Abstract:
BACKGROUND:Biliary atresia (BA) is one of the most common and perplexing causes of neonatal cholestasis. Each year many cases of neonatal cholestasis are misdiagnosed as BA, resulting in unnecessary exploratory surgery. Therefore, the aim of our study was to analyze the clinical features and parameters that contribute to the misdiagnosis of BA. We used a retrospective study to compare BA and similar neonatal cholestatic diseases, which were confirmed by intraoperative cholangiography. METHODS:Six hundred and two infants that were suspected to have BA were recruited for the study. All cases were divided into a non-BA group and a BA group according to intraoperative cholangiography. In addition, each group was divided into three subgroups according to the patients age at surgery (group i, < 60 d; group ii, 60-90 d; and group iii > 90 d). The annual misdiagnosis rate of non-BA patients was calculated. Age at onset of jaundice and the liver function and ultrasound results were compared between the two groups and subgroups. Moreover, the positive predictive value and false positive rate of hepatobiliary scintigraphy in the diagnosis of BA were calculated. Finally, the disease spectrum of the non-BA group was analyzed. RESULTS:Of the 602 cases, 83 patients were diagnosed as non-BA. The remaining 519 cases were confirmed to have BA. There was no significant decline in the misdiagnosis rate of suspected BA cases by year. The age at onset of jaundice, total bilirubin (TBIL), direct bilirubin (DBIL), DBIL/TBIL and alanine aminotransferase (ALT) values before the exploratory operation showed no statistically significant difference (P > 0.05) in the non-BA versus BA groups. However, the mean level of gamma-glutamyl transpeptidase (γ-GT) was 263.2 mmol/l in the non-BA group and 902.7 mmol/l in the BA group (P < 0.01). The length of the liver below the ribs was detected with ultrasound and found to be smaller in the non-BA group than that of the BA group (2.99 cm ± 1.62 vs. 3.61 cm ± 1.26, respectively; P < 0.05). Among the 498 infants who received hepatobiliary scintigraphy examination, the false positive rate was 13.3% (66/498) and the positive predictive value was 86.7% (432/498). In the non-BA group, 58 infants suffered from hepatitis syndrome, 16 cases were biliary dysplasia, 5 cases were TPN related cholestasis, 2 cases were bile duct perforation and 2 were bile-plug syndrome. CONCLUSION:The similarity of liver function tests and excessive dependence on hepatobiliary scintigraphy may contribute to the misdiagnosis of infants with jaundice. The age at onset of jaundice, the level of γ-GT and the liver length below the ribs may be helpful in the differential diagnosis of jaundice in infants.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Sun S,Chen G,Zheng S,Xiao X,Xu M,Yu H,Dong Rdoi
10.1016/j.jpedsurg.2013.02.034subject
Has Abstractpub_date
2013-07-01 00:00:00pages
1490-4issue
7eissn
0022-3468issn
1531-5037pii
S0022-3468(13)00128-0journal_volume
48pub_type
杂志文章abstract::The radical anions of molecular oxygen reduction, superoxide (O2), hydrogen peroxide (H2O2), and hydroxyl radical (OH), have been implicated in a number of disease processes, including ischemic bowel injury. This report evaluates the effect of superoxide dismutase (SOD), catalase (CAT), dimethyl sulfoxide (DMSO), sele...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(84)80361-9
更新日期:1984-12-01 00:00:00
abstract::Herein, we describe a male infant with an antenatally diagnosed single umbilical artery and extensive varicosities of the umbilical vein with tumor-like appearances. Consumption coagulopathy occurred postnatally, and surgical resection of the umbilical cord led to a normalization of the platelet count. ...
