Management of pediatric splenic injuries in Canada.


PURPOSE:Nonoperative management (NOM) of blunt splenic injuries has become the standard of care in hemodynamically stable children. This study compares the management of these injuries between pediatric and nonpediatric hospitals in Canada. METHODS:Data were obtained from the Canadian Institute of Health Information trauma database on all patients aged 2 to 16 years, admitted to a Canadian hospital with a diagnosis of splenic injury between May 2002 and April 2004. Variables included age, sex, associated major injuries, splenic procedures, intensive care unit (ICU) admissions, blood transfusions, and length of stay. Hospitals were coded as pediatric or nonpediatric. Univariate analysis and logistic regression were used to determine associations between hospital type and outcomes. RESULTS:Of 1284 cases, 654 were managed at pediatric hospitals and 630 at nonpediatric centers. Patients at pediatric centers tended to be younger and more likely to have associated major injuries. Controlling for covariates, including associated major injuries, patients managed at pediatric centers were less likely to undergo splenectomy compared with those managed at nonpediatric centers (odds ratio [OR], 0.2; 95% confidence interval, 0.1-0.4). The risk of receiving blood products, admission to the ICU, and staying in hospital for more than 5 days was associated only with having associated major injuries. CONCLUSION:Even in the presence of other major injuries, successful NOM of blunt splenic injuries occurs more frequently in pediatric hospitals in Canada. This has policy relevance regarding education of adult surgeons about the appropriateness of NOM in children and developing guidelines on appropriate regional triaging of pediatric patients with splenic injury in Canada.


J Pediatr Surg


McDonald LA,Yanchar NL




Has Abstract


2012-03-01 00:00:00














  • Unilateral leg edema caused by abdominoscrotal hydrocele: elegant diagnosis by MRI.

    abstract::A 5-month-old boy presented with bilateral hydroceles since birth and right leg edema. An ultrasound of the pelvis showed a 4-cm cystic mass that was diagnosed as a teratoma or cystic hygroma. Magnetic resonance imaging was performed, which showed a dumbbell shaped contiguous, fluid filled mass extending intraabdomina...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章,评审


    authors: Krasna IH,Solomon M,Mezrich R

    更新日期:1992-10-01 00:00:00

  • Usefulness of echocardiographic measurement of bilateral pulmonary artery dimensions in congenital diaphragmatic hernia.

    abstract::In nine patients with left-sided congenital diaphragmatic hernia (CDH) developing within 24 hours of birth, the authors measured the dimensions of the bilateral main pulmonary arteries by echocardiography, and investigated whether the left:right main pulmonary artery dimension ratio (PAD ratio) was a useful index for ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Hasegawa S,Kohno S,Sugiyama T,Sato Y,Seki S,Yagyu M,Saito A

    更新日期:1994-05-01 00:00:00

  • Presentation and management of epigastric hernias in children.

    abstract:BACKGROUND/PURPOSE:Although epigastric hernias are common, there are no reports that describe the presentation and treatment of these defects in children. The authors reviewed their experience with these hernias to develop recommendations for their management in this age group. METHODS:Medical records were reviewed fo...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Coats RD,Helikson MA,Burd RS

    更新日期:2000-12-01 00:00:00

  • Nectotizing enterocolitis: is there a place for resection and primary anatomosis?

    abstract::While most situations of peritonitis, perforation and compromised blood flow in necrotizing enterocolitis are best handled by resection and stoma formation, primary resection and anastomosis should be considered in selected cases. Nine premature infants with NEC underwent bowel resection with primary anastomosis in th...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Kiessewetter WB,Taghizadeh F,Bower RJ

    更新日期:1979-06-01 00:00:00

  • Appendiceal carcinoid tumor with lymph node metastasis in a child: case report and review of the literature.

    abstract::Most appendiceal carcinoids (ACs) in children present without lymph node metastasis. Lymph node metastasis is rarely present when primary tumor diameter exceeds 1 cm. We present the extraordinary case of an AC with a primary tumor diameter of 0.7 cm and infiltration of the mesentery, as well as 1 positive lymph node o...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Cernaianu G,Tannapfel A,Nounla J,Gonzalez-Vasquez R,Wiesel T,Tröbs RB

