Abstract:
BACKGROUND/PURPOSE:The aim of this study was to determine if the presence of "blush" (an indication of active bleeding) on abdominal CT in children with blunt liver injury adversely affected their clinical outcome as has been reported in adults. METHODS:The authors reviewed the records of 105 children ages 1 to 16 years with blunt liver injury seen on admission IV contrast CT seen over a 6-year period. Demographic characteristics measured were age, mechanism of injury, and injury severity score (ISS). Clinical outcomes included ICU stay, hospital length of stay (LOS), transfusion requirement (milliliters per kilogram), operations performed, and mortality rate. CT scans were evaluated retrospectively by a radiologist blinded to prior reports, for a "blush" and grade of liver injury. No patient underwent arterial embolization. The authors eliminated children with grade I-II injuries (30 patients), because only one had a blush, and analyzed the 75 patients with severe liver injuries (grades III-V). Those patients without a blush (n = 53) seen on CT were the control group, whereas patients with a blush (n = 22) were the study group. Data were analyzed using the Fisher's Exact and Mann-Whitney U test. The level of significance was set at.05. RESULTS:Patients with a blush had a significantly larger transfusion requirement (17.3 +/- 30.5 mL/kg v 5.0 +/- 10.9 mL/kg; P =.02) and mortality rate (23% v 4%; P =.02), but the ISS also was significantly greater (25.8 +/- 14.5 v 17.5 +/- 12.2; P =.019). All other data were similar between the 2 groups. CONCLUSIONS:Children with a blush seen on abdominal CT after blunt liver injury have higher transfusion requirements and greater risk of mortality than those without blush. Mortality is primarily related to the severity of their other injuries.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Eubanks JW 3rd,Meier DE,Hicks BA,Joglar J,Guzzetta PCdoi
10.1053/jpsu.2003.50109subject
Has Abstractpub_date
2003-03-01 00:00:00pages
363-6; discussion 363-6issue
3eissn
0022-3468issn
1531-5037pii
S0022346802631173journal_volume
38pub_type
杂志文章,评审abstract:BACKGROUND/PURPOSE:Abdominal compartment syndrome (ACS) is the cardiac, pulmonary, and renal dysfunction that occurs as a result of elevated intraabdominal pressure. The authors present their experience with patch abdominoplasty (PA) in pediatric patients as a means to treat and prevent ACS. METHODS:The charts of pati...
journal_title:Journal of pediatric surgery
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doi:10.1053/jpsu.2000.6027
更新日期:2000-05-01 00:00:00
abstract::Primary laparoscopic repair of Morgagni-Larrey hernia has been described in adult patients but not in children. This is the first report of primary laparoscopic correction in the pediatric age group without using a prosthesis. A Morgagni-Larrey hernia was found incidentally in a 3-year-old-girl. Laparoscopic correctio...
journal_title:Journal of pediatric surgery
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abstract::The distribution and localization of neurofilament (NF) and microtubule-associated tau protein (Tau) in the colon from Hirschsprung's disease were examined by immunohistochemistry. Specimens of the normoganglionic, oligoganglionic, and aganglionic segments of colons from nine patients with Hirschsprung's disease were ...
journal_title:Journal of pediatric surgery
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doi:10.1016/0022-3468(93)90688-h
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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
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doi:10.1016/j.jpedsurg.2008.06.011
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abstract::To determine whether the current "gatekeeper" controls on health care lead to an increase in treatment delay and morbidity of acute appendicitis in children, we reviewed the experience with this disease at a large children's hospital over a 10-year period. One hundred seven consecutive children 18 years and younger op...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90225-a
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:Failure of the gut barrier and endotoxemia have been implicated in sepsis and multiple organ failure (MOF) syndromes in adults. The contributions of endotoxin (ETX) and proinflammatory cytokines (CKs) to the pathophysiology of disease and the outcomes of infants in the neonatal intensive care unit (N...
journal_title:Journal of pediatric surgery
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doi:10.1016/j.jpedsurg.2006.10.038
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abstract:BACKGROUND/PURPOSE:Delayed gastric emptying (DGE) is frequent in patients with gastroesophageal reflux disease (GERD) and may require additional investigation. The current study assesses whether relative esophageal exposure, postprandial (PP) versus fasting, diagnosed by pH monitoring could predict DGE. METHODS:Thirty...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpedsurg.2004.06.023
更新日期:2004-10-01 00:00:00
abstract::Sixteen patients with biliary atresia had 44 steroid courses for treatment of cholangitis or diminution of bile flow following Kasai hepatic portoenterostomy operations. A "blast" type (high dose/short duration) steroid administration was employed to potentiate the choleretic and anti-inflammatory effect. There was a ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(85)80026-9
更新日期:1985-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:There is a paucity of outcome prediction models for injured children. Using the National Pediatric Trauma Registry (NPTR), the authors developed an artificial neural network (ANN) to predict pediatric trauma death and compared it with logistic regression (LR). METHODS:Patients in the NPTR from 1996 ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.33885
更新日期:2002-07-01 00:00:00
abstract::Serum gastrin determinations were performed in 32 normal-term infants to determine the level of this hormone in normal infants at birth and its response to normal feeding. Significant differences were noted between newborn cord blood and maternal blood at birth. Further significant elevations in fasting serum gastrins...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(78)80204-8
更新日期:1978-02-01 00:00:00
abstract:PURPOSE:Treatment of pediatric papillary thyroid cancer (p-PTC) often follows adult guidelines, including total thyroidectomy for tumors >1cm. This study examined the association between operation type and overall survival (OS) for tumors >1cm in size in the pediatric population. METHODS:Patients ≤ 21 years of age wit...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.03.031
更新日期:2015-06-01 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::A 10-year-old boy presented with features of Cushing's syndrome. Investigations, including ultrasound scan and computed tomography scans, demonstrated a right adrenal tumor. The tumor was excised and histologically found to be an encapsulated adrenal adenoma. Surgical excision is the treatment of choice for adrenal tu...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/s0022-3468(98)90335-9
