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 without intracranial hemorrhage were prospectively enrolled from February 2010 to February 2014. RESULTS:Eighty-eight patients (median age=10months) were enrolled. Fall was the most common mechanism of injury (87%). The overall admission rate was 57%, representing an 18% decrease from that reported prior to guideline implementation (2003-2008; p=0.001). Guideline criteria for admission included vomiting, abnormal neurologic exam, concern for abuse, and others. Forty-two percent of patients were admitted outside of the guideline, primarily because of young age (20%). Patients transferred from another hospital (36%) were more likely to be admitted, though the majority (63%) did not meet admission criteria. No ED-discharged patient returned for neurologic symptoms, and none reported significant ongoing symptoms on follow-up phone call. CONCLUSIONS:Implementation of a new guideline for management of ISF resulted in a reduction of admissions without compromising patient safety. Young age remains a common concern for practitioners despite not being a criterion for admission. Interhospital transfer may be unnecessary in many cases.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Metzger RR,Smith J,Wells M,Eldridge L,Holsti M,Scaife ER,Barnhart DC,Rollins MDdoi
10.1016/j.jpedsurg.2014.09.038subject
Has Abstractpub_date
2014-12-01 00:00:00pages
1856-60issue
12eissn
0022-3468issn
1531-5037pii
S0022-3468(14)00571-5journal_volume
49pub_type
杂志文章abstract：INTRODUCTION:Medical conferences are integral to academic medicine, with academic posters being a well-established medium for presenting research. However, conferences carry an ecological footprint due to greenhouse gas emissions. Furthermore, traditional conference formats have recently not been possible due to the CO...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2020.07.013
更新日期：2020-07-16 00:00:00
abstract：:Although infestation with Ascaris lumbricoides causes various intestinal complications, massive gastrointestinal bleeding is rare. The authors report on 2 infants who presented with massive hematemesis. In the first patient, a gastroduodenoscopy was performed. Roundworms were found adhering to an oozing duodenal ulcer...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(03)00584-0
更新日期：2003-11-01 00:00:00
abstract：AIM:Extrahepatic portal vein obstruction (EPVO) is a common cause of portal hypertension in children and can lead to life-threatening bleeding, thrombocytopenia, and coagulation disorders. Mesoportal bypass (MPB) restores normal physiologic portal flow to the liver and corrects portal hypertension. There is, however, l...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.08.019
更新日期：2010-01-01 00:00:00
abstract：:Baseline, preinduction, postinduction, and postsurgical plasma samples were collected for glucose, insulin, and cortisol in 16 neonates and infants. Glucose infusion rate was maintained constant (mean +/- SD 4.1 +/- 1.2 mg/kg/min) prior to and during surgery; additional fluid losses during surgery were replaced by flu...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(86)80395-5
更新日期：1986-08-01 00:00:00
abstract：:Small intestinal myoelectric activity has been studied extensively in adult humans and in many animal models. However, little is known about gut myoelectrical activity in newborns, a population susceptible to primary and secondary motility disorders. We report the development of a chronic neonatal piglet model for ass...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(90)90075-k
更新日期：1990-03-01 00:00:00
abstract：BACKGROUND/PURPOSE:The etiology of idiopathic gastric perforation (IGP) in neonates is unclear. Interstitial cells of Cajal (ICC) express tyrosine kinase receptor C-kit, and act as gastrointestinal pacemaker cells. Stem cell factor (SCF) is a C-kit ligand and plays an important role in immune system homeostasis in the ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2000.5940
更新日期：2000-05-01 00:00:00
abstract：INTRODUCTION:Traditionally Hirschsprung's disease has been treated by a three-stage procedure. This approach has been associated with stoma problems, three episodes of hospitalization, and a theoretical disadvantage, because of the delayed passage of feces via the rectum, in controlling defecation. The aim of this stud...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(97)90187-1
更新日期：1997-02-01 00:00:00
abstract：:Lung scanning using solubilized xenon 133 can provide important information concerning both pulmonary perfusion and ventilation. This technique proved valuable in establishing the diagnosis of congenital lobar emphysema in a 7-month-old baby. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80005-8
更新日期：1988-11-01 00:00:00
abstract：BACKGROUND/PURPOSE:Our approach to full-thickness anorectal prolapse has transitioned to laparoscopic suture rectopexy (LSRP). The purpose of this study was to describe the indications, technique, and postoperative outcomes for LSRP. METHODS:Rectopexy was performed using 3 or 4 laparoscopic ports. Redundant rectum was...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2010.06.006
更新日期：2010-10-01 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/PURPOSE:Similar to open appendectomy (OA), most of the methods described for laparoscopic appendectomy (LA) require two steps: (1) dissection and division of mesoappendix and (2) excision of appendix. Dissection of mesoappendix requires more skill and experience during LA. In single endoscopic GIA stapler la...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90004-5
更新日期：1998-09-01 00:00:00
abstract：BACKGROUND/PURPOSE:Acidified diets are protective against intestinal bacterial colonization and translocation. Probiotic diets are designed to modulate the intestinal flora to enhance mucosal immunity. This study was designed to determine if formula acidified with live probiotic decreases bacterial gut colonization and...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.09.013
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND/PURPOSE:In Japan, surgical repair of a laryngotracheoesophageal cleft (LTEC) typically consists of the anterior approach, with the lateral approach as an alternative. Endoscopic surgery to repair the tracheoesophageal septum has been reported, and this study reviewed our experience treating several cases of ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2015.07.018