journal_title:Journal of pediatric surgery
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doi:10.1016/j.jpedsurg.2012.06.018
更新日期:2012-09-01 00:00:00
abstract:AIM:Our study aimed to compare the efficacy of two endoscopic techniques used for the correction of vesicoureteral reflux (VUR): subureteral transurethral injection (STING) and hydrodistension implantation technique (HIT). METHODS:A systematic review was conducted using MEDLINE, Google scholar, and Cochrane databases ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpedsurg.2016.09.028
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:Hepatocyte growth factor (HGF), originally known to stimulate hepatocyte DNA synthesis, also has been shown to stimulate growth of intestinal epithelial cells in vitro. The authors recently demonstrated that HGF can dramatically increase substrate absorption beyond the normal adaptive response after ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(98)90351-7
更新日期:1998-01-01 00:00:00
abstract::An exceptional cause of intestinal obstruction is reported. Ileus is an 8-yr-old boy persisted for 9 days after successful reduction of an axial dislocation of L1 on L2. At laparotomy, a paraduodenal hernia with bowel strangulated between the bodies of L1 and L2 was discovered. The successful treatment consisted of cl...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(80)80017-0
更新日期:1980-04-01 00:00:00
abstract::A rare case of duodenal duplication cyst containing stones in a 17-year-old patient is presented. The cyst, acting as a leading point for duodeno-jejunal intussusception caused proximal small bowel obstruction and hyperbilirubinemia. Preoperative diagnosis was based on abdominal computerized tomography. At operation, ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90176-8
更新日期:1999-08-01 00:00:00
abstract::Laryngeal and laryngotracheoesophageal clefts (L-LTEC) are uncommon anomalies in neonates that cause significant morbidity secondary to aspiration, pneumonia, and respiratory distress. Other anomalies of development, such as esophageal atresia and tracheoesophageal fistula (EA-TEF), are observed in 20% of patients wit...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90191-b
更新日期:1990-08-01 00:00:00
abstract::The ability of physicians to identify a patent processus vaginalis by laparoscopic examination of the internal ring is now well established, but the efficacy on patient outcome is not. The authors reviewed their experience to determine the effect of diagnostic laparoscopy of the internal ring on the management of chil...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90562-6
更新日期:1995-02-01 00:00:00
abstract::A Newfoundland family with the apparently unique syndrome of complex coarctation of the aortic arch, bilateral stenoses of the subclavian arteries, bilateral ptosis, sensorineural deafness, and bronchial asthma is reported. This syndrome appears to have affected at least four generations, and has the characteristics o...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80613-9
更新日期:1987-08-01 00:00:00
abstract::A new surgical technique for the treatment of total colonic aganglionosis is described. Preservation of the right colon and the ileocecal valve is possible by performing an end-to-back anastomosis between a prececal short ileum segment and the uneffected ileum, and by creating a side-to-side anastomosis between an iso...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90128-8
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:Trauma centers (TC) are certified based on widely accepted criteria. These specific criteria rarely are scrutinized individually. The purpose of this study was to analyze the individual components of a pediatric trauma center for their effect on outcome. METHODS:Members of the National Pediatric Tra...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s0022-3468(99)90392-5
更新日期:1999-05-01 00:00:00
abstract::Vaginal reflux during voiding cystourethrography (VCUG) is a common finding in young females. Reflux of urine into the uterus, fallopian tubes, and peritoneal cavity documented by contrast studies is rare and considered abnormal. Chronic retrograde flow of urine and its contaminants through an incompetent cervical os ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80200-0
更新日期:1983-08-01 00:00:00
abstract:PURPOSE:The purpose of the study was to compare the outcomes in children undergoing thoracoscopic versus open resection of congenital lung lesions. METHODS:Retrospective review of 12 consecutive children (<3 years of age) undergoing thoracoscopic resection of a congenital lung lesion between 2004 and 2005 was performe...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.01.043
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The treatment of incidentally encountered asymptomatic Meckel diverticulum (MD) is controversial. We evaluated whether the macroscopic appearance correlates with clinical features, histopathological findings, future complications, and management decisions. METHODS:Patients who underwent MD resection at a si...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.08.066
更新日期:2016-07-01 00:00:00
abstract::In order to compare the results of renal transplantation in pediatric and adult recipients, a retrospective analysis of first transplants done at a single institution over a 6-yr period was carried out. The study included 21 pediatric and 196 adult recipients of cadaveric grafts, and 18 pediatric and 156 adult recipie...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(80)80140-0
