Articles: child.
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Data on the incidence of recurrent adhesive small bowel obstruction (ASBO) following index admission for ASBO in children are limited. We sought to determine if operative management was associated with a lower rate of recurrence compared to non-operative management (NOM). ⋯ Although the rate of recurrent ASBO in children is nearly 15% within one year, this rate does not differ based on the initial management strategy. Among children with recurrent ASBO, one-third underwent an urgent or emergent operation at readmission. NOM appears to be as effective in preventing recurrent ASBO as surgery.
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A systematic literature review and consensus using Delphi method. ⋯ Pediatric age is a modifier for the management of Chiari Malformation (CM). Prompt diagnosis and appropriate decompressive surgery with duraplasty before puberty are essential to mitigate the impact of the condition on the child's well-being. Increased awareness among healthcare professionals, timely access to specialized expertise in neurosurgical interventions are crucial, especially for type 2 CM patients that require urgent decompression of CVJ and cervical spine.
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The traditional management of pregnant patients with Chiari I malformation (CM-I) heavily favors cesarean section and general anesthesia to limit the perceived risk of maternal neurological complications attributed to vaginal delivery and neuraxial anesthesia. The aim of this study was to compare reported neurological symptoms and radiographic presentations before and after childbirth performed by patients with CM-I, with and without associated syrinx. ⋯ Our findings suggest that patients with CM-I may deliver vaginally and receive neuraxial anesthesia with low risk of neurological complications or radiographic worsening. As these patients were not prospectively selected, limitations exist, and it remains important to consider the severity of the patient's clinical and radiographic presentation when selecting anesthetic and delivery modality.