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 trauma registry was reviewed to identify children (age 18 years or less) treated for a severe blunt liver injury for the period 1993 to 1998. Only children with an American Association for the Surgery of Trauma grade V (AIS code 541828.5) liver injury were included. Database records were reviewed for demographic information, associated injuries, survival rate, length of stay (LOS), intensive care days (ICUD), and treatment rendered after resuscitation in the emergency department. RESULTS:Thirty children with a grade V liver injury were identified. The mean age was 11.2 years (range, 1 to 18), and the overall survival rate was 56%. Data for 5 patients were excluded (4 patients died in the emergency department, and 1 patient was transferred to another institution after arrival). Survivors had a trend toward a lower injury severity score (ISS) (36.1 v 44.6; P <.1) and a significantly higher Glasgow Coma Scale (GCS), 12.5 v 6.6; P <.007). Patients with a decreased GCS had a lower overall survival rate (GCS < 8, 30% v GCS > 8, 76%). In the subset of 14 patients taken directly to the operating room, there was no difference between survivors (n = 6, 43%) and nonsurvivors (n = 8, 57%) in ISS (43 v 43; P value, not significant) or GCS (8.6 v 8.0; P value, not significant). Of the 11 patients treated nonoperatively, 10 (91%) survived with an average ISS of 33 and GCS of 13.8. Nonsurvivors more often had identified associated injuries to other abdominal and retroperitoneal organs. CONCLUSIONS:Severe hepatic injury is associated with a very high overall mortality rate in children. A low GCS is associated with a significant decrease in survival rate and may be the most important factor in outcome. Patients taken directly to the operating room have a slightly greater injury severity and a decreased survival rate compared with those treated nonoperatively. Thresholds and indications for laparotomy in these patients are not clear, and the need for operative management should be guided by the child's physiologic response to resuscitation. For those patients whose physiologic response to resuscitation permitted nonoperative management, a good outcome was achieved.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Pryor JP,Stafford PW,Nance MLdoi
10.1053/jpsu.2001.24720subject
Has Abstractpub_date
2001-07-01 00:00:00pages
974-9issue
7eissn
0022-3468issn
1531-5037pii
S0022-3468(01)75404-8journal_volume
36pub_type
杂志文章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::Experience with spinal opioids in children is limited but is expanding. Anatomy, pharmacology, technique, and results are reviewed. Complications and side effects are described. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/s0022-3468(89)80404-x
更新日期:1989-05-01 00:00:00
abstract::Emergency pneumonostomy was curative in a critically ill child with acute lung abscess. This procedure may be indicated for the rare acute lung abscess which fails to respond to medical therapy. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80377-7
更新日期:1983-10-01 00:00:00
abstract:PURPOSE:Adaptive growth of the intestinal mucosa in response to massive gut loss is fundamental for autonomy from parenteral nutrition. Although angiogenesis is essential for cellular proliferation in other tissues, its relevance to intestinal adaptation is unknown. We tested the hypothesis that resection-induced adapt...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.02.036
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Prenatal diagnosis and outcome of right congenital diaphragmatic hernia (RCDH) are far less well known than the more common left CDH (LCDH). In addition, onset of RCDH beyond the neonatal period with a spectrum of atypical symptoms is not unusual. A retrospective analysis of RCDH treated at a single center o...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.10.044
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:To characterize referrals to a vascular anomalies center to determine which lesions should be treated by specialists. STUDY DESIGN:Patients sent to our center between 1999 and 2010 were reviewed. Type of anomaly, anatomical location, sex, accuracy of referral diagnosis, and the geographic origin of the refer...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.05.006
更新日期:2011-09-01 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:PURPOSE:Lymphomas account for nearly 20% of the malignancies in childhood and the majority of patients with Hodgkin's Disease (HD) and non-Hodgkin's lymphoma (NHL) have radiological evidence of mediastinal involvement at presentation. Children with mediastinal tumors are at risk for the development of lethal airway obs...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90197-4
更新日期:1997-02-01 00:00:00
abstract:PURPOSE:Our objective was to investigate the feasibility of engineering cartilage on the esophagus layer and outside the esophagus. Moreover, we investigated the feasibility of tracheoplasty with cartilage engineered on the esophagus in rabbits. METHODS:Chondrocytes were isolated from auricular cartilages. 1. Engineer...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.07.005
更新日期:2015-07-01 00:00:00
abstract::Idiopathic adnexal torsion threatens ovarian function. The best ways to maximize ovarian salvage have not been stressed widely. The authors describe 2 girls who illustrate the benefit of untwisting the torsion, limiting resection and performing bilateral gonadopexy to prevent both ipsilateral recurrence and contralate...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.0350624
更新日期:2000-04-01 00:00:00
abstract::Two children with congenital microgastria and associated anomalies requiring surgery as infants, developed severe dumping syndrome which necessitated a remedial operation. A Roux-en-Y jejunal pouch (Hunt-Lawrence) was formed at 22 months and 10 months respectively. Weight gain was immediate in both patients and has be...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80017-7
更新日期:1983-12-01 00:00:00
abstract::The aims of this experiment were: (1) to establish a reovirus type 3-induced murine model of biliary atresia/neonatal hepatitis that as far as possible corresponds to the human disease; (2) to demonstrate that the disease is histologically similar to the human disease, and to investigate the natural history of reoviru...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90380-p
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:A variety of prosthetic materials are used in the pediatric population for abdominal and chest wall reconstruction. Pediatric experience of non-cross-linked porcine acellular dermal matrix is limited to patients following liver transplantation. We review our outcomes in patients in whom this matrix was used....
