Pulmonary hernia in a two-year-old child.

Pulmonary hernia, also known as lung herniation or intercostal herniation, is best explained as the lung parenchyma protruding beyond the confines of the thoracic wall. This rare finding can be classified as congenital or acquired. Acquired pulmonary herniations are often the complication of blunt or penetrating trauma to the chest wall.

Soccer injuries in children requiring trauma center admission.

Background: Soccer continues to gain popularity among youth athletes, and increased numbers of children playing soccer can be expected to result in increased injuries.

Objective: We reviewed children with soccer injuries severe enough to require trauma activation at our Level I trauma center to determine injury patterns and outcome. Our goal is to raise awareness of the potential for injury in youth soccer.

Embolization for pediatric blunt splenic injury is an alternative to splenectomy when observation fails.

Background: Management of splenic injury has shifted from operative to nonoperative management in both children and adults with reports of high success rates. Benefits of splenic conservation include decreased hospital stay, blood transfusion, and mortality, as well as avoidance of infectious complications. Angiography with embolization is an innovative adjunct to nonoperative management and has resulted in increased splenic salvage in adults; however, data in the pediatric population are scant.

Blast injury in children: an analysis from Afghanistan and Iraq, 2002-2010.

Background: Throughout history, children have been victims of armed conflict, including the blast injury complex, however, the pattern of injury, physiologic impact, and treatment needs of children with this injury are not well documented.

Methods: The Joint Theatre Trauma Registry provides data on all civilians admitted to US military treatment facilities from 2002 to 2010 with injuries from an explosive device. The data were stratified by age and analyzed for differences in anatomic injury patterns, Injury Severity Score (ISS), Revised Trauma Score (RTS), mortality, intensive care unit days, and length of hospitalization.

A 22-year experience in global transport extracorporeal membrane oxygenation.

Background/purpose: Transport extracorporeal membrane oxygenation (ECMO) is currently available at 12 centers. We report a 22-year experience from the only facility providing global transport ECMO. Indications for transport ECMO include lack of ECMO services, inability to transport conventionally, inability to wean from cardiopulmonary bypass, extracorporeal cardiopulmonary resuscitation, and need to move a patient on ECMO for specialized services such as organ transplantation.

Intercostal hernia and spontaneous pneumothorax in a liver transplant recipient: a case report.

Intercostal hernia can occur after blunt trauma and can also complicate thoracotomy. This report describes a 13-year-old liver transplant recipient with chronic asymptomatic intercostal hernia at site of thoracotomy. This hernia became manifest upon development of spontaneous pneumothorax.

Superior mesenteric artery syndrome in a basic military trainee.

We present the case of a 19-year-old woman with feeding intolerance, due to superior mesenteric artery (SMA) syndrome, after weight loss experienced during basic military training. She had previous good health and presented with vomiting 8 weeks after starting military training. She had experienced a 16-pound (7 kg) weight loss during the course of training and was increasingly unable to tolerate meals, solids worse than liquids.

Prophylactic bilateral salpingo-oopherectomy in a 17-year-old with Frasier syndrome reveals gonadoblastoma and seminoma: a case report.

Mutations in the Wilms' tumor gene are present in children with Frasier syndrome, Denys-Drash syndrome, WAGR syndrome, and some cases of Wilms' tumor. The Wilms' tumor gene product, WT1, is necessary for normal urogenital development. Frasier syndrome is an association between focal segmental glomerulosclerosis, beginning in the second and third decade, male to female sex reversal, and dysgenetic gonads.

Experience with wound VAC and delayed primary closure of contaminated soft tissue injuries in Iraq.

Background: Wartime missile injuries are frequently high-energy wounds that devitalize and contaminate tissue, with high risk for infection and wound complications. Debridement, irrigation, and closure by secondary intention are fundamental principles for the management of these injuries. However, closure by secondary intention was impractical in Iraqi patients.

Children treated at an expeditionary military hospital in Iraq.

Objective: To describe the treatment of children at an expeditionary military hospital in wartime Iraq.

Design: Descriptive, retrospective study.

Setting: The 332nd Air Force Theater Hospital in Balad, Iraq, January 1, 2004, to May 31, 2005.

A surgeon in your corner.

The surgical emergencies presented in this article encompass the vast majority of the nontraumatic emergencies seen by a pediatric surgeon but represent only a small proportion of surgical disease in children. Most children seeking outpatient medical care do not need a surgeon, but those who do need one quickly. When one of the processes detailed above is suspected, it is always best to avail oneself of the opinion of a surgeon in a timely manner.

Nitrovasodilator responses in pulmonary arterioles from rats with nitrofen-induced congenital diaphragmatic hernia.

Background/purpose: Many infants with congenital diaphragmatic hernias (CDHs) experience persistent pulmonary hypertension that is refractory to treatment with inhaled nitric oxide (NO). We have examined the responses of isolated pulmonary arterioles from prenatal and postnatal rats with and without nitrofen (2,4-dichlorophenyl-p-nitrophenyl ether)-induced CDH to a variety of activators of the NO-cyclic guanosine monophosphate (cGMP) pathway.

Methods: Right-sided CDH was induced in fetal rats by feeding nitrofen to pregnant rats on day 12 of gestation.

Repetitive deformation and pressure activate small bowel and colonic mucosal tyrosine kinase activity in vivo.

Physical forces like deformation and pressure modulate signaling and phenotype in cultured cells. However, it is more difficult to establish that such phenomena occur in vivo. We studied the effects of 0 to 10 minutes of rhythmic distension with an isotonic electrolyte and polyethylene glycol solution to 30 cm H(2)O pressure on defunctionalized small and large bowel segments in adult male Sprague Dawley rats.