Journal of pediatric surgery
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Medical and surgical approaches toward children with ulcerative colitis (UC) vary and have differing implications for health care use. The goal of this study was to define hospital use and complications for children with UC before and after staged restorative proctocolectomy. ⋯ Children with UC who undergo colectomy use a large number of hospital resources before surgery and exhibit decreased hospital use after surgical completion. Children undergoing colectomy at children's and high-volume hospitals experience fewer surgical complications and shorter hospitalization.
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Comparative Study
Ovarian torsion: diagnosis of inclusion mandates earlier intervention.
The treatment of ovarian torsion (OT) is often delayed because of diagnostic uncertainty and dependence on radiologic confirmation. In contrast, when testicular torsion (TT) is suspected, diagnosis and management are expedited despite lack of certainty, and operative exploration is not delayed by radiologic investigations. We compared the management of torsion in both sexes to define a better clinical pathway for suspected OT. ⋯ Girls with suspected OT waited 2.5 times as long for diagnostic imaging and 2.7 times as long to be taken to the operating room. In addition, the gonadal salvage rate was significantly worse for girls compared with boys with TT. More urgent intervention for OT, with liberal use of diagnostic laparoscopy and without reliance on a definitive diagnosis by imaging, should be considered in girls with lower abdominal pain.
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This study sought to summarize the experience of diagnosis and treatment of tracheobronchial foreign bodies in children to effectively reduce complications and mortality. ⋯ Timely accurate diagnosis and treatment of tracheobronchial foreign bodies in children can avoid delay in treatment and effectively reduce complications and mortality.
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Transrectal small bowel evisceration (TSBE) is a rare entity that can occur after traumatic injuries. It has been described after impalement, sexual assault, blunt abdominal trauma, and swimming pool drain suction. The authors encountered such a case in a 4-year-old by following a crush abdominal injury. ⋯ There was no fecal soilage, and no protective colostomy was performed. The mortality and morbidity of TSBE are usually related with the severity and type of trauma. The mesenteric laceration and concomitant injuries can cause significant bleeding leading to a hemorrhagic shock and multiorgan failure.
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Posttraumatic growth (PTG) is a positive psychological change, or benefit, as a result of a major life trauma and/or loss. The role of emotional intelligence (EI), social support, self-efficacy, posttraumatic stress symptoms (PTSS), and resilience in PTG was evaluated in parents of children undergoing a surgical procedure for congenital disease. ⋯ The relationship between PTG and other variables have been examined at only one point in time. Longitudinal studies in exploring the impact of EI and other variables affecting PTG can be used to reduce the impact of bidirectionality that may have impact on the conclusions drawn. Emotional management programs should focus on the use of EI as a proactive measure for enhancing emotional well-being and promoting positive emotions.