更新日期：2015-10-01 00:00:00
abstract：:In 25 years, from 1959 to 1984, esophageal substitution was performed in 32 patients. In most, the transverse colon was used, brought through the left chest on a vascular pedicle of the left colic artery. Indications for operation included: 21, esophageal atresia; 5, caustic injury; 3, peptic stricture; 2, esophageal ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(85)80051-8
更新日期：1985-12-01 00:00:00
abstract：BACKGROUND:There is ongoing debate concerning the use of peritoneal irrigation in the setting of complicated appendicitis (CA) in children. Our aim was to conduct a prospective randomized controlled trial for the treatment of CA during a laparoscopic appendicectomy in children. METHODS:Following ethical approval (REC1...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jpedsurg.2019.08.039
更新日期：2019-12-01 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
abstract：:There is increasing evidence to suggest that reactive oxygen and nitrogen species play a role in the pathogenesis of renal ischemia-reperfusion (I/R) injury. This study was designed to determine the possible protective effects of trapidil treatment against oxidative and nitrosative tissue injury of kidney induced by I...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.05.064
更新日期：2006-10-01 00:00:00
abstract：:Severe bronchomalacia occurred in a 14-month-old boy, as a result of compression of the left mainstem bronchus by a bronchogenic cyst. After resection of the cyst, the bronchomalacia was corrected by suspension of the posterolateral bronchial wall to the ligamentum arteriosum. This method of bronchopexy may be of valu...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(91)90499-j
更新日期：1991-03-01 00:00:00
abstract：:The informed consent process for emergency surgery in children poses a challenge for pediatric surgeons because the child and his/her surrogates (usually parents) must make medical decisions in a relatively short period. The unique circumstances of a surgical emergency create potential barriers to achieving the centra...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2005.05.019
更新日期：2005-08-01 00:00:00
abstract：PURPOSE:The adrenal cortex is a critical component of the hypothalamic-pituitary-adrenal/gonadal axis that coordinates the stress response and maintains homeostasis. The authors hypothesize that adrenal cortical cells can be transplanted in adrenal insufficiency states to regenerate the adrenal cortex. METHODS:Murine ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.08.006
更新日期：2004-12-01 00:00:00
abstract：BACKGROUND/PURPOSE:Restrictions for ECMO in neonates include birth weight less than 2kg (BW <2kg) and/or gestational age less than 34weeks (GA <34weeks). We sought to describe their relationship on mortality. METHODS:Neonates with a primary diagnosis code of CDH were identified in the Extracorporeal Life Support Organ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.08.037
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:Rhabdoid tumors (RTs) of the liver are rare, aggressive and nonsecreting malignancies occurring mainly during the first year of life. Definition of RT relies on characteristic morphology and on the inactivation of the SMARCB1 tumor suppressor gene. The aim of this study was to analyze clinical data, treatmen...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.09.005
更新日期：2018-03-01 00:00:00
abstract：BACKGROUND:Urologic complications after pediatric renal transplantation can adversely effect the outcome and may result in decreased graft survival. Efforts to prevent these complications are worthwhile. This study investigates the incidence of these complications in a clinical transplant program and reports on an anim...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(99)90654-1
更新日期：1999-11-01 00:00:00
abstract：:This report described a patient with multiple injuries in whom a major bronchial tear was not diagnosed early because the lung reexpanded initially. When pulmonary sepsis intervened and the bronchial injury was discovered, repair could not be accomplished because of continuing sepsis. The case emphasizes the need for ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(77)90187-7
更新日期：1977-08-01 00:00:00
abstract：PURPOSE:Beginning in 2003, the pediatric emergency medicine (PEM) physician replaced the surgeon as the team leader for all level II trauma resuscitations at a busy pediatric trauma center. The purpose was to review the outcomes 10 years after implementing this practice change. METHODS:Trauma registry data for all lev...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2014.10.041
更新日期：2015-01-01 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:Liver transplantation using split adult segmental grafts in infants can be a technical challenge because the small abdominal cavity cannot comfortably accommodate the graft, leading to compression. This size mismatch can be a particularly difficult problem when the anteroposterior diameter of the graft is gr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.05.022
更新日期：2008-09-01 00:00:00
abstract：:We report three additional cases of primary extrarenal Wilms' tumor and review those cases previously documented. Analysis of the location, histopathology, treatment, and survival of these cases supports the following conclusions: Wilms' tumor may occur in an extrarenal location without primary renal involvement and m...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80568-8
更新日期：1989-12-01 00:00:00
abstract：:Aortoesophageal fistula (AOF) in children with no history of cardiac disease or trauma is extremely rare, and survival is even rarer. We present a case of a 2-year-old boy who presented with massive hematemesis secondary to a primary aortoesophageal fistula and was found at endoscopy to have a submucosal hematoma. He ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.09.054
更新日期：2011-12-01 00:00:00
abstract：:Legend holds that treating the hundreds of children injured in the Halifax explosion of December 6, 1917, compelled Dr. William E. Ladd (1880-1967) to dedicate his career to the surgical care of infants and children. However, he had made the commitment to be a pediatric surgeon several years before when he joined the ...
journal_title：Journal of pediatric surgery
pub_type： 传,历史文章,杂志文章
doi：10.1016/j.jpedsurg.2017.08.047
更新日期：2017-12-01 00:00:00
