Background: The association of a rotavirus vaccine and intussusception has renewed interest in understanding the incidence, clinical presentation and outcome of intussusception.
Methods: A ...retrospective chart review of all patients diagnosed with intussusception at Royal Children’s Hospital, Melbourne over a 6.5‐year period (1 January 1995–30 June 2001) was conducted using patients identified by a medical record database (ICD‐9‐CM code 560.0 1993–1997; ICD‐10‐CM code 56.1 1998–2001). Patient profile, clinical presentation, diagnosis methods, treatment and outcome were analyzed and compared to data previously reported on children with intussusception at the same hospital during 1962–1968.
Results: The hospitalization rate for primary idiopathic intussusception increased marginally from 0.19 to 0.27 per 1000 live births during the period 1962–1968 to 1995–2001. Most patients (80%) were <12 months of age (median age 7 months, range 2–72 months). The combination of abdominal pain, lethargy and vomiting was reported in 78% of infants. Air enema confirmed the diagnosis of intussusception in 186 of 191 cases (97%) and air reduction was successful in most cases (82%). Factors associated with increased risk of intestinal resection included abdominal distension (32%), bowel obstruction on abdominal X‐ray (27%) and hypovolemic shock (40%). No mortality was observed in the present study.
Conclusions: Over the past 40 years at Royal Children’s Hospital, Melbourne the hospitalization rate due to primary idiopathic intussusception has marginally increased from 0.19 to 0.27 per 1000 live births. Diagnosis and treatment using air enema has been highly successful, resulting in a reduction in patients requiring surgery and reduced hospital stays.
Background:The association of a rotavirus vaccine and intussusception has renewed interest in understanding the incidence, clinical presentation and outcome of intussusception. Methods:A ...retrospective chart review of all patients diagnosed with intussusception at Royal Children's Hospital, Melbourne over a 6.5-year period (1 January 1995-30 June 2001) was conducted using patients identified by a medical record database (ICD-9-CM code 560.0 1993-1997; ICD-10-CM code 56.1 1998-2001). Patient profile, clinical presentation, diagnosis methods, treatment and outcome were analyzed and compared to data previously reported on children with intussusception at the same hospital during 1962-1968. Results:The hospitalization rate for primary idiopathic intussusception increased marginally from 0.19 to 0.27 per 1000 live births during the period 1962-1968 to 1995-2001. Most patients (80%) were <12 months of age (median age 7 months, range 2-72 months). The combination of abdominal pain, lethargy and vomiting was reported in 78% of infants. Air enema confirmed the diagnosis of intussusception in 186 of 191 cases (97%) and air reduction was successful in most cases (82%). Factors associated with increased risk of intestinal resection included abdominal distension (32%), bowel obstruction on abdominal X-ray (27%) and hypovolemic shock (40%). No mortality was observed in the present study. Conclusions:Over the past 40 years at Royal Children's Hospital, Melbourne the hospitalization rate due to primary idiopathic intussusception has marginally increased from 0.19 to 0.27 per 1000 live births. Diagnosis and treatment using air enema has been highly successful, resulting in a reduction in patients requiring surgery and reduced hospital stays.
Pediatric Thoracic Surgery Parikh, D. H; Auldist, Alex; Rothenberg, Steven
2009, 20090101, 2009-04-27
eBook
This text covers new innovations and concepts in pediatric thoracic surgery practice, basic science and evidence, and the technical aspects of common and rare operative procedures. It is essential ...for pediatric surgical trainees and consultants with interest in pediatric thoracic surgery. Providing comprehensive coverage of newer developments, it is also a useful reference work for pediatric and thoracic surgeons and a valuable guide for surgeons (adult or pediatric) managing pediatric thoracic surgery on occasional basis or only during acute emergency.Covering the subjects within pediatric thoracic surgery (non-cardiac) in significant depth, this book acts as a reference text for consultants undertaking pediatric thoracic work as well as for pediatric respiratory, anesthetists and fetal medicine doctors. Topics within this book will also be of interest to pediatric respiratory physicians and pediatric oncologists.
Prematurity of 34 weeks' gestation or less occurs in 12% of infants born with esophageal atresia and distal tracheoesophageal fistula, and is likely to result in moderate or severe hyaline membrane ...disease. In the past, these infants have often had their surgical treatment delayed or staged. Based on our experience of 24 such patients since 1977, we propose that optimal treatment involves early division of the distal tracheoesophageal fistula via a thoracotomy and simultaneous repair of the esophagus where the patient's condition permits. This should be in the first 12 hours of life, before the hyaline membrane disease becomes fully established. Gastrostomy is not required and may be contraindicated.
An 8‐year‐old boy with persistent duodenal ulceration was found to have hypergastrinaemia due to a solitary hepatic gastrinom. Surgical resection has been followed by total clinical remission for a ...period exceeding 2 years.
