Small bowel obstruction from hollow foreign body ingestion: A case report and brief review of literature.

While ingestion of a foreign body by children is common, diagnosis is often challenging, especially when the consumption by a young child is unwitnessed and presenting symptoms mimic other medical conditions. If the foreign body does not pass spontaneously, radiological imaging studies are typically performed, but visualization and identification of the ingested foreign object can be inconclusive, especially when an unidentified mass is radio translucent. Under this circumstance, physicians often have to go on a "fishing expedition", using exploratory endoscopy and/or surgery to identify and extract the object that became lodged.

Excessive Postoperative Fluid Administration in Infants with Gastroschisis.

Careful fluid management is a cornerstone of neonatology because the cardiovascular, respiratory, and gastrointestinal systems in the newborn are sensitive to overhydration. Fluid management in gastroschisis is complicated by insensible fluid loss and postoperative third-space fluid shifts. Study of perioperative fluid management in gastroschisis is limited and has not undergone careful scrutiny.

Primary ovarian leiomyoma: a rare cause of ovarian tumor in adolescence.

A pediatric case of ovarian leiomyoma is presented. A review of the literature indicates that, in contrast to older patients, pediatric/young adult patients usually present with bilateral disease and do not have associated uterine leiomyomas.

A proposed classification system for familial intestinal atresia and its relevance to the understanding of the etiology of jejunoileal atresia.

Familial cases of the various types of intestinal atresia are well described, and we now report an additional family. Based on a review of the literature, a classification system for the different types of familial atresia is presented. Current teaching attributes most jejunoileal atresias to in utero vascular accidents occurring relatively late in gestation (after the 11th or 12th week).

Primary epithelial lung malignancies in the pediatric population.

Background: Primary epithelial lung malignancies are rare in childhood and adolescence. We reviewed the Memorial Sloan-Kettering Cancer Center experience with these tumors to better understand their histology, time to diagnosis, treatment, and outcome.

Procedure: A retrospective review was performed on all patients 21 years of age or younger at diagnosis, treated for primary epithelial lung malignancies at Memorial Sloan-Kettering Cancer Center between 1980 and 2001.

Metachronous skeletal osteosarcoma in patients treated with adjuvant and neoadjuvant chemotherapy for nonmetastatic osteosarcoma.

Purpose: The prognosis for patients who develop metachronous skeletal osteosarcoma (OS) has been considered grave compared with that for patients with relapse limited to the lungs. We investigated the incidence and outcome of metachronous skeletal OS after initial treatment of the primary tumor.

Patients And Methods: Twenty-three (median age 18.

Second malignant neoplasms in long-term survivors of osteosarcoma: Memorial Sloan-Kettering Cancer Center Experience.

Background: The authors investigated the incidence and relative risk of secondary malignant neoplasms in long-term survivors of osteosarcoma.

Methods: A comprehensive list of 509 patients with primary osteosarcoma treated at our institution between February 1973 and March 2000 was identified. All study patients received chemotherapy and/or surgery on one of six different protocols (T4, 5, 7, 10, 12, and CCG-7921/POG-9351).

Central hepatic resection for pediatric tumors.

Background/purpose: Resection of hepatic malignancies in childhood has been facilitated greatly by an understanding of hepatic segmental anatomy. This report documents the indications and technique of central hepatic resection (mesohepatectomy) in children with hepatic malignancies.

Methods: This is a retrospective study, and data are obtained from patient charts and operative reports.

Malignant pancreatic tumors in childhood and adolescence: The Memorial Sloan-Kettering experience, 1967 to present.

Background: Malignant tumors of the pancreas are uncommon in children and adolescents and only recently have the most common tumor types been well characterized. As a result, the treatment approach to these patients has yet to be standardized, and much of the information available in the literature, particularly with regard to the role of chemotherapy and radiation, is anecdotal.

Methods: A retrospective review was undertaken of all patients less than 21 years of age with malignant pancreatic tumors who were cared for at Memorial Sloan-Kettering since 1967.

Hydrostatic balloon dilation of congenital esophageal stenoses associated with esophageal atresia.

