Journal of pediatric surgery
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Review Case Reports
Tracheal rupture after blunt chest trauma in a child.
Blunt traumatic tracheal rupture is a life-threatening injury. The authors report on a 14-year-old boy who suffered such an injury in a road accident, underwent surgery immediately, and survived. The relevant literature is reviewed.
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There have been few documented cases of sand aspiration. The authors report on a 3-year-old boy who suffered severe respiratory compromise secondary to sand aspiration. Emergency intubation and subsequent bronchoscopy were required to relieve airway obstruction. The patient did well and suffered no long-term sequelae.
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Review Case Reports
Coexisting left congenital diaphragmatic hernia and esophageal atresia with tracheoesophageal fistula: successful management in a premature neonate.
The combination of left congenital diaphragmatic hernia (CDH) with esophageal atresia (EA) and distal tracheoesophageal fistula (TEF) is extremely rare and is considered highly lethal. The authors describe a premature neonate with this association, who is alive at 6 1/2 years of age. Temporary banding of the gastroesophageal junction and gastrostomy was performed concurrently with hernia repair and prosthetic abdominoplasty to enlarge the abdominal cavity. ⋯ The methods that have been suggested in the literature are discussed. The institution of ECMO at birth could allow a primary complete surgical repair of EA and CDH. Nevertheless, surgical management with staged repair, as described herein, can be useful.
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Review Case Reports
Conn syndrome in a child, caused by adrenal adenoma.
Hyperaldosteronism owing to aldosterone-producing adenoma (Conn syndrome) is a rare but potentially curable form of pediatric hypertension. The authors report on a 5-year-old girl who had symptoms of polyuria, polydipsia, and fatigue, and for whom the diagnosis of hyperaldosteronemia was suggested by a low serum potassium level and persistent hypertension. ⋯ The left adrenal gland was excised, and pathological assessment showed an adenoma. Only 14 other pediatric cases (< 16 years of age) have been reported in the English-language literature.
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Marine envenomations are the statistical price that humankind pays for intruding into the aquatic domain. Individual risk can be reduced by knowledge and prudence. If envenomations do occur, lives can be saved, complications prevented, and convalescence facilitated by knowledge of and interest in these fascinating creatures of the sea.