    更新日期:2010-11-01 00:00:00

  • An unusual case of small bowel obstruction in a child caused by ingestion of water-storing gel beads.

    abstract::Foreign body ingestion occurs most commonly in the pediatric population. Small bowel obstruction is a rare complication that can occur, and surgical intervention is required. We present the first report of a case of an 18-month-old child with a jejunal obstruction caused by ingestion of water-storing gel beads used fo...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Moon JS,Bliss D,Hunter CJ

    更新日期:2012-09-01 00:00:00

  • Pediatric gastric adenocarcinoma: A National Cancer Data Base review.

    abstract:PURPOSE:We sought to compare the presentation, management, and outcomes in gastric adenocarcinoma cancer for pediatric and adult patients. METHODS:Using the 2004 to 2014 National Cancer Database (NCDB), patients ≤21 years (pediatric) were retrospectively compared to >21 years (adult). Chi-squared tests were used to co...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Tessler RA,Dellinger M,Richards MK,Goldin AB,Beierle EA,Doski JJ,Goldfarb M,Langer M,Nuchtern JG,Raval MV,Vasudevan S,Gow KW

    更新日期:2019-05-01 00:00:00

  • Iatrogenic esophageal perforation in children: patterns of injury, presentation, management, and outcome.

    abstract::Iatrogenic esophageal perforations in children are rare. To evaluate patterns of injury, clinical presentation, and treatment options for such patients, the authors reviewed the case records of 11 children who had sustained transmural injury to the esophagus during a dilatation procedure at their institution between 1...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Panieri E,Millar AJ,Rode H,Brown RA,Cywes S

    更新日期:1996-07-01 00:00:00

  • Erythropoietin restores bowel damage and hypoperistalsis in gastroschisis.

    abstract:BACKGROUND AND PURPOSE:Despite the decreased mortality in gastroschisis (Gx), patients experience postoperative intestinal hypoperistalsis, malabsorption, and shortened bowel length. The trophic effects of recombinant human erythropoietin (rEpo) in the developing small bowel have been reported, increasing the length an...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Ozdamar A,Topcu K,Gumustekin M,Gurel D,Gelal A,Ozer E,Ucan B,Temir G,Karkiner A,Karaca I,Hosgor M

    更新日期:2006-02-01 00:00:00

  • Treatment of postoperative tracheal granulation tissue with inhaled budesonide in congenital tracheal stenosis.

    abstract:PURPOSE:Tracheal obstruction by granulation tissue can compromise the postoperative course in congenital tracheal stenosis (CTS). Balloon dilatation and stenting may be required. Budesonide is a corticosteroid with topical anti-inflammatory effects. In 2008, we used inhaled budesonide for treatment of postoperative gra...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Yokoi A,Nakao M,Bitoh Y,Arai H,Oshima Y,Nishijima E

    更新日期:2014-02-01 00:00:00

  • Restorative proctocolectomy in children and adolescents.

    abstract::Children and adolescents with colitis present specific problems for surgeons. There has been a fashion, particularly in North America, for restoring continuity after colectomy by a direct ileo-anal anastomosis. The authors reviewed their experience with restorative proctocolectomy with ileal reservoir (RPC) in patient...

    journal_title:Journal of pediatric surgery

    pub_type: 临床试验,杂志文章


    authors: Romanos J,Stebbing JF,Mortensen NJ,Kettlewell MG

    更新日期:1996-12-01 00:00:00

  • Embryogenesis of triple neural tube defects: sonic hedgehog--a key?

    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


    authors: Mahalik SK,Vaze D,Lyngdoh TS,Tewari MK,Narasimhan KL

    更新日期:2011-02-01 00:00:00

  • Long-term follow-up of patients with high-risk congenital diaphragmatic hernia.

    abstract:BACKGROUND/PURPOSE:Recent advances including prenatal diagnosis, high-frequency oscillatory ventilation, and nitric oxide inhalation therapy have gradually improved the survival of high-risk congenital diaphragmatic hernia. However, the factors affecting the long-term outcome of these patients have not been well establ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Kamata S,Usui N,Kamiyama M,Tazuke Y,Nose K,Sawai T,Fukuzawa M

    更新日期:2005-12-01 00:00:00

  • The evolution of the serial transverse enteroplasty for pediatric short bowel syndrome at a single institution.

