Diagnosis and management of pediatric appendicitis, intussusception, and Meckel diverticulum.

Three of the most common causes of surgical abdominal pain in pediatric patients include appendicitis, Meckel diverticulum, and intussusception. All 3 can present with right lower quadrant pain, and can lead to significant morbidity and even mortality. Although ultrasound is the preferred method of diagnosis with appendicitis and intussusception, considerable variety exists in the modalities needed in the diagnosis of Meckel diverticulum.

Nuss procedure: decrease in bar movement requiring reoperation with primary placement of two bars.

Background: The Nuss procedure, first reported in 1998, is currently the treatment of choice for pectus excavatum. The most significant bar-related complication documented is bar movement, requiring reoperation in 3.4%-27% of reports.

Simultaneous carriage of multiple genotypes of Staphylococcus aureus in children.

The co-existence of multiple genotypes in colonization by Staphylococcus aureus has not been fully investigated. The aim of this study was to evaluate the heterogeneity of S. aureus carriage in children.

Transumbilical laparoscopically assisted appendectomy: an alternative minimally invasive technique in pediatric patients.

Introduction: Transumbilical laparoscopically assisted appendectomy (TULAA) has been reported in the literature as an alternative to traditional three-port laparoscopic appendectomy (LA). Our study compares outcomes between LA and the one-trocar transumbilical technique in a single institution over a concurrent time frame for all cases of pediatric appendicitis.

Methods: An Institutional Review Board-approved retrospective chart review of all appendectomies from July 2007 through June 2009 was performed.

Incision and loop drainage: a minimally invasive technique for subcutaneous abscess management in children.

Purpose: The aim of the study was to evaluate outcomes after a minimally invasive approach to pediatric subcutaneous abscess management as a replacement for wide exposure, debridement, and repetitive packing.

Methods: A retrospective study was performed of all children who underwent incision and loop drainage for subcutaneous abscesses between January 2002 and October 2007 at our institution.

Technique: Two mini incisions, 4-5 mm each, were made on the abscess, as far apart as possible.

Laparoscopic Ladd's procedure: treatment of choice for midgut malrotation in infants and children.

Introduction: Rotational anomalies of the midgut encompass a broad spectrum of incomplete rotational events with malfixation of the intestines during fetal development. Ladd's procedure, as a correction of these anomalies, has traditionally been performed by laparotomy. In our institution, the laparoscopic Ladd's (LL) procedure was introduced in May 2004 and soon became the standard approach.

A prospective study of methicillin-resistant Staphylococcus aureus colonization in children scheduled for elective surgery.

Background: Staphylococcus aureus is a major cause of surgical wound infections. To obtain contemporary data on S aureus, we performed a prospective study of colonization and infection in children scheduled for elective surgical procedures.

Methods: A nasal swab and clinical information were obtained at the presurgical outpatient visit.