当前位置： SCI文献检索 > JOURNAL OF PEDIATRIC SURGERY期刊下所有文献 > A screening algorithm for the efficient exclusion of biliary atresia in infants with cholestatic jaundice.

A screening algorithm for the efficient exclusion of biliary atresia in infants with cholestatic jaundice.

Abstract：

BACKGROUND:Neonates with cholestasis may undergo many tests before biliary atresia (BA) or an alternative diagnosis is reached, and delayed intervention may worsen outcomes. An optimal diagnostic approach to reduce risk, cost, and delay has yet to be defined. The purpose of this study was to develop an algorithm that rapidly and accurately excludes BA for infants with cholestatic jaundice. METHODS:A single-center retrospective comparison of diagnostic workup was made between cholestatic infants with BA, and those without BA who underwent hepatobiliary iminodiacetic acid (HIDA) scan during admission. Patients were born between 2000 and 2010 and those older than 100days at assessment were excluded. Sensitivity and specificity analysis of predictive variables was performed and an algorithm constructed. RESULTS:There were 45 BA and 167 non-BA patients. Some variables were 100% sensitive for the exclusion of BA: conjugated bilirubin <2.5mg/dL, gamma-glutamyl transpeptidase <150U/L, excretion on HIDA, or a normal percutaneous cholangiogram. Clinical variables and ultrasound were less useful as screening tests owing to low specificity and sensitivity, respectively. Liver biopsy was 98% sensitive and 84% specific in the diagnosis of BA. An algorithm was constructed that rules out BA with a negative laparotomy rate of 3-22%. CONCLUSION:We propose a screening algorithm for infants with conjugated hyperbilirubinemia that permits efficient exclusion of BA with minimal invasive testing and with a low risk of negative laparotomy. This algorithm now requires prospective evaluation to determine its diagnostic accuracy and its ability to reduce hospital costs, patient morbidity, and time to Kasai portoenterostomy in patients with BA.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Jancelewicz T,Barmherzig R,Chung CT,Ling SC,Kamath BM,Ng VL,Amaral J,O'Connor C,Fecteau A,Langer JC

doi

10.1016/j.jpedsurg.2014.08.014

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

363-70

issue

3

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(14)00513-2

journal_volume

50

pub_type

杂志文章

相关文献

JOURNAL OF PEDIATRIC SURGERY文献大全
  • Pulmonary metastasectomy in pediatric/adolescent patients with synovial sarcoma: an institutional review.

    abstract：PURPOSE:Synovial sarcoma (SS) often metastasizes to the lung; however, the indications for and outcomes of pulmonary metastasectomy have not been evaluated in pediatric/adolescent patients. METHODS:The records of pediatric patients (age <22years) with pathologically confirmed SS and pulmonary metastasis treated betwee...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2012.09.042

    authors： Stanelle EJ,Christison-Lagay ER,Wolden SL,Meyers PA,La Quaglia MP

    更新日期：2013-04-01 00:00:00

  • Conjoined twins--past, present, and future.

    abstract：BACKGROUND/PURPOSE:Conjoined twins are rare and complex anomalies of the newborn. They require a highly experienced team and a center equipped to deal with such challenging anatomy. METHOD:A review of 31 sets of conjoined twins was managed by one team over a 15-year period. The spectrum of the anomalies, management st...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2005.12.045

    authors： Al Rabeeah A

    更新日期：2006-05-01 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

    doi：10.1016/j.jpedsurg.2018.09.005

    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

  • Utility of admission serum lactate in pediatric trauma.

    abstract：BACKGROUND/PURPOSE:Serum lactate measurement has a predictive value in adult trauma. To date, there has been no prospective analysis of the predictive value of admission serum lactate in pediatric trauma. METHODS:Admission serum lactate was prospectively measured over a two year period on all children under age 15 yea...

    journal_title：Journal of pediatric surgery

    pub_type： 临床试验,杂志文章

    doi：10.1016/j.jpedsurg.2014.08.013

    authors： Ramanathan R,Parrish DW,Hartwich JE,Haynes JH

    更新日期：2015-04-01 00:00:00

  • Effects of intraoperative temperatures on postoperative infections in infants and neonates.

    abstract：BACKGROUND:Perioperative hypothermia has been shown to increase surgical site infection (SSI) rates in adults. We sought to characterize whether intraoperative hypothermia or hyperthermia is associated with postoperative infections in infants. METHODS:We conducted a retrospective review of patients ≤6 months old who u...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2019.09.060

    authors： Walker S,Amin R,Arca MJ,Datta A

    更新日期：2020-01-01 00:00:00

  • The missing link in the pathogenesis of gastroschisis.

