Ellen Encisco
0 statements · 0 topics · summaries given as host listed separately
Abdominal Wall Defects
· guest expert
Aerodigestive / ENT
· guest expert
Biliary Atresia
· episode host
Choledochal Cyst / Biliary
· episode host
Colorectal / ARM & Hirschsprung
· episode host
Congenital Lung Lesions (CPAM)
· episode host
Etiologies (Gastroschisis/NEC/Atresia/Volvulus)
· guest expert
Fetal Surgery
· episode host
Intestinal Failure
· episode host
Intestinal Rehab
· episode host
Liver Tumors (Hepatoblastoma/HCC)
· episode host
Motility / Pseudo-obstruction
· episode host
Pectus Excavatum
· episode host
Peritoneal Dialysis Access
· guest expert
Sarcoma (Ewing/Rhabdo)
· episode host
Short Bowel Syndrome
· episode host
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Summaries Ellen gave as host · 544 summaries
Recaps of other experts' statements, not Ellen's own clinical position.
Summaries Ellen gave as host · Abdominal Wall Defects 20 summaries
Open the Abdominal Wall Defects collection →
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
Host summary
Ellen Encisco summarizing the discussion: Mucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.
Open
Host summary
Ellen Encisco summarizing the discussion: Gastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.
Open
Quick Literature Updates Episode 6
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Ellen Encisco summarizing a resource: Gunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.
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Ellen Encisco summarizing a resource: Teodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.
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Ellen Encisco summarizing a resource: Teodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.
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Ellen Encisco summarizing a resource: In California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.
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Host summary
Ellen Encisco summarizing a resource: Gunshot wound victims were 7.8 times more likely to die than MVC victims.
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Quick Literature Updates Episode 11
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Ellen Encisco summarizing a resource: Stevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.
Open
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Ellen Encisco summarizing a resource: There was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.
Open
Host summary
Ellen Encisco summarizing a resource: As other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.
Open
Host summary
Ellen Encisco summarizing a resource: Stronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.
Open
Host summary
Ellen Encisco summarizing a resource: In recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.
Open
Host summary
Ellen Encisco summarizing a resource: Stevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.
Open
Quick Literature Updates Episode 16
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Ellen Encisco summarizes what Dr. Alex Halpern said: Connecticut Children's Medical Center implemented an algorithm for managing esophageal button batteries in 2019 that includes activating the critical airway response team.
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Ellen Encisco summarizes what Dr. Alex Halpern said: The Brent et al. study compared patients presenting with esophageal button batteries before algorithm implementation (2015-2019) to those after implementation (2019-2022).
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Ellen Encisco summarizes what Dr. Alex Halpern said: There was a significant reduction in time from chest X-ray to OR for button battery removal after implementing the new algorithm at Connecticut Children's.
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Ellen Encisco summarizes what Dr. Alex Halpern said: Based on this data, it looks like the implementation of this algorithm helped the kids get the care they needed faster.
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Ellen Encisco summarizes what Dr. Alex Halpern said: What does your institution do for oesophageal button batteries?
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Update Course Rewind: Omphalocele & Gastroschisis 2020
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Ellen Encisco summarizing the discussion: A Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging
Open
Host summary
Ellen Encisco summarizing the discussion: Component separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space
Open
Summaries Ellen gave as host · Anorectal Malformation 12 summaries
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Update Course Rewind: Pediatric Colorectal Consortium 2021
Host summary
Ellen Encisco summarizing the discussion: There is literature suggesting a component of psychosocial, psychological dissociation in children on later testing related to anal dilations.
Open
Host summary
Ellen Encisco summarizing the discussion: The number of strictures, number needing anoplasties, and number of redo operations were the same between dilation and no-dilation groups.
Open
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Ellen Encisco summarizing the discussion: The number of patients who had rectal prolapse is consistent with the literature.
Open
Host summary
Ellen