Journal of pediatric surgery
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Review Case Reports
Foregut duplication cyst of the hypopharynx: a rare cause of upper airway obstruction.
Foregut duplication cysts of the hypopharynx are extremely rare, and only 6 cases, all of which have been described as solid lesions and contained heterotopic gastric epithelium, could be found during our literature review. We present a unique case of a hypopharyngeal foregut duplication cyst that was grossly cystic and had no heterotopic epithelium microscopically. ⋯ Congenital laryngeal cysts can appear similar to this lesion. However, the hypopharyngeal location of a cyst is a clue for the diagnosis of duplication on endoscopic examination.
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Unadjusted abuse-related mortality has been demonstrated to be nearly 4-fold higher for African American (AA) children. Little is known about the etiology of this disparity. This study examines the importance of injury severity and initial presentation in explaining the observed disparity. ⋯ Despite attempts to control for the clinical presentation and injury severity of abused children, significant differences in mortality persist between AA and white children.
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Nonoperative management (NOM) of blunt splenic trauma is the standard of care in hemodynamically stable children. The long-term risk of this strategy remains unknown. The object of this study was to investigate the incidence of long-term complications after NOM of pediatric splenic injury. ⋯ The incidence of long-term complications after NOM of pediatric splenic injury was 1 (0.44%) in 228 patients. Nonoperative management of pediatric blunt splenic trauma in children is associated with a minimal risk of long-term complications.
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The purpose of this study was to determine the outcome of "minor resuscitation" trauma patients managed without the immediate presence of a surgeon. ⋯ Pediatric emergency medicine physicians discharged more patients than the surgeons, but also upgraded more to level 1 status. Level 2 trauma patients can be safely managed without immediate surgeon presence.
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We set out to examine whether pediatric trauma care resulted in a financial burden. ⋯ Pediatric trauma care is a profitable enterprise. Inadequate reimbursement remains for Medicaid and self-pay patients, which could result in financial losses should this proportion of the patient mix be more than 55%.