    abstract:PURPOSE:The serial transverse enteroplasty (STEP) tapers and lengthens the gut to improve adaptation. Mortality has decreased with multidisciplinary intestinal rehabilitation programs (IRP) allowing more time to reach adaptive potential. We reviewed our STEP experience to compare surgical outcomes between early and lat...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Fitzgerald K,Muto M,Belza C,De Silva N,Avitzur Y,Wales PW

    更新日期:2019-05-01 00:00:00

  • The EXIT procedure: experience and outcome in 31 cases.

    abstract:BACKGROUND:The EXIT (ex utero intrapartum treatment) procedure, although initially designed for reversal of tracheal occlusion in fetuses with congenital diaphragmatic hernias (CDH), has been adapted to treat a variety of fetal conditions. METHODS:A retrospective chart review of all consecutive EXIT procedures since 1...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Bouchard S,Johnson MP,Flake AW,Howell LJ,Myers LB,Adzick NS,Crombleholme TM

    更新日期:2002-03-01 00:00:00

  • Swallowing disorders after esophageal atresia evaluated with videomanometry.

    abstract:BACKGROUND:Patients with repaired esophageal atresia often show persistent motility disorders of the esophagus. METHODS:In this study, the authors used a newly developed method, videomanometry, to study intraluminal pressures and function of the pharynx and upper esophagus in such a group of patients and compared the ...

    journal_title:Journal of pediatric surgery

    pub_type: 临床试验,杂志文章


    authors: Montgomery M,Witt H,Kuylenstierna R,Frenckner B

    更新日期:1998-08-01 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


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

    更新日期:1993-07-01 00:00:00

  • Fetal hydronephrosis: selection and surgical repair.

    abstract::Newly developed diagnostic techniques allowed us to select a fetus with potentially reversible renal damage from the usually fatal group with bilateral hydronephrosis and severe oligohydramnios early in gestation. Fetal surgery to marsupialize the fetal bladder at 24 weeks gestation restored normal amniotic fluid dyna...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Harrison MR,Golbus MS,Filly RA,Anderson RL,Flake AW,Rosen M,Huff RW

    更新日期:1987-06-01 00:00:00

  • Serum and erythrocyte acetylcholinesterase activity in Hirschsprung's disease.

    abstract::Acetylcholinesterase activity was measured in the serum and erythrocytes from 22 children. The 12 patients in whom the diagnosis of Hirschsprung's disease was confirmed, had a significantly higher concentration of enzyme in both serum and erythrocytes than the 10 children in whom the diagnosis was excluded. This syste...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Boston VE,Cywes S,Davies MR

    更新日期:1978-08-01 00:00:00

  • Idiopathic small bowel diaphragm disease identified by laparoscopic-assisted double-balloon enteroscopy in a child: an integrated successful definitive therapeutic method.

    abstract::In adults, small bowel diaphragm disease is a rare complication of small bowel enteropathy secondary to the use of nonsteroidal antiinflammatory drugs. The main clinical manifestations are gastrointestinal bleeding and subacute obstruction, and management can be challenging. We present a case of a 5-year-old girl with...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Soccorso G,Sarkhy A,Lindley RM,Marven SS,Thomson M

    更新日期:2012-08-01 00:00:00

  • Approach to cervicothoracic neuroblastomas via a trap-door incision.

    abstract::Neuroblastomas located in the apex of the hemithorax or in the lower cervical region may make complete resection via a cervical or a thoracic approach difficult. The authors recently managed two patients with cervicothoracic neuroblastomas through an approach using the trap-door incision often applied in the setting o...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Pranikoff T,Hirschl RB,Schnaufer L

    更新日期:1995-04-01 00:00:00

  • Acute acalculous cholecystitis as the initial presentation of primary Epstein-Barr virus infection.

    abstract::The case of a 13-year-old girl with primary Epstein-Barr virus (EBV) infection and concomitant cholestatic hepatitis, which initially presented as acute acalculous cholecystitis (AAC), is described. The diagnosis of AAC was documented by clinical and ultrasonographic criteria, whereas acute EBV infection was confirmed...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Prassouli A,Panagiotou J,Vakaki M,Giannatou I,Atilakos A,Garoufi A,Papaevangelou V

