Is pre-operative imaging of external angular dermoid cysts in children necessary?

Aim: To investigate the frequency and modality of pre-operative imaging in children with an external angular dermoid cyst and whether this influenced subsequent management.

Methods: A retrospective study was undertaken to assess the presentation, investigation, treatment and outcomes in children aged less than 16 years with an external angular dermoid cyst. All children who underwent external angular dermoid cyst excision between January 2008 and April 2021 at a regional children's hospital were analysed.

Esophageal length in children: Reference data and a novel predictive equation.

Minimal information exists on the length of the child's esophagus, namely the distance from the cricopharyngeus to the esophagogastric junction (EGJ). We aimed to investigate the relationship between esophageal length (EL) and the age, height, and weight of the child. Children undergoing upper gastrointestinal endoscopy between February 2019 and May 2021 at our institution were prospectively audited.

Intestinal malrotation in extremely premature infants: a potential trap.

Introduction: Intestinal malrotation is life-threatening and often presents during infancy with bilious vomiting. The prevalence and presentation among extremely premature infants are unknown.

Methods: We retrospectively reviewed all infants born at less than 28 weeks' gestation diagnosed with symptomatic intestinal malrotation in a tertiary neonatal intensive care unit over a 10-year period (2010-2020).

Periprosthetic fractures of the femur in primary total hip arthroplasty: a New Zealand Joint Registry analysis.

Background: Periprosthetic femoral fractures around total hip arthroplasty (THA) are increasing annually, and are a major cause for revision surgery in the New Zealand Joint Registry (NZJR). The aim of this study was to determine the timing and risk factors for periprosthetic femoral fractures in THA requiring revision surgery in the NZJR.

Methods: All patients with a primary THA who sustained a periprosthetic femoral fracture requiring revision THA recorded in the NZJR were reviewed to determine age, gender, body mass index, American Society of Anesthesiologists (ASA) rating and femoral stem fixation (cemented or uncemented).

Epigastric Hernias in Children: A Personal Series and Systematic Review of the Literature.

Epigastric hernias are relatively uncommon in children, and there is a paucity of literature on their incidence, presenting features, natural history, and surgical outcomes. A systematic review was conducted according to PRISMA guidelines. Articles describing the incidence, outcome, and interventions for pediatric epigastric hernias, both open and laparoscopic, were analyzed.

A self-report questionnaire for pregnancy-related symphyseal pain.

Background: Symphyseal pain (SP) experienced during pregnancy is a common condition that can negatively influence function and wellbeing. Despite its adverse impact on quality of life, standardised diagnostic criteria for SP as a distinct type of pelvic girdle pain (PGP) are lacking.

Objectives: To develop a reliable self-administered instrument that could differentiate SP from posterior PGP in pregnant women, and ultimately be used for epidemiological or clinical purposes.

Contemporary management of Hirschsprung disease in New Zealand.

Background: The aim of this study was to report the contemporary management of Hirschsprung disease (HD) in New Zealand.

Methods: We undertook a national multi-centre retrospective review of all newly diagnosed cases of HD during a 16-year period (2000-2015). Demographics, genetic and syndromic associations, family history, radiology and histology results and surgical interventions were analysed.

Scoliosis after thoracotomy repair of esophageal atresia: a systematic review.

Standard surgical repair of esophageal atresia/tracheoesophageal fistula (EA/TEF) is via a right posterolateral thoracotomy. A recognized complication is the later development of scoliosis. The prevalence and pathogenesis of secondary scoliosis are poorly understood.

Pectoralis Major Rupture in an Active Female.

Pectoralis major rupture was historically a rare occurrence, but the incidence is increasing. Most cases occur from indirect trauma in active men aged 20 to 40 years, especially during bench press. Pectoralis major rupture has never been reported in the literature in a woman in this age group.

Gastric heterotopic pancreas in children: A prospective endoscopic study.

Purpose: To document the prevalence and variable appearance of gastric heterotopic pancreas (HP) in children undergoing upper gastrointestinal (GI) endoscopy.

Methods: A prospective 4-year study of children undergoing flexible upper GI endoscopy in a single institution.

Results: A total of 607 upper GI endoscopies were performed in 478 pediatric patients during the 4-year period.

Risk factors for periprosthetic femoral fractures around total hip arthroplasty: a systematic review and meta-analysis.

Background: Periprosthetic fractures are becoming increasingly common, often leading to poor patient outcomes. The aim of this study was to identify risk factors associated with periprosthetic femoral fractures (PPFFx).

Methods: Two independent reviewers conducted a systematic review of the databases MEDLINE, Embase and Cochrane Library according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, from the earliest available date to December 2017.

State targeted response to the opioid Crisis grants (opioid STR) program: Preliminary findings from two case studies and the national cross-site evaluation.

Opioid misuse is a national health crisis that requires sustained treatment, prevention, and recovery efforts. This study evaluates the innovative treatment approaches that two states - Kentucky and Missouri - implemented in their states using State Targeted Response to the Opioid Crisis Grant (Opioid STR) program funds from the Substance Abuse Mental Health and Services Administration (SAMHSA), as well as preliminary findings from the Opioid STR national, cross-site evaluation that is funded and managed by SAMHSA. The Kentucky approach discusses the Emergency Department (ED) bridge model, which links patients discharged from EDs to appropriate professional treatment and recovery services.

Outcomes of infants born at 23 and 24 weeks' gestation with gut perforation.

Purpose: The provision of neonatal intensive care to infants born at 23 or 24 weeks' gestation poses medical, surgical and ethical challenges. Gastrointestinal perforation is a well-recognized complication of preterm birth, occurring most often as a result of necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP). Given the risk of morbidity and mortality in these 'periviable' infants, this complication may prompt transition from active management to palliative care.

Ethnic variations in the childhood prevalence of Hirschsprung disease in New Zealand.

Background: Epidemiological studies have suggested that there may be ethnic variations in the prevalence of Hirschsprung disease (HD) but no study has systematically investigated this issue or potential ethnic variations in the extent of aganglionosis in HD. This study aimed to investigate this in a childhood population in New Zealand.

Methods: A multicentre national retrospective review was undertaken of all newly diagnosed cases of HD at each of the four paediatric surgical centres in New Zealand over a 16-year period (January 2000 to December 2015).

Thrombocytosis and portal vein thrombosis after splenectomy for paediatric haemolytic disorders: How should they be managed?

Splenectomy is indicated in selected children with haemolytic anaemia. Postoperatively, thrombocytosis occurs in at least 80% and is one of the factors implicated in the development of acute portal venous thrombosis after splenectomy in adults. A literature review shows that children are also at risk of this complication, but the incidence is low.

Acute appendicitis.

Acute appendicitis is the most common reason for abdominal surgery in children. Luminal obstruction of the appendix progresses to suppurative inflammation and perforation, which causes generalised peritonitis or an appendix mass/abscess. Classical features include periumbilical pain that migrates to the right iliac fossa, anorexia, fever, and tenderness and guarding in the right iliac fossa.

Preoperative laryngotracheobronchoscopy in infants with esophageal atresia: why is it not routine?

The value of laryngotracheobronchoscopy (LTB) immediately prior to repair of esophageal atresia with or without tracheo-esophageal fistula is contentious. Currently, there is a wide range of opinion on the utility of this investigation which is reflected by huge variation in clinical practice. This review is a critical analysis of the arguments for and against performing routine LTB prior to esophageal atresia repair.

Fetal megacystis: Institutional experience and outcomes.

Background: Fetal megacystis is a sonographic feature that may be indicative of several underlying pathologies. Despite advances in diagnosis and management, the overall prognosis of affected fetuses remains poor and about 50% of such pregnancies are terminated.

Aims: To define the frequency, management, survival and renal outcomes of fetal megacystis over nine years at Wellington Hospital, New Zealand.