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. METHODS:Patients from 2 different periods (period 1, 99 consecutive children [group 1] and period 2, 62 consecutive children [group 2] with suspected appendicitis) were prospectively evaluated. Variables predicting appendicitis were obtained from group 1. By means of a regression analysis, a scoring system was created and applied to the patients of group 2. Missed appendicitis and negative appendectomy rates obtained by clinical practice were compared with the results that would have been accomplished based on the scoring system. Thereafter, the scoring system was externally validated in a group of children presented at another hospital (group 3, n = 114). RESULTS:The variables, leukocyte count > or = 10.10(9)/L (2 points); rebound tenderness (2 points); and temperature > or = 38 degrees C (1 point) correlated significantly with appendicitis. The scoring system was used to categorize patients into 3 groups: appendicitis unlikely, doubtful appendicitis, and suspected appendicitis. The specificity and sensitivity of the scoring system were, respectively, 85% and 89%. Applying the scoring system would lead to comparable negative appendectomy rates of 8% versus 6% using clinical judgement and a comparable number of performed laparoscopies (26% v 31%). However, it could lead to a lower missed appendicitis rate (1% v 6%) and a lower perforation rate (0% v 11%). External validation showed comparable performed laparoscopies (32%) and missed appendicitis (2%) rates but a higher negative appendectomy rate (19%), probably owing to a lower percentage of appendicitis in hospital (2, 47%) compared with hospital (1, 71%). CONCLUSIONS:Children can be observed if leukocyte count is less than 10.10(9)/L and rebound tenderness is absent; a diagnostic laparoscopy should be performed if one of these is present, and if both are present one could perform an appendectomy.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
van den Broek WT,van der Ende ED,Bijnen AB,Breslau PJ,Gouma DJdoi
10.1016/j.jpedsurg.2003.12.015subject
Has Abstractpub_date
2004-04-01 00:00:00pages
570-4issue
4eissn
0022-3468issn
1531-5037pii
S0022346803009369journal_volume
39pub_type
杂志文章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
更新日期:2012-06-01 00:00:00
abstract::An 8-month-old boy was found to have a solitary hepatic mesenchymal hamartoma. Histologically, the lesion appeared as a large island of loose mesenchymal tissue with few cystic bile ducts and liver cells. Electronmicroscopy showed microvilli on the surface of tumor cells and desmosomes between the cells. Immunohistoch...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(84)80197-9
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:The American College of Surgeons Committee on Trauma (ACS-COT) view over- and undertriage rates based on trauma team activation (TTA) criteria as surrogate markers for quality trauma patient care. Undertriage occurs when classifying patients as not needing a TTA when they do. Over-triage occurs when a TTA is...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpedsurg.2016.04.010
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:The intrahepatic gallstone is known as one of the complications of choledochal cyst. Stenosis of the hepatic duct may contribute to the formation of the stone. This report describes concurrent congenital stenosis of the hepatic duct identified during the primary operation of choledochal cyst. METHODS:Fourte...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.06.011
更新日期:2009-03-01 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::A 10-month-old boy was noted to have hepatomegaly, and hepatic angiography showed a huge tumor of the medial segment of the left lobe, located close to the hepatic hilum and involving the anterior segment of the right lobe in contiguity. We considered at first that resection would not be possible, but at operation the...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80109-5
更新日期:1989-11-01 00:00:00
abstract::Of 156 children undergoing elective inguinal herniotomy under general anesthesia, 81 also had a regional nerve block using Bupivacaine. All were treated as outpatients and recovery was assessed by postanesthetic room nurses and by interrogating the parents as to the child's behavior at home. It was concluded that the ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(80)80757-3
更新日期:1980-08-01 00:00:00
abstract:PURPOSE:Delayed gastric emptying (DGE) as indicated by preoperative gastric emptying scan (GES) is one rationale for performing a gastric emptying procedure (GEP) at time of fundoplication for gastroesophageal reflux disease (GERD). However, the role of GES and GEP in the surgical management of GERD remains unclear. We...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.10.077
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Recently, concerns have been raised over delays that result from transferring patients to designated trauma centers. This study aimed to assess whether transfer status had an impact on pediatric trauma outcomes. METHODS:Using a local 1996-2014 pediatric trauma database containing 1541 patients, the followin...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.02.035
更新日期:2016-05-01 00:00:00
abstract:PURPOSE:The aim of this study was to report the clinical presentation, mode of diagnosis, and treatment of patients with anterior urethral valves (AUV), a rare congenital anomaly causing infravesical obstruction in children. METHODS:Three patients with anterior urethral valves were admitted in the Pediatric Urology Un...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.0350556
更新日期:2000-04-01 00:00:00
abstract::Esophageal resection or replacement has become the standard therapy for severe esophageal strictures chiefly because less aggressive methods generally have failed. We hereby report our experience with 12 consecutive infants and children who have been managed successfully by means of Stamm gastrostomy and string-guided...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80529-9
更新日期:1989-08-01 00:00:00
abstract::The hormonal responses to surgical stress in adults are well characterized. We hypothesized that children have age-related differences in the "stress responses" to surgery. To test this hypothesis we prospectively studied 98 children (aged 2 to 20 years) undergoing elective surgical procedures under general anesthesia...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(05)80343-4
更新日期:1993-01-01 00:00:00
abstract::Primitive neuroectodermal tumors (PNETs) are uncommon, representing approximately 1% of all sarcomas. Pancreatic PNETs have been reported only 12 times in the literature. This report presents the first case of a patient with a PNET exhibiting precocious puberty. The clinical presentation, surgical management, and path...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.05.046