    更新日期:2007-01-01 00:00:00

  • Gastrostomy tube placement in infants and children: is there a preferred technique?

    abstract:PURPOSE:Advances in percutaneous endoscopic gastrostomy (PEG) and laparoscopic (LAP) techniques, including LAP-assisted PEG, offer alternatives to the standard open gastrostomy technique. This study compares the outcomes of the PEG and LAP techniques. METHODS:All gastrostomy tube placements were reviewed at our instit...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Akay B,Capizzani TR,Lee AM,Drongowski RA,Geiger JD,Hirschl RB,Mychaliska GB

    更新日期:2010-06-01 00:00:00

  • Management of breast lesions in children and adolescents.

    abstract::The records of 207 patients evaluated and treated for breast abnormalities during a 10-yr period were reviewed. Patients ranged in age from 1 wk through 16 yr. Seventy-eight per cent were female. Operative procedures were performed in 134 patients (64%). Most common diagnoses were fibroadenoma, premature thelarche, an...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Bower R,Bell MJ,Ternberg JL

    更新日期:1976-06-01 00:00:00

  • Subcutaneous entomophthoromycosis mimicking soft-tissue sarcoma in children.

    abstract:AIM:Subcutaneous entomophthoromycosis (EM) is an uncommon fungal infection of childhood. This article is intended to draw the attention of pediatric surgeons to the fact that EM can mimic soft-tissue tumor. METHODS:It is a retrospective review of 16 children treated for subcutaneous EM between 2000 and 2013. RESULTS:...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Raveenthiran V,Mangayarkarasi V,Kousalya M,Viswanathan P,Dhanalakshmi M,Anandi V

    更新日期:2015-07-01 00:00:00

  • Fetal and neonatal rhabdoid tumor.

    abstract:PURPOSE:Few studies have focused on the behavior of rhabdoid tumor (RT) in the fetus and neonate. The purpose of this review is to show that perinatal RTs are associated with unusual findings and a poor prognosis. METHODS:The author conducted a 40-year systematic review of the literature. Clinical presentation, pathol...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章,评审


    authors: Isaacs H Jr

    更新日期:2010-03-01 00:00:00

  • Single umbilical artery and the VATER-animal model.

    abstract:BACKGROUND/PURPOSE:Vascular disruption is recognized as a cause of congenital malformations. The authors analyzed the significance of single umbilical artery (SUA) in the Adriamycin-animal model to find out if it was associated with organ malformations. METHODS:Pregnant SD rats were injected with Adriamycin intraperit...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Merei JM

    更新日期:2003-12-01 00:00:00

  • Alternative method for repair of the difficult infant hernia.

    abstract:BACKGROUND:Inguinal hernia repair in the small infant is often technically difficult. An alternative operative approach has been developed that can simplify troublesome repairs, while decreasing the potential risks of damage to cord structures and of recurrence. METHODS:Thirteen small infants (weight 1400-3000 grams) ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Applebaum H,Bautista N,Cymerman J

    更新日期:2000-02-01 00:00:00

  • Lung abscess: an unusual presentation of congenital tracheoesophageal fistula without atresia.

    abstract::Tracheoesophageal fistula (TEF) without atresia is rare and usually presents with symptoms from birth. In this report, a 9-year-old boy presented with productive cough of 4 month's duration and was shown to have a right lung abscess seen on chest radiograph. His parents denied earlier respiratory symptoms or illnesses...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Quah BS,Indudharan R,Hashim I,Simpson H

    更新日期:1998-12-01 00:00:00

  • Robotic versus laparoscopic ipsilateral uretero-ureterostomy for upper urinary tract duplications in the pediatric population: A multi-institutional review of outcomes and complications.

    abstract:OBJECTIVE:To review and compare robotic ipsilateral uretero-ureterostomy (RIUU) and laparoscopic ipsilateral uretero-ureterostomy (LIUU) in terms of safety, efficacy, and outcomes. MATERIALS AND METHODS:A retrospective chart review, including all pediatric patients who underwent RIUU and LIUU at 5 different medical ce...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Chertin L,Neeman BB,Stav K,Noh PH,Koucherov S,Gaber J,Zisman A,Chertin B,Dubrov V,Bondarenko S,Neheman A

    更新日期:2021-01-07 00:00:00