    abstract：:Is gastroschisis embryologically distinct from omphalocele or simply a ruptured small omphalocele (hernia of the umbilical cord)? Serial sonographic imaging of a fetus with a small omphalocele at 27 weeks gestation has now provided the "missing link" in the pathogenesis of gastroschisis by documenting in utero rupture...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/s0022-3468(85)80229-3

    authors： Glick PL,Harrison MR,Adzick NS,Filly RA,deLorimier AA,Callen PW

    更新日期：1985-08-01 00:00:00

  • Diagnosis of spontaneous perforation of the biliary tract in the newborn.

    abstract：:This report is of a 2-month-old child with spontaneous perforation of the common bile duct diagnosed by 99m-Tc disofenin nuclear hepatobiliary imaging. Of the agents available, the radiopharmaceutical properties of this compound allow the most accurate, safe, high-resolution imaging of the hepatobiliary tree in the di...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/0022-3468(86)90027-8

    authors： Kolbe A,Beaver BL,Rosenbaum R,Hill JL

    更新日期：1986-12-01 00:00:00

  • Temporary fetal tracheal occlusion using a gel plug in a rabbit model of congenital diaphragmatic hernia.

    abstract：PURPOSE:Temporary tracheal occlusion induces lung growth in congenital diaphragmatic hernia (CDH) but has significant drawbacks because the device must be removed in utero. We devised a gel plug (GP) that can be placed in the fetal trachea in a rabbit model of CDH to provide temporary tracheal occlusion and evaluated i...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2012.03.005

    authors： Muensterer OJ,Nicola T,Farmer S,Harmon CM,Ambalavanan N

    更新日期：2012-06-01 00:00:00

  • Association of gastroschisis and choledochal cyst.

    abstract：:Two infants are described who presented in the neonatal period with a direct hyperbilirubinemia. This was initially presumed to be because of the diagnosis of gastroschisis and the prolonged use of parenteral nutrition. However, both infants were eventually found to have an associated choledochal cyst. The cases are a...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2008.12.005

    authors： Serber J,Stranzinger E,Geiger JD,Teitelbaum DH

    更新日期：2009-03-01 00:00:00

  • What predicts spontaneous passage of ≤1 cm ureteral stones in children?

    abstract：PURPOSE:The aim of this study is to determine what factors predict spontaneous passage of ≤1 cm ureteral stones in children. METHODS:Files of the patients diagnosed with a single ureteral stone on a given side between 2008 and 2017 were retrospectively reviewed. Patients with congenital obstructive uropathy, neurogeni...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2019.05.012

    authors： Elmacı AM,Dönmez Mİ,Akın F,Çetin B,Gündüz M

    更新日期：2020-07-01 00:00:00

  • An unusual presentation of a congenital intrahepatic arterioportal fistula in an infant with Down syndrome.

    abstract：:Congenital intrahepatic arterioportal fistula is a rare entity that most often presents with symptoms of portal hypertension and malabsorption. We discuss a patient who presented with distributive shock, congestive heart failure, pulmonary hypertension, ascites, and a history of severe constipation. ...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2010.08.016

    authors： Bogert JN,Potter DD,Crow S,Arteaga GM,Freese DK

    更新日期：2011-01-01 00:00:00

  • Bevacizumab and interferon reduce venous recanalization following sclerotherapy.

    abstract：PURPOSE:The treatment of venous malformations is difficult because these lesions frequently recur after resection or sclerotherapy. The purpose of this study was to determine whether recanalization of sclerosed venous lumens could be prevented with systemic angiogenic inhibition using bevacizumab or peginterferon alfa-...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2016.06.009

    authors： Kulungowski AM,Hassanein AH,Foster CC,Greene AK,Fishman SJ

    更新日期：2016-10-01 00:00:00

  • Neutropenic enterocolitis as a presenting complication of acute lymphoblastic leukemia: an unusual case marked by delayed perforation of the descending colon.

    abstract：:Neutropenic enterocolitis (NE) is a life-threatening complication most commonly seen in patients receiving intensive chemotherapy for acute leukemia. The condition usually affects the terminal ileum, cecum, or ascending colon. In rare instances, NE may occur before the initiation of chemotherapy or involve more distal...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2004.03.083

    authors： Wilson DB,Rao A,Hulbert M,Mychaliska KP,Luchtman-Jones L,Hill DA,Foglia RP

    更新日期：2004-07-01 00:00:00

  • Dorsal mesenteric agenesis without small bowel atresia: a rare cause of midgut volvulus in children.

    abstract：:Agenesis of the dorsal mesentery in association with jejunal atresia is a well-recognized congenital anomaly. Only few reports exist in the English literature of children with agenesis of the dorsal mesentery without small bowel atresia. Herein, we report a child with total mesenteric agenesis presenting with midgut v...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2006.05.011

    authors： Cascio S,Tien AS,Agarwal P,Tan HL

    更新日期：2006-09-01 00:00:00

  • Efficacy of video-assisted thoracoscopic surgery in managing childhood empyema: a large single-centre study.