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:Inguinal hernia repair (IHR) is a common operation in preterm and term infants. Recently, spinal anesthesia (SA) has been proposed as an alternative to avoid exposure to general anesthesia (GA) during early life. The aim of this study was to compare surgical outcomes of open IHR performed under SA versus GA ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.09.064
更新日期:2020-10-08 00:00:00
abstract:PURPOSE:We sought to examine the long-term clinical success rates of a bowel management program (BMP) for children with severe constipation or fecal incontinence. METHODS:A single center review was conducted of children (≤18 years) enrolled in a BMP and followed in a colorectal specialty clinic (2011-2017). All patien...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.10.062
更新日期:2020-03-01 00:00:00
abstract::During the years 1982 through 1991, stitch granulomata complicated 15 of 2,447 inguinal herniotomies. The lesions were diagnosed 3 to 120 months (mean +/- SE, 2.46 +/- 0.65 years) following surgery. Granulomata were associated with male sex (P = .02), emergency herniotomy (P = 0.016), surgery during the neonatal perio...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90442-n
更新日期:1993-11-01 00:00:00
abstract::A patient who died of hepatic failure nearly 29 years after hepatic portojejunostomy is reported. His death may be attributed to several faults in treatment. From our experiences it can be said that biliary atresia is a curable disease, although liver-transplantation is required in some patients in whom hepato portoen...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(88)80441-x
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abstract::Fetuses can survive with complete airway obstruction caused by placental gas exchange until birth when full ventilatory function is required. The authors present a case in which prenatal scans suggested that adequate ventilation would not be achievable because of the presence of an intrathoracic tumor. An EXIT procedu...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.05.025
更新日期:2004-09-01 00:00:00
abstract::To minimize the risk of exsanguinating hemorrhage, the authors describe a technique of laparoscopic ligation of the median sacral artery before posterior sagittal resection of type I sacrococcygeal teratoma (SCT). Two female infants with antenatally diagnosed SCT underwent postnatal evaluation and preoperative imaging...
journal_title:Journal of pediatric surgery
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doi:10.1016/j.jpedsurg.2004.04.042
更新日期:2004-08-01 00:00:00
abstract::Data from 31 infants with gastrointestinal perforation were analyzed to determine the microorganisms usually present in the peritoneum and blood, and the antibiotic susceptibility of those organisms. Multimicrobial contamination of the peritoneal cavity was present in over one-half of the patients and 23% were found t...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(80)80775-5
更新日期:1980-08-01 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::Dysphagia and gastroesophageal reflux (GER) probably caused by structural disorganization of the esophagus occur frequently after repair of tracheoesophageal fistula (TEF), and the extent to which they may improve beyond childhood is not known. The aim of the present study is to assess by combined ambulatory 24-hour m...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90029-2
更新日期:1995-08-01 00:00:00
abstract::This report describes the surgical management of 2 children with fusiform choledochal cysts who had accessory hepatic ducts (AHD) identified during excisional surgery for fusiform choledochal cysts (CC). Two children presenting with a triad of recurrent jaundice, fever, and abdominal pain were investigated and found t...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.24767
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Guidelines for evaluating the cervical spine in pediatric trauma patients recommend cervical spine CT (CSCT) when plain radiographs suggest an injury. Our objective was to compare usage of CSCT between a pediatric trauma center (PTC) and referral general emergency departments (GEDs). METHODS:Patient data fr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.10.006
更新日期:2014-02-01 00:00:00
abstract::A cantaloupe-sized intrathoracic tumor destroying the eighth rib with a pleural effusion is ominous. This case of an aneurysmal bone cyst of a rib mimicking a malignant chest wall tumor was both interesting and instructive. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(77)90620-0
更新日期:1977-12-01 00:00:00
abstract:PURPOSE:In oncology practice, angioembolization has been reported for tumor reduction before surgery, treatment of life-threatening conditions, and for palliative care. Nevertheless, the overall experience with angioembolization for the treatment of tumors is limited. We report our experience in 7 nonvascular solid ped...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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更新日期:2009-09-01 00:00:00
abstract:PURPOSE:The aim of this study was to expand on our previous report of 115 patients after more than a decade-long experience using incision and loop drainage for pediatric subcutaneous abscess management. This report comprises the largest consecutive series of pediatric abscess patients from a single institution ever re...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.12.018
更新日期:2017-09-01 00:00:00
abstract::Small bowel atresia is associated with a large size discrepancy between the proximal and distal segments of bowel that has traditionally been managed by resection of the dilated segment, tapering enteroplasty, or plication. Longitudinal intestinal lengthening is rarely performed at the time of the initial operation. M...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.11.005
更新日期:2005-03-01 00:00:00