Journal of pediatric surgery
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Comparative Study
Pedicled skin flap of foreskin for phalloplasty in the management of completely concealed penis.
To evaluate the effect of pedicled skin flap of foreskin for phalloplasty in the management of completely concealed penis. ⋯ Numerous operative procedures have been described and adopted for the management of completely concealed penis, but the pedicled skin flap phalloplasty can achieve maximum utilization of prepuce to assure coverage of the exposed penile shaft. It has fewer complications, achieving marked aesthetics and often functional improvement. This suggests pedicled foreskin skin flap for phalloplasty is a relatively ideal means for treating completely concealed penis.
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Case Reports
Surgically assisted trans-hepatic anterior approach for central venous catheter placement: safety and efficacy.
We describe a child dependent on parenteral nutrition who developed loss of all conventional central venous catheter insertion sites coupled with very unusual collateralization due to extensive thrombosis of both the superior and inferior vena cava, including the azygos vein. We successfully achieved trans-hepatic anterior access to the infra-diaphragmatic vena cava. Since the success rate for this technique is low due to catheter dislodgement, the procedure was surgically assisted for increased safety and efficacy.
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We have previously reported the use of EC-CPR for the treatment of hypothermic cardiac arrest with an overall survival of 50%. As we have continued this protocol for an additional 5 years, we sought to update this information. ⋯ Cold water drowning and avalanche suffocations cause dramatic hypothermic cardiac arrests in previously robust children. A protocolized rapid response with EC-CPR can save some of these children despite prolonged periods of cardiac arrest prior to initiation of bypass. The overall survival rate is likely less than our prior more optimistic report suggested.
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Comparative Study
Managing radiation exposure in children--reexamining the role of ultrasound in the diagnosis of appendicitis.
To assess the efficacy and accuracy of ultrasonography (US) and selective computed tomography (CT) in the diagnosis of acute appendicitis in children. ⋯ US followed by selective CT for the diagnosis of acute appendicitis is useful and accurate. This has important implications in the reduction of childhood radiation exposure.
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Comparative Study
Retroperitoneal pelvic packing for haemodynamically unstable pelvic fractures in children and adolescents: a level-one trauma-centre experience.
This study aims to review the outcomes of haemodynamically unstable paediatric patients with pelvic fractures undergoing protocol intervention of retroperitoneal pelvic packing (RPP) with external fixation and angiography. ⋯ Fall from heights is a major cause for severe pelvic injuries in our locality. RPP is a simple effective procedure to include in protocol intervention for pelvic fractures. This case series suggests it helps improve haemostasis and survival in unstable young patients, although larger cohorts will be necessary to validate this.