Traumatic Anterior L4 Fracture Dislocation With Iliac Artery Compression in a 6-Year-Old Patient: A Case Report.

Case: A six-year-old Caucasian boy sustained an L4 anterior fracture dislocation with cauda equina transection at L3/L4 level with L4 vertebral body compression of the left common iliac artery after a single motor vehicle accident. He was treated with emergent open reduction and pedicle screw fixation with return of left common iliac patency. This was followed by multiple bowel resections on postadmission day 3.

NASPGHAN Clinical Report on Postoperative Recurrence in Pediatric Crohn Disease.

Pediatric Crohn disease is characterized by clinical and endoscopic relapses. The inflammatory process is considered to be progressive and may lead to strictures, fistulas, and penetrating disease that may require surgery. In addition, medically refractory disease may be treated by surgical resection of inflamed bowel in an effort to reverse growth failure.

Prospective observational study to assess the need for postoperative antibiotics following surgical incision and drainage of skin and soft tissue abscess in pediatric patients.

Background: Post-operative antibiotics are often utilized for skin and soft tissue infection (SSTI) requiring surgical incision and drainage (I&D). We propose that antibiotics are unnecessary following I&D.

Methods: Patients aged 3months to 6years with SSTI of the buttocks, groin, thigh, and/or labia requiring I&D were prospectively enrolled.

Laparoscopic splenopexy for wandering spleen, a video demonstration of technique by encircling the spleen with polyglactin 910 woven mesh.

Background: Wandering spleen is a rare clinical entity caused by absence of the spleen's peritoneal attachments, allowing the spleen to move freely within the peritoneal cavity [1]. This disease is most commonly seen in children and young women [1, 2]. Affected individuals are predisposed to complications including splenic torsion, splenic infarction, and pancreatic necrosis [3, 4].

Same-day discharge after incision and drainage of soft-tissue abscess in diaper-age children is safe and effective.

Purpose: Many pediatric centers admit patients following incision and drainage (I&D) of soft-tissue abscesses. The purpose of this study is to assess the safety and efficacy of the same-day discharge following I&D.

Methods: Retrospective review was performed of children aged 3 months-4 years who underwent operative I&D of an abscess followed by same-day discharge.

Pediatric surgery - a changing field: national trends in pediatric surgical practice.

Background: Over the last decade, our institution has experienced a relative increase in the number of mundane cases, such as appendectomy and incision and drainage of abscess, versus index (complex) cases. We sought to determine if this trend is present at the national level.

Methods: A retrospective review of surgical case volume at 36 freestanding children's hospitals was performed between January 2004 and December 2013 using the Pediatric Health Information System (PHIS) database.

Robotic Surgery may Not "Make the Cut" in Pediatrics.

Since the introduction of robotic surgery in children in 2001, it has been employed by select pediatric laparoscopic surgeons, but not to the degree of adult surgical specialists. It has been suggested that the technical capabilities of the robot may be ideal for complex pediatric surgical cases that require intricate dissection. However, due to the size constraints of the robot for small pediatric patients, the tight financial margins that pediatric hospitals face, and the lack of high level data displaying patient benefit when compared to conventional laparoscopic surgery, it may be some time before the robotic surgical platform is widely embraced in pediatric surgical practice.

Intra-abdominal (Type IV) sacrococcygeal teratoma presenting with buttock hemangioma.

Sacrococcygeal teratoma is the most common type of extragonadal germ cell tumor in infants and young children. Sacrococcygeal teratomas can uncommonly present in an intra-abdominal fashion, with minimal clinical findings. Dermatologic lesions overlying the vertebrae or buttocks are often associated with sacrococcygeal teratoma and may be the only clue to their presence.

Chylopericardium and chylothorax: unusual mechanical complications of central venous catheters.

Obstruction and thrombosis of major systemic veins can occur due to indwelling central venous catheters. If obstruction of the innominate vein or superior vena cava occurs, lymphatic drainage can be impaired due to an increase in pressure in the thoracic duct and lymphatics. We describe a case where superior vena cava syndrome, chylopericardium and chylothorax occurred in a 16-year-old girl due to an indwelling central venous catheter.

Metastatic osteosarcoma to the stomach and ascending colon in a pediatric patient causing gastrointestinal hemorrhage.

Osteosarcoma metastasis to the gastrointestinal tract is a rare phenomenon (Horiuchi A, Watanabe Y, Yoshida M, et al.: Metastatic osteosarcoma in the jejunum with intussusception: report of a case. Surg Today 2007;37:440-2).

Circulating thyrotropin receptor messenger RNA for evaluation of thyroid nodules and surveillance of thyroid cancer in children.

Purpose: The aim of this study was to determine the role of thyrotropin receptor messenger RNA as a novel blood test for evaluation of thyroid nodules and cancer in children.

Methods: We reviewed thyroid disease management of patients younger than 18 years with thyrotropin receptor messenger RNA measurements identified from a prospective, institutional review board-approved registry during 2008 to 2010.

Results: Thirty-nine thyrotropin receptor messenger RNA measurements were made in 21 female patients (12-17 years old; median, 16 years).

Dermatitis in patients undergoing the Nuss procedure for correction of pectus excavatum.

Background: The Nuss procedure was introduced in 1987 for the correction of pectus excavatum. In this procedure, a stainless steel bar is placed underneath the sternum.

Objectives: To report cutaneous reactions associated with Nuss bar placement.

Primary colonic congenital infantile fibrosarcoma presenting as meconium peritonitis.

Congenital infantile fibrosarcoma is a rare soft tissue malignancy that occurs in both axial and extremity locations. We report a case of this tumor arising from the left colon in a newborn presenting with an intrauterine perforation and meconium peritonitis.

Unilateral Coexisting Intralobar and Extralobar Pulmonary Sequestrations.

Pulmonary sequestration is a focal area of nonfunctioning, dysplastic lung parenchyma that lacks communication with the normal tracheobronchial tree. It is supplied by the systemic arterial circulation and has two types, intralobar and extralobar, that can be differentiated from each other by the pleural covering and the venous drainage. Their coexistence is extremely rare.

Perfusion induced hyperthermia for oncologic therapy with cardiac and cerebral protection.

Cancer can be preferentially damaged and killed at temperatures above 41.0 degrees C. However, the heart and brain malfunction at this temperature, limiting the application of systemic hyperthermia in the treatment of metastatic cancer.