    abstract：BACKGROUND/PURPOSE:A randomised controlled trial evaluating the role of video-assisted thoracoscopic surgery (VATS) in childhood empyema reported a failure rate of 16.6%. Our aim is to determine the outcome of VATS in a large series of children managed by 3 paediatric surgeons experienced in endoscopic surgery. METHOD...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2008.10.083

    authors： Bishay M,Short M,Shah K,Nagraj S,Arul S,Parikh D,Jawaheer G

    更新日期：2009-02-01 00:00:00

  • Initial laparoscopic appendectomy versus initial nonoperative management and interval appendectomy for perforated appendicitis with abscess: a prospective, randomized trial.

    abstract：INTRODUCTION:Perforated appendicitis is a common condition in children, which, in a small number of patients, may be complicated by a well-formed abscess. Initial nonoperative management with percutaneous drainage/aspiration of the abscess followed by intravenous antibiotics usually allows for an uneventful interval ap...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章,随机对照试验

    doi：10.1016/j.jpedsurg.2009.10.039

    authors： St Peter SD,Aguayo P,Fraser JD,Keckler SJ,Sharp SW,Leys CM,Murphy JP,Snyder CL,Sharp RJ,Andrews WS,Holcomb GW 3rd,Ostlie DJ

    更新日期：2010-01-01 00:00:00

  • Sequential assay of expired breath hydrogen as a means of predicting necrotizing enterocolitis in susceptible infants.

    abstract：:Breath hydrogen levels were investigated prospectively from birth, in a population of neonates at risk of developing NEC. This was standardized to the quantity of carbohydrate in the feed. Children who developed NEC, confirmed radiologically, were compared with matched controls. There was a significant increase in bre...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/s0022-3468(87)80329-9

    authors： Garstin WI,Boston VE

    更新日期：1987-03-01 00:00:00

  • Diaphragmatic agenesis as a distinct clinical entity.

    abstract：:Anatomically, diaphragmatic agenesis (DA) is the most extreme form of congenital diaphragmatic defect, but clinically it has not been defined separately from Bochdalek's hernia (BH). Between 1986 and 1992, the authors treated 55 neonates who had diaphragmatic defects. Forty-eight of these cases presented within 24 hou...

    journal_title：Journal of pediatric surgery

    pub_type： 临床试验,杂志文章

    doi：10.1016/0022-3468(95)90599-5

    authors： Tsang TM,Tam PK,Dudley NE,Stevens J

    更新日期：1995-01-01 00:00:00

  • Which children could benefit from additional diagnostic tools in case of suspected appendicitis?

    abstract：BACKGROUND:New diagnostic tools such as ultrasound scan, computed tomography (CT) scan, and diagnostic laparoscopy, have become available for children with suspected appendicitis but should be reserved for equivocal cases. The aim of this study was to develop a scoring system to identify this subgroup of children. MET...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2003.12.015

    authors： van den Broek WT,van der Ende ED,Bijnen AB,Breslau PJ,Gouma DJ

    更新日期：2004-04-01 00:00:00

  • The treatment of Wilms' tumor: results from Royal Children's Hospital, Melbourne, 1967-1977.

    abstract：:A retrospective review of the treatment of Wilms' tumor from 1967 to 1977 at the Royal Children's Hospital, Melbourne, was undertaken, allowing a minimum 2-yr followup. Fifty-four (77%) of the 70 patients in the study are alive, with 23/25 (92%) in Stage I, 12/16 (75%) in Stage II, 12/19 (63%) in Stage III, and 7/9 (7...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/s0022-3468(83)80091-8

    authors： Hutson JM,Kent M,Ekert H,Waters KD

    更新日期：1983-06-01 00:00:00

  • Management of pulmonary insufficiency in diaphragmatic hernia using extracorporeal circulation with a membrane oxygenator (ECMO).

    abstract：:Persistent fetal circulation (PFC) causes severe pulmonary insufficiency in patients who have demonstrated adequate lung function following diaphragmatic hernia repair. Patent ductus arteriosus (PDA) ligation corrects this condition, but carries the risk of sudden right ventricular failure. Pharmacologic reversal of P...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/0022-3468(77)90600-5

    authors： German JC,Gazzaniga AB,Amlie R,Huxtable RF,Bartlett RH

    更新日期：1977-12-01 00:00:00

  • A technique for temporary control of colostomy prolapse in children.

    abstract：:Stomal prolapse is a common complication of colostomies and, if severe, may affect the timing of the definitive procedure. A simple technique for postreduction bowel fixation without stomal revision is presented. The reduced bowel is attached to the parietal peritoneum using a "U" type suture a few centimeters from th...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/s0022-3468(85)80017-8

    authors： Gauderer MW,Izant RJ Jr

    更新日期：1985-12-01 00:00:00

  • Primary Hemophilus influenzae lung abscesses with bronchial obstruction.

    abstract：:A primary lung abscess due to non type B Hemophilus influenzae was diagnosed in three children who failed to improve after prolonged antibiotic treatment for dense, pneumonic infiltrates. In each instance percutaneous aspiration yielded pure cultures of Hemophilus influenzae, one of which was ampicillin resistant. Bec...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/s0022-3468(82)80013-4

    authors： Liechty E,Kleiman MB,Ballantine TV,Grosfeld JL

    更新日期：1982-06-01 00:00:00

  • First reported successful management of Serratia marcescens bacteremia after open heart surgery in a child.

    abstract：:A 7 and one-half yr-old girl developed bacteremia from S. marcescens following debanding of the pulmonary artery and closure of multiple ventricular septal defects with a Dacron patch and multiple Teflon pledgets. The site of entry was probably a radial arterial catheter left in place for 8 days. Infection was eradica...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章,评审

    doi：10.1016/s0022-3468(75)80098-4

    authors： Saxena NC,Friedman S,Plotkin S,Edmunds LH Jr

    更新日期：1975-12-01 00:00:00

  • Revascularization technique for reduced-size liver transplantation for infants weighing less than 10 kg.

    abstract：:Reduced-size liver transplantation has been recognized as a powerful modality in alleviating the global donor shortage in pediatric liver transplantation. We describe, for the first time, a technique for revascularizing reduced-size grafts which has not been patterned after adult revascularization techniques. This rev...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/0022-3468(93)90698-k

    authors： Nakazato PZ,Cox KL,Concepcion W,Berquist WE,Esquivel CO

    更新日期：1993-07-01 00:00:00

  • Use of the aspartate aminotransferase to platelet ratio index to follow liver fibrosis progression in infants with short gut.

    abstract：BACKGROUND:Infants with parenteral nutrition dependence may develop liver dysfunction and progress to liver failure requiring transplantation. The aspartate aminotransferase-to-platelet ratio index (APRI) has good correlation with liver fibrosis progression in adults. This study applies APRI scoring to parenteral nutri...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2010.02.098

    authors： Mangus RS,O'Connor MG,Tector AJ,Lim JD,Vianna RM

    更新日期：2010-06-01 00:00:00

  • Early experience with the use of rhomboid excision and Limberg flap in 16 adolescents with pilonidal disease.

    abstract：BACKGROUND:Rhomboid excision with Limberg flap (RELF) repair has been shown to be effective in the management of pilonidal disease (PD) in adults. Wide excision allows complete removal of diseased tissue, and the rotational flap allows tensionless coverage as well as helps flatten the natal crease, which is believed to...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2008.11.033

    authors： Yamout SZ,Caty MG,Lee YH,Lau ST,Escobar MA,Glick PL

    更新日期：2009-08-01 00:00:00

  • Predicting inadequate long-term lung development in children with congenital diaphragmatic hernia: an analysis of longitudinal changes in ventilation and perfusion.

    abstract：PURPOSE:Infants born with congenital diaphragmatic hernia (CDH) demonstrate a wide variability in postnatal catch-up lung growth. The goals of this study were to assess the pulmonary development of children born with CDH using sequential ventilation-perfusion (V/Q) scintigraphy and to identify the perinatal factors tha...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2006.09.011

    authors： Hayward MJ,Kharasch V,Sheils C,Friedman S,Dunleavy MJ,Utter S,Zurakowski D,Jennings R,Wilson JM

    更新日期：2007-01-01 00:00:00

  • Secretion and expression of epithelial markers supports the biliary origin of solitary nonparasitic cyst of the liver in infancy.

    abstract：:Solitary nonparasitic cyst of the liver (SNPCL) is rare in children. Although there are several hypotheses regarding the pathogenesis, the true origin of SNPCL remains unknown. The authors present an infant with a huge SNPCL in whom the epithelial markers, CA19-9, DU-PAN-2, and SPan-1, were elevated in the serum and c...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/j.jpedsurg.2005.08.039

    authors： Otani Y,Takayasu H,Ishimaru Y,Okamura K,Yamagishi J,Ikeda H

    更新日期：2005-12-01 00:00:00

  • Tissue plasminogen activator for the treatment of intraabdominal abscesses in a neonate.

    abstract：:Fibrinolytic agents have been used successfully in the management of loculated empyema; however, their use in the treatment of intraabdominal abscesses is limited. The authors describe the case of a 4-week-old girl with intraabdominal abscesses secondary to intestinal perforation that were not amenable to percutaneous...

    journal_title：Journal of pediatric surgery

    pub_type： 杂志文章

    doi：10.1016/s0022-3468(03)00275-6

    authors： Diamond IR,Wales PW,Connolly B,Gerstle T

    更新日期：2003-08-01 00:00:00