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Gastric outlet obstruction (GOO) may be caused by various congenital and acquired conditions in children. The authors report 11 cases of GOO caused by muscular hypertrophy of the pylorus, which was proven histologically in 7. They describe this entity as "late-onset hypertrophic pyloric stenosis ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.04.014
更新日期:2010-09-01 00:00:00
abstract::In some children, contrast radiography and endoscopy fail to confirm suspected Crohn's disease, or fail to evaluate the extent of disease. This report documents seven cases in which laparoscopy was used to look for creeping mesenteric fat involving the small intestine, a pathological finding reported only for Crohn's ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90150-5
更新日期:1996-06-01 00:00:00
abstract::Between 1986 and 1991, the authors used polyglycolic acid mesh slings (placed at or above the sacral promontory) in eight children with pelvic malignancies to exclude all small bowel from the pelvis during pelvic radiation therapy. The only complications of this treatment were prolonged postoperative ileus (one patien...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90015-9
更新日期:1994-07-01 00:00:00
abstract::Two infants with renal tumors and associated hypertension are presented. By using an antibody to purified human renal renin, the sites of renin production were localized immunohistochemically in each tumor. The first case was a 9-month-old girl with Beckwith-Wiedemann syndrome. She presented with bilateral renal masse...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(88)80435-4
更新日期:1988-05-01 00:00:00
abstract::A method of back closure with the use of latissimus dorsi myocutaneous flap in cases of myelomeningocele is reported. A three-layer cover consisting of the skin, subcutaneous fat, and the muscle with proper innervation and blood supply of the flap permits successful closure of large defects. Well-vascularized coverage...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90110-s
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:Constipation is a major complication in patients who have undergone posterior sagittal anorectoplasty (PSARP) operation for a high anorectal malformation. Overflow incontinence is the main cause of fecal soiling in these patients. The aim of this study was to outline the natural history of constipati...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.25766
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abstract:BACKGROUND/PURPOSE:Inguinal hernia repair and orchidopexy are among the most common operations in boys. The impact on future fertility has not been conclusively defined. This study evaluates sperm quality after previous inguinal surgery. METHODS:Spermiograms of men with a desire to conceive children were analyzed. His...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
abstract::The authors report the case of a 7-month-old Japanese infant with congenital intrahepatic portosystemic shunts. He had hypergalactosaemia and hyperammonemia at age 1 month. The diagnosis was made by ultrasonography and angiography. Coil embolization was performed successfully, and then hyperammonemia and hypergalactos...
journal_title:Journal of pediatric surgery
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更新日期:1999-06-01 00:00:00
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journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.09.023
更新日期:2019-09-01 00:00:00
abstract::Congenital microgastria is an extremely uncommon dysplasic condition of the newborn stomach. With only 26 well-documented accounts of this anomaly reported in the literature, its treatment and long-term outcome have not been well elucidated. Herein, the authors report on a newborn with multiple congenital anomalies wh...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90228-3
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:Delaying surgery for infants with CDH until they achieve clinical stability is common practice. Stability, however, is inconsistently defined, and many infants fail to reach pre-established criteria. We sought to determine if infants undergoing surgery without meeting pre-established criteria could achieve m...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.02.002
更新日期:2013-05-01 00:00:00
abstract:IMPORTANCE:Telemedicine is an emerging strategy for healthcare delivery that has the potential to expand access, optimize efficiency, minimize cost, and enhance patient satisfaction. OBJECTIVE:To review the current spectrum, potential strategies, and implementation process of telemedicine in pediatric surgery. DESIGN...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2018.04.038
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Pectus excavatum (PE) is the most common chest well deformity seen in children. In 1997, the Miniature Access Pectus Excavatum repair (MAPER) was presented by Nuss et al, adding a new option for PE repair. This operation entails placing a custom bent metal bar across the chest to mechanically raise the stern...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.01.046
更新日期:2004-05-01 00:00:00
abstract:PURPOSE:To evaluate the effect of free vascularized fibula grafts on developing donor leg function, the authors reviewed their experience of procedures performed in children. METHODS:Over a 10-year period, 30 children (average age 7.2 years, without gender concern) underwent fibula harvest via an anterolateral approac...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.8759
更新日期:2000-08-01 00:00:00
abstract:UNLABELLED:The absorption of carbon dioxide (CO2) used for positive pressure pneumoperitoneum may lead to an increased CO2 load. CO2 elimination during laparoscopy has not been investigated previously in paediatrics. The aim of this study was to characterise the pattern of CO2 elimination during laparoscopic surgery in...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2003.50021
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Gastroschisis and omphalocele are congenital abdominal wall defects (AWD). Atrazine and nitrates are common agricultural fertilizers. METHODS:The Centers for Disease Control and Prevention natality data set was used to collect data for patients with AWD born between January 1990 and December 2002. Similar d...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.01.027
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND/PURPOSE:A randomised controlled trial evaluating the role of video-assisted thoracoscopic surgery (VATS) in childhood empyema reported a failure rate of 16.6%. Our aim is to determine the outcome of VATS in a large series of children managed by 3 paediatric surgeons experienced in endoscopic surgery. METHOD...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.10.083
更新日期:2009-02-01 00:00:00