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 appendectomy. Although this strategy has become well accepted, there are no published data comparing initial nonoperative management (drainage/interval appendectomy) to appendectomy upon presentation with an abscess. Therefore, we conducted a randomized trial comparing these 2 management strategies. METHODS:After internal review board approval (#06 11-164), children who presented with a well-defined abdominal abscess by computed tomographic imaging were randomized on admission to laparoscopic appendectomy or intravenous antibiotics with percutaneous drainage of the abscess (when possible), followed by interval laparoscopic appendectomy approximately 10 weeks later. This was a pilot study with a sample size of 40, which was based on our recent volume of patients presenting with appendicitis and abscess. RESULTS:On presentation, there were no differences between the 2 groups regarding age, weight, body mass index, sex distribution, temperature, leukocyte count, number of abscesses, or greatest 2-dimensional area of abscess in the axial view. Regarding outcomes, there were no differences in length of total hospitalization, recurrent abscess rates, or overall charges. There was a trend toward a longer operating time in patients undergoing initial appendectomy (61 minutes versus 42 minutes mean, P = .06). CONCLUSIONS:Although initial laparoscopic appendectomy trends toward a requiring longer operative time, there seems to be no advantages between these strategies in terms of total hospitalization, recurrent abscess rate, or total charges.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
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 DJdoi
10.1016/j.jpedsurg.2009.10.039subject
Has Abstractpub_date
2010-01-01 00:00:00pages
236-40issue
1eissn
0022-3468issn
1531-5037pii
S0022-3468(09)00821-5journal_volume
45pub_type
杂志文章,随机对照试验abstract::Percutaneous aspiration and tetracycline sclerosis is a safe but temporary therapy of large splenic cysts in children. Between 1985 and 1987, three girls with splenic cysts were seen. Their ages ranged from 5 to 14 years, and the cysts were from 8 to 16 cm in diameter. Despite their large size, all were asymptomatic a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80711-0
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND/PURPOSE:Biliary anastomotic strictures (BAS) after left lateral segment liver transplantation (LLST) may cause graft dysfunction, sepsis, and patient mortality. A review of the authors' experience was performed to better characterize the risk factors and corrective management. METHODS:The medical records of...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.6932
更新日期:2000-06-01 00:00:00
abstract::We here report the clinical findings and management of 9 consecutive cases of chylothorax, 5 of which occurred spontaneously. One cases followed cardiac surgery. Three cases occurred in low-birth-weight, premature infants concurrently with other symptoms of the superior vena cava syndrome secondary to central intraven...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(80)80133-3
更新日期:1980-06-01 00:00:00
abstract::Branchial abnormalities constitute 32% to 45% of all neck pathologies in children. They may be a part of branchiootorenal (BOR) syndrome, which is characterized by branchial arch anomalies, preauricular pits, hearing impairment, and renal malformations. Typically, the management of a branchial fistula does not necessa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2008.10.034
更新日期:2009-03-01 00:00:00
abstract::During the period between 1974 and 1988 44 patients were treated for congenital intrinsic duodenal obstruction using a diamond-shaped anastomosis (35 atresias, including two multiple atresias and nine stenoses). Neither gastrostomy nor transanastomotic tube was used. Postoperatively, oral feeding was started on days 2...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90241-z
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Severe blunt hepatic injury in children is associated with a high mortality rate. Although nonoperative management has become the treatment of choice for mild to moderate liver trauma, there is no consensus as to the optimal treatment for the most severe hepatic injuries in children. METHODS:A statewide tra...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.24720
更新日期:2001-07-01 00:00:00
abstract::Most of inguinal masses in children correspond to inguinal indirect hernias, but other pathologic entities may be found. Dermoid cysts of the spermatic cord are very rare, with only 9 clear cases reported in the literature to date, all of them in adults. We present a case of dermoid cyst of the spermatic cord in a 2-y...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2010.05.007
更新日期:2010-10-01 00:00:00
abstract::Pilomatrixoma is a benign tumor of hair follicles that usually occurs as a single tumor and appears in the head and neck region, extremities, and trunk. The authors present a case of pilomatrixoma with multifocal localization. Simple excision of lesions is the recommended procedure, and recurrence usually is rare. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.34496
更新日期:2002-08-01 00:00:00
abstract:PURPOSE:The aim of this study was to investigate the prenatal courses and management of abdominal surgical diseases. METHODS:Of the 327 patients registered with our fetal treatment board since March 2002, 83 fetuses referred to the surgical department were enrolled for the current study. The prenatal diagnosis, sequen...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.08.039
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:In the absence of robust data from low- and middle-income countries (LMICs), most disease burden estimates and related resource allocation choices are based on historic Northern demographics. We hypothesize that significant discrepancies exist between directly reported LMIC data and surrogate high-income cou...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.01.034
更新日期:2019-05-01 00:00:00
abstract::The prevalence and type of life-threatening complications related to the minimally invasive repair of pectus excavatum (MIRPE) and bar removal are unknown and underreported. The purpose of this communication is to make surgeons aware of the risk of these life threatening complications as well as the modifications whic...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2017.07.020
更新日期:2018-04-01 00:00:00
abstract:PURPOSE:While obesity is associated with increased mortality and decreased functional outcomes in adult burn patients, the ramifications of larger than average body size in the pediatric burn population are less well understood. The present study examines whether obesity was associated with poor outcomes following pedi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.07.012
更新日期:2014-03-01 00:00:00
abstract::The authors report on an infant who had a multiloculated cystic lesion located in segment IV of the liver, consistent with Caroli's disease diagnosed, by routine prenatal ultrasound at 25 weeks' gestation, and confirmed by hepatobiliary HIDA scan and computed tomography soon after birth. Because there was no sign of b...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.9349
更新日期:2000-09-01 00:00:00
abstract::This study reviews our experience from 1977 to 1991 with 32 children born with esophageal atresia and tracheoesophageal fistula (EA-TEF) who later underwent surgery for severe tracheomalacia. Indications for surgery included dying spells (21), inability to extubate the airway (nasotracheal tube 5, tracheotomy 3), and ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90575-r
更新日期:1992-08-01 00:00:00
abstract::This study was conducted to investigate the newborn's response to surgical trauma. Ten newborns and 10 infants as a control group undergoing similar surgical procedures were studied. All patients had moderate surgical stress, and there was no difference between the groups regarding the degree of surgical trauma. Alter...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90147-7
更新日期:1995-04-01 00:00:00
abstract::Internal sphincteric function was studied manometrically in 19 children with translevator anal anomalies. The normal internal sphincter inhibitory response to rectal distension was present in ten pateints, attenuated in six, and absent in three. Our findings suggest that a functional internal sphincter is usually pres...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(76)80011-5
更新日期:1976-08-01 00:00:00
abstract::From 1964 to 1985 inclusive, gastric tubes have been constructed in 36 infants and children to replace a congenitally defective esophagus or an esophagus with acquired irreparable damage. This report reviews our entire series to date covering a 21-year experience. There were 24 boys and 12 girls ranging in age from 3 ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80021-0
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:The aim of this study was to compare the size of the right internal jugular vein between neonates with congenital diaphragmatic hernia (CDH) who need extracorporeal membrane oxygenation (ECMO) and non-CDH neonates. The purpose also was to describe a method for cannulation of the right brachiocephalic...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1053/jpsu.2002.32908
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND/PURPOSE:The purpose of this study is to describe the prenatal findings and postnatal outcomes of fetuses with axillary lymphatic malformations. METHODS:Retrospective chart review of fetuses with the prenatal diagnosis of isolated axillary lymphatic malformation detected between 2009 and 2013. RESULTS:There...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.03.066
更新日期:2015-10-01 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:BACKGROUND/PURPOSE:The management of neonates with giant omphalocele remains challenging and multiple strategies have been described. We present the case of a 34-week-old neonate with isolated giant omphalocele managed with an external surgical skin closure system as a component of a staged closure strategy. CASE PRES...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.05.004
更新日期:2010-07-01 00:00:00
abstract:PURPOSE:We sought to determine optimal timing for CPAM resection within the first year of life. METHODS:We queried the National Surgical Quality Improvement Program pediatric database from 2012 to 2015 for elective CPAM resections on patients less than 1year of age. Patients were divided by age in months: 1-3 (n=57), ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.02.032
更新日期:2018-05-01 00:00:00
abstract::Metabolic alkalosis is regarded as the "classical" electrolyte abnormality occurring with hypertrophic pyloric stenosis (HPS) but recent experience suggests that atypical electrolyte findings frequently occur and delay establishing the correct diagnosis. The records of 65 infants with HPS treated by pyloromyotomy duri...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80188-2
更新日期:1983-08-01 00:00:00
abstract::Pneumothorax is a common complication of ventilator therapy and usually responds to tube thoracostomy. Persistent pneumothorax with a large air leak may indicate the presence of a bronchopleural fistula (mean weight 1360 g) with (BPF) required FIO2 of 1.0, a peak inspiratory pressure of 33 cm H2O and were hypoxemic (x...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(80)80746-9
更新日期:1980-08-01 00:00:00
abstract:BACKGROUND/PURPOSE:Synoptic, or standardized, reporting of surgery and pathology reports has been widely adopted in surgical oncology. Patients with Hirschsprung disease may experience morbidity related to surgical factors or underlying pathology and often undergo multiple operations. Our aim is to improve the postoper...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2019.03.010
更新日期:2019-10-01 00:00:00
abstract::Two large bladder diverticula that induced severe micturition disturbances were surgically removed in a 5-year-old boy with Ehlers-Danlos syndrome (EDS). One year after surgery, a new, asymptomatic diverticulum developed. This case is discussed in the light of nine similar cases that have already been published. It is...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/s0022-3468(89)80115-0
更新日期:1989-11-01 00:00:00
abstract:PURPOSE:The aim of this study was to determine how to manage children with recurrence of intussusception. METHODS:Medical records of patients treated for intussusception from 1976 to 2008 at the Queen Sirikit National Institute of Child Health were reviewed. Information on patients who developed recurrent intussuscept...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.07.029
更新日期:2010-11-01 00:00:00
abstract::The management of 108 patients with posterior urethral valves from 7 pediatric surgical centers has been reviewed. All the patients have been treated in the 10 year period since 1970. 53 were under 3 mo of age at presentation (Group I), 8 between 3 mo and 1 yr (Group II), 22 between 1 and 5 yr (Group III), and 25 over...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80276-0
更新日期:1983-02-01 00:00:00
abstract:PURPOSE:Congenital midureteric strictures (CMUS) are an uncommon cause of obstructive uropathy. There are only a few case reports of laparoscopic management of CMUS. We present our experience with laparoscopic repair of CMUS in 7 children. PATIENTS AND METHODS:The records of all children (n=7, 5 infants) undergoing la...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.07.013
更新日期:2015-11-01 00:00:00
abstract::Chronic idiopathic intestinal pseudoobstruction (CIIP) is a disorder of alimentary tract motility with onset of symptoms in adolescence or young adulthood, characterized by recurring attacks of abdominal pain, distention, vomiting, and constipation often leading to malnutrition and death. Starting with an adolescent p...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(79)80253-5
更新日期:1979-12-01 00:00:00