IAT) who had one...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.11.016
更新日期：2020-09-01 00:00:00
abstract：BACKGROUND:Advances in neonatal intensive care have improved the survival of the extremely premature infant. However, survival at less than 25 weeks' gestational age remains tenuous, with intestinal perforation presenting a significant mortality. METHODS:During an 18-month period from 1995 to 1996, nine patients weigh...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90465-1
更新日期：1998-02-01 00:00:00
abstract：:Forty-six records of infant girls with so-called imperforate anus have been reviewed to determine the position of the rectal opening in relation to the hymen. Eight of these children proved to have the cloacal deformity, in which the rectum enters high into a single tube and just behind the opening of a double or sept...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(75)90099-8
更新日期：1975-06-01 00:00:00
abstract：:Four infants had adrenal masses detected prenatally, through ultrasonography, between 18 and 30 weeks' gestation. Two were predominantly cystic, and two were solid. The sizes ranged from 0.8 to 1.5 cm. There were no associated prenatal maternal complications or stress factors. The urine vanillylmandelic acid levels at...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90339-5
更新日期：1996-01-01 00:00:00
abstract：OBJECTIVE:The repair of pectus excavatum with bar placement is associated with substantial postoperative pain. Optimal pain control strategy has not been addressed with level 1 or substantial level 2 evidence. Many institutions operate under the assumption that a thoracic epidural offers the best pain control for these...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.09.024
更新日期：2008-01-01 00:00:00
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. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2020.02.021
更新日期：2020-08-01 00:00:00
abstract：INTRODUCTION:Necrotizing enterocolitis (NEC) has been a long-recognized complication of prematurity, but there is a paucity of studies on term infants. We sought to characterize the clinical presentation and outcomes of full term (FT) infants with NEC and compare these to our experience with preterm (PT) neonates. MET...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.02.046
更新日期：2019-06-01 00:00:00
abstract：INTRODUCTION:Bacterial intestinal translocation plays an important role in neonatal sepsis. We aimed to elucidate the importance of such translocation in causing central line associated blood stream infection (CLABSI) in patients undergoing gastrointestinal surgery (GIS). METHODS:Using a database of pediatric patients...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2020.02.012
更新日期：2020-08-01 00:00:00
abstract：:We report a case of intrarenal teratoma arising from a horseshoe kidney. A 6-day-old girl was admitted with an abdominal mass that had been noticed at 37 weeks gestation by routine ultrasonography. At 20 days of age, a tumorectomy with a right nephrectomy was performed. The pathological diagnosis was an immature terat...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.03.019
更新日期：2006-07-01 00:00:00
abstract：BACKGROUND/PURPOSE:The focused assessment for the sonographic evaluation of trauma patients (FAST) in adults is effective in detecting intraperitoneal and intrapericardial fluid and can be performed quickly by surgeons in the emergency department (ED). The authors sought to validate the accuracy of FAST performed by su...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0022-3468(98)90455-9
更新日期：1998-02-01 00:00:00
abstract：:The capacity of fetal and newborn hepatic macrophages to produce cachectin/tumor necrosis factor (TNF) has not been previously examined. The role that TNF plays in newborn infection is also unknown. In the present report, fetal and newborn rat hepatic macrophages have been maintained in short-term tissue culture, and ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80296-9
更新日期：1989-01-01 00:00:00
abstract：BACKGROUND:Pediatric intestinal failure (PIF) is a life-altering chronic condition with significant morbidity and mortality. Omegaven® therapy has been used to treat children with advanced intestinal failure associated liver disease. Our objective was to determine the evolution of hepatic fibrosis in PIF patients who r...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.01.048
更新日期：2017-05-01 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：:The need for feeding gastrostomy seems to be increasing in children with neurological impairment and swallowing incoordination. Because gastrostomy can cause or increase gastroesophageal reflux, an antireflux procedure has been advocated at the time of gastrostomy placement in neurologically impaired children. A gastr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(90)90209-r
更新日期：1990-10-01 00:00:00
abstract：BACKGROUND:Abdominal compartment syndrome (ACS) is a pathological increase of the intra-abdominal pressure (IAP) with dysfunction of one or more organs. There is lack of clarity in neonates regarding what intravesical pressure (IVP) value, a surrogate marker for IAP, indicates the need for intervention for ACS. METHOD...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.08.003
更新日期：2020-07-01 00:00:00