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.10.083
更新日期:2016-03-01 00:00:00
abstract::This is an introduction to the sucking sump catheter as a method of continuous salivary suction from the oral cavity for the treatment of esophageal atresia and other diseases. Upper pouch suction on many occasions is not easy. The double lumen catheter was devised by Replogle to achieve better suction efficiency, but...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80262-3
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND/PURPOSE:The authors have previously reported the occurrence of spontaneous bacterial translocation (BT) and its resolution with age in the newborn rabbit. They have also reported a close correlation between small bowel bacterial colonization (BC-SB) and BT at 1 week of age, suggesting that the presence of lu...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90553-4
更新日期:1997-10-01 00:00:00
abstract:PURPOSE:Patients with intestinal failure (IF) are known to have impaired absorption of nutrients required for maintenance of skeletal mass. Rates and risk factors of low bone mineral density (BMD) are unknown in pediatric IF patients. METHODS:Following IRB approval, patients with IF having undergone DXA scans were ide...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.10.010
更新日期:2015-01-01 00:00:00
abstract::Children with anal atresia often have compromised function. This is especially common with the anatomic "high lesion." Twenty-five patients have been studied using clinical evaluation, computed tomography (CT), and manometry to make an objective evaluation. The patients were an average of 9.6 years old; the male-to-fe...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(05)80274-x
更新日期:1993-02-01 00:00:00
abstract::Neonates with congenital diaphragmatic hernias (CDH) often die because of pulmonary hypoplasia and high pulmonary vascular resistance (PVR). Pulmonary hypertension and right-to-left shunting precedes progressive hypoxia and death. PVR is increased by acidosis and by high airway pressures. High-frequency oscillation (H...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80030-x
更新日期:1983-12-01 00:00:00
abstract:BACKGROUND:Conjugated jaundice arising during infancy may be caused by a number of different surgical conditions. The aim of this study was to compare clinical features, management, and outcome of all types of surgical jaundice presenting in the first year of life. METHODS:A retrospective review was conducted of all i...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(03)00498-6
更新日期:2003-10-01 00:00:00
abstract::Pancreatic pseudocysts have not been reported to occur in the fetus or newborn. The authors report two cases of histologically proven pancreatic pseudocysts in neonates, which were detected using prenatal ultrasonography. Surgical management included external marsupialization followed by internal drainage in one case,...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90185-2
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND/PURPOSE:The optimal mode of delivery for infants with gastroschisis is controversial. The authors compared the outcomes of infants with gastroschisis born vaginally (VD) or by cesarean section (CS). METHODS:A retrospective analysis of infants with gastroschisis born between 1990 and 2000 was performed. Asse...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.01.042
更新日期:2004-05-01 00:00:00
abstract:INTRODUCTION:Non-Accidental Trauma (NAT) is a significant cause of childhood morbidity and mortality, causing 50% of trauma-related deaths at our institution. Our purpose was to evaluate the necessity of primary surgical evaluation and admission to the trauma service for children presenting with NAT. METHODS:We review...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.03.035
更新日期:2013-06-01 00:00:00
abstract: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 t...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.08.009
更新日期:2012-03-01 00:00:00
abstract::Aortoesophageal fistula (AOF) in children with no history of cardiac disease or trauma is extremely rare, and survival is even rarer. We present a case of a 2-year-old boy who presented with massive hematemesis secondary to a primary aortoesophageal fistula and was found at endoscopy to have a submucosal hematoma. He ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.09.054
更新日期:2011-12-01 00:00:00
abstract:PURPOSE:The commonly cited ages at presentation of many pediatric conditions have been based largely on single center or outdated epidemiologic evidence. Thus, we sought to examine the ages at presentation of common pediatric surgical conditions using cases from large national databases. METHODS:A retrospective analys...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpedsurg.2014.01.039
更新日期:2014-06-01 00:00:00
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
doi:10.1016/j.jpedsurg.2014.11.031
更新日期:2015-07-01 00:00:00
abstract:INTRODUCTION:Necrotizing enterocolitis (NEC) has been a long-recognized complication of prematurity, but there is a paucity of studies on term infants. We sought to characterize the clinical presentation and outcomes of full term (FT) infants with NEC and compare these to our experience with preterm (PT) neonates. MET...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.02.046
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND/PURPOSE:Human immunodeficiency virus (HIV) disease is an increasingly common infection in children in sub-Sahara Africa. Rectal fistulation is one such condition with which these patients present to the paediatric surgeon. This appeared to be an exclusively female condition until 2 male patients were treated...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2003.50011
更新日期:2003-01-01 00:00:00
abstract::Hepatocellular carcinoma (HCC) remains chemoresistant and, therefore, the principal treatment of HCC is surgical resection. After a 9-year-old boy with huge HCC with lung metastasis received the 5 cycles of chemotherapy (cisplatin and Adriamycin), the lung metastasis had been resolved completely and the size of HCC in...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.27068
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND/PURPOSE:The purpose of this study was to examine the natural history and outcomes of prenatally diagnosed lung masses that appear to undergo complete regression before birth. METHODS:An IRB-approved retrospective review was performed on 100 consecutive fetuses with a congenital lung malformation at a single...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.03.025
更新日期:2015-06-01 00:00:00