更新日期:2006-11-01 00:00:00
abstract::MURCS association is rare, first described by Duncan in 1979, including nonrandom association of Mullerian duct aplasia or hypoplasia (MU), renal agenesis or ectopy (R), and cervicothoracic somite dysplasia. A 5-year-old girl was admitted to the clinic with a complaint of anteriorly located anus. Physical and radiolog...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2003.50060
更新日期:2003-02-01 00:00:00
abstract:AIM:Even with prompt diagnosis and treatment, testicular torsion may lead to infertility and atrophy after testicular salvage. The aims of this study were to investigate the long-term protective effects of short-interval postconditioning on testicular atrophy and to optimize the reperfusion period. MATERIALS AND METHO...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.10.070
更新日期:2012-04-01 00:00:00
abstract::A 15-year-old girl had massive watery and protein-losing diarrhea. She was found to have a pancreatic islet cell tumor secreting high levels of vasoactive intestinal polypeptide. Eighty-five percent pancreatic resection was needed to remove the tumor. She has normal serum VIP levels and no tumor recurrence 6 years lat...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(86)80116-6
更新日期:1986-11-01 00:00:00
abstract::Injuries of the popliteal artery have the highest rate of limb loss compared with other peripheral vascular injuries. Particularly, blunt popliteal artery trauma is known to be associated with a high rate of amputation. Traumatic vascular injuries are usually associated with dislocations and fractures. We describe the...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.03.046
更新日期:2012-06-01 00:00:00
abstract::Whole bowel irrigation was used in 24 patients ages 8 to 17 yr, mean 13 yr, in preparation for colonoscopy (18), colon surgery (2), therapeutic irrigation for treatment of drug overdose (2), and constipation (2). An average of 9 liters warm, normal saline with added KCL (5 mEq/liter) was infused through a nasogastric ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(82)80486-7
更新日期:1982-08-01 00:00:00
abstract::Preoperative transfusion therapy is largely responsible for the recently improved morbidity and mortality in patients with sickle cell anemia undergoing surgery. The transfusion techniques recommended are several. Fifty patients have undergone 67 operations over the past 15 yr. The complications encountered in patient...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(81)80683-5
更新日期:1981-06-01 00:00:00
abstract:BACKGROUND:The continually rising incidence of soft tissue abscesses in children has prompted us to seek an alternative to the traditional open incision and drainage (I&D) that would minimize the pain associated with packing during dressing changes and eliminate the need for home nursing care. STUDY DESIGN:A retrospec...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.08.019
更新日期:2011-03-01 00:00:00
abstract::The occurrence of malignant schwannoma in children is rare. A search of English language literature did not reveal involvement of cranial nerve among children. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(86)80090-2
更新日期:1986-11-01 00:00:00
abstract::Necrotizing enterocolitis (NEC) is a serious condition affecting predominantly the premature infant. The purpose of this study is to report a multicenter experience of complications in 252 infants requiring surgical therapy for NEC. Data from eight institutions for the years 1980 through 1990 were collected and analyz...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/0022-3468(95)90328-3
更新日期:1995-07-01 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
abstract:INTRODUCTION:Umbilical mesenchymal stem cells (USC) have been shown to reduce illness in animal models of necrotizing enterocolitis (NEC), possibly through the paracrine release of hydrogen sulfide (H2S). We hypothesized that animals treated with USCs with inhibited H2S synthesis would exhibit more severe disease. MET...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.02.037
更新日期:2019-06-01 00:00:00
abstract:INTRODUCTION:The purpose of this study is to examine the scientific program of the Canadian Association of Pediatric Surgeons (CAPS) to determine if the quality of research has improved. METHODS:CAPS abstracts from 2010 to 2013 were reviewed by two independent researchers. Presentation type, study design, and level of...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2015.02.045
更新日期:2015-05-01 00:00:00
abstract:AIMS:To outline the use of radiological investigations in patients with congenital portosystemic shunts (CPS) and to assess the degree of portal venous deprivation in relation to the development of liver tumors. METHODS:Single center retrospective cohort study of all patients with CPS referred from 1990 to 2016. Radio...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.05.027
更新日期:2020-04-01 00:00:00
abstract::Gastrointestinal manifestations of collagen diseases are very rare. The authors report on a patient who has features of Marfan syndrome with mobile liver caused by the absence of its suspensory ligaments. This patient presented with an acute intestinal obstruction secondary to a congenital band across the distal trans...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90136-7
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND/PURPOSE:Microgastria and postgastrectomy morbidities are substantial. The authors hypothesized a functional living tissue-engineered stomach could function as a replacement alternative. METHODS:Stomach organoid units, mesenchymal cores surrounded by epithelia, were isolated from neonatal and adult rats and ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(03)00386-5
更新日期:2003-09-01 00:00:00
abstract::The authors report a case of neuronal intestinal dysplasia in a 6-year-old girl. The disease is characterized by hyperplastic ganglia throughout the large and small intestine, associated with severe constipation. To better understand the pathophysiology of this disease the authors investigated the histopathologic, ult...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90124-4
更新日期:1993-12-01 00:00:00
abstract::Since 1982 we have developed a diagnostic method for differentiation between atretic prolonged obstructive jaundice (biliary atresia) and nonatretic prolonged obstructive jaundice in a neonate. The first report was presented at the Fukuoka Meeting in 1983. Analysis of duodenal juice (excretion test of intravenous inje...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(05)80024-7
更新日期:1990-07-01 00:00:00