It has been stated that congenital cartilage rings in the esophagus do not respond to dilation and should be resected. The authors report on 3 infants with congenital esophageal stenoses who were treated successfully with hydrostatic balloon dilation. Based on the appearance during dilation the authors believe that these stenoses were cartilage rings.

Extralobar pulmonary sequestration receiving its arterial supply from the innominate artery.

Pulmonary sequestration is a rare bronchopulmonary foregut malformation, for which the arterial blood supply is usually derived from the descending thoracic or abdominal aorta. A 5-week-old infant is described with an extralobar pulmonary sequestration supplied by a large artery originating from the innominate artery, an arrangement only described once previously. Helical CT scan now makes arteriography unnecessary in the evaluation of these malformations.

The posterior approach to pyloric sonography.

Overlying bowel gas or gastric distension may occasionally hinder the sonographic diagnosis of hypertrophic pyloric stenosis. To address this problem, a novel approach for obtaining posterior views of the pylorus is reported. Utilizing this approach may decrease the incidence of nondiagnostic pyloric ultrasonography.

Prolonged intestinal exposure to amniotic fluid does not result in peel formation in gastroschisis.

The etiology of bowel wall changes in infants with gastroschisis remains unknown. Currently, debate focuses on the relative roles of amniotic fluid exposure versus that of intestinal ischemia. The authors report five cases of prenatally diagnosed gastroschisis in which the bowel was exposed to amniotic fluid for up to 21.

Snowboarding injuries in children and adolescents.

To study snowboarding injuries in children and adolescents, a 6-year retrospective study was conducted of patients 18 years old and younger admitted to a pediatric trauma center after snowboarding accidents. The study was designed to identify the most severely injured patients. Comparison was made to data from a recent comparable study of skiing injuries.

Indomethacin-associated bowel perforations: a study of possible risk factors.

Background: The association between indomethacin administration and bowel perforation in premature infants is well known. The goal of this study was to examine possible risk factors for this complication.

Methods: Fifteen cases of indomethacin-associated bowel perforation occurred from 1993 to 1996.

Childhood sledding injuries.

Sledding is only rarely thought of as a potentially dangerous childhood activity. However, serious injuries and occasional deaths do occur. A review of patients 18 years old and younger admitted to a pediatric trauma center following a sledding accident from 1991 to 1997 was conducted.

Teenage driving fatalities.

Background/purpose: A recent legislative effort in New Hampshire to institute a graduated licensing system for teenagers (TA) led to an analysis of state data on fatal crashes involving TA drivers. This provides an overview of these events and suggests possible prevention strategies.

Methods: Data on fatal crashes involving TA drivers was obtained for the years 1991 through 1996 from the Fatal Accident Unit, Division of State Police, New Hampshire Department of Safety.

Variation in the management of pediatric splenic injuries in New Hampshire.

Purpose: The aim of this study was to determine if variation in the management of pediatric splenic injuries occurs among hospitals in New Hampshire.

Methods: Data accrued for each patient less than 18 years of age discharged from an acute care hospital in New Hampshire with a splenic injury diagnosis code or splenic procedure code were analyzed for the years 1991 through 1994. The splenectomy, splenorrhaphy, and nonoperative management rates of each hospital were analyzed and adjusted for case mix using direct standardization.

Surgical aspects of an outbreak of Yersinia enterocolitis.

Eleven patients with Yersinia enterocolitica infections were identified in the Upper Valley of New Hampshire and Vermont during October and November of 1995. Three children presented with an appendicitis-like picture. Two underwent appendectomy, one of whom was the outbreak's index case.

Furuncular cuterebrid myiasis.

Myiasis is the infestation of skin bythe larvae of flies. In North America cases are caused by the botfly (Cuterebra) and occur most commonly in children. The usual presentation is a subcutaneous abscess, and for this reason these patients may be referred to surgeons.

Slipping rib syndrome in childhood.

Slipping rib syndrome is an unusual cause of lower chest and upper abdominal pain in children not mentioned in major pediatric surgical texts. The syndrome occurs when the medial fibrous attachments of the eighth, ninth, or tenth ribs are inadequate or ruptured, allowing their cartilage tip to slip superiorly and impinge on the intervening intercostal nerve. This may cause a variety of somatic and visceral complaints.