Diagnostic Ultrasound for Acute Appendicitis: The Gold Standard.

Background: Acute appendicitis may present a diagnostic dilemma. The aim of this study was to review the accuracy of ultrasound in the diagnosis of paediatric acute appendicitis.

Method: Ultrasound studies performed for investigation of appendicitis during 2015-2021 were retrieved from a tertiary paediatric hospital database and reviewed.

Ultrasound guided hydrostatic enema reduction of ileocolic intussusception: a safe and effective technique.

Background: Currently, the primary management of ileocolic intussusception in children is usually by non-operative image-guided enema reduction. In most centres around the world especially in Australasia the predominant technique is the pneumatic reduction under fluoroscopic guidance. At our institution, we have been performing ultrasound-guided hydrostatic reduction since 2012.

Subcutaneous nodules following vaccination.

Five patients presented to surgical clinics at our institution with subcutaneous nodules of the upper arm or thigh present for 6-18 months. Excisional or fine-needle biopsy was performed due to diagnostic uncertainty and parental concern. Histopathological examination revealed these to be cutaneous lymphoid hyperplasia in reaction to vaccine components.

Ultrasound imaging as the first line of investigation to diagnose intestinal malrotation in children: Safety and efficacy.

Background: Upper gastrointestinal contrast study is considered the gold standard investigation to diagnose intestinal malrotation and midgut volvulus which is potentially devastating condition. Ultrasound imaging is an alternative but has been considered unreliable due to significant false negative results. At our institution we have been using ultrasound imaging as the first line investigation to diagnose malrotation since 2008 with a preliminary study of 139 patients published in 2014.

Testicular Appendage Torsion-To Explore the Other Side or Not?

Objective: To investigate and compare the risks vs benefits of synchronous contralateral scrotal compartment exploration when testicular appendage torsion is diagnosed intra-operatively.

Methods: Emergency scrotal explorations performed at the Women's and Children's Hospital between 2002 and 2017 were retrospectively analysed to identify patients with testicular appendage torsion. Primary outcome measures were metachronous acute scrotum re-presentations and returns to theatre.

Sutured point-fixation versus Jaboulay fixation for salvaged testicular torsion in children.

Background: Surgical techniques for fixation of the testis are varied and subject to ongoing debate. Non-sutured techniques may avoid the theoretical morbidities of sutured fixation of the testis yet are criticized for insufficient prophylaxis against future torsion. This study aims to compare outcomes between sutured (point-fixation) versus Jaboulay fixation.

Diagnosis and management of omental infarction in children: Our 10 year experience with ultrasound.

Aim: To review children with Omental Infarction (OI) and the role of Ultrasound Scan (US) in its diagnosis and management.

Methods: Cases of OI were identified retrospectively from 2004 to 2014 through screening of admission coding, pathology databases and radiology records. Demographic, clinical and pathological data were extracted from case records.

Beware the Looping Vas Deferens in Orchidopexy.

A looping vas deferens may be present in up to 20% of undescended testes located within or proximal to the inguinal canal. This associated abnormality is vulnerable to transection during orchidopexy. We present an example of a very long looping vas to emphasize the importance of inspection for this anomaly, and demonstrate the extreme extent that a looping vas may extend.

Benchmarking the value of ultrasound for acute appendicitis in children.

Background: This study appraises the diagnostic quality of ultrasound for acute appendicitis in children and consequently challenges the perception of inferior accuracy and suitability compared to computed tomography (CT).

Methods: Radiologist reports for consecutive "query appendicitis" ultrasound studies were retrieved from a hospital database for the study period 2009-2014. Children who subsequently underwent appendicectomy were identified.

Bilateral perinatal testicular torsion: successful salvage supports emergency surgery.

Perinatal testicular torsion (PTT) has poor rates of testicular salvage. Although rare, bilateral PTT carries the risk of anorchia. We present a case of a 2-day-old term infant with acute onset right-sided scrotal discolouration and tenderness.

Simplified technique for retrieval of large trichobezoars in children.

Trichobezoars are concentrations of indigestible hair or hair-like fibres within the proximal intestinal tract. In children, delayed presentation with large bezoar masses is not unusual as bezoar formation is an indolent process that takes many months or years before becoming symptomatic. Surgical management is challenging and becomes inevitable once a trichobezoar becomes more established.

Utility of sonographic assessment of the position of the third part of the duodenum using water instillation in intestinal malrotation: a single-center retrospective audit.

Background: Intestinal malrotation and particularly volvulus are potentially devastating conditions. Upper gastrointestinal (UGI) contrast studies have been considered the gold standard for diagnosis. However the use of ultrasonography (US) has been increasingly described.

Testicular and paratesticular pathology in children: a 12-year histopathological review.

Background: Our institution is the principal pediatric surgical referral center for a population of 1.6 million. The objective of this study was to determine the spectrum and incidence of pediatric testicular and paratesticular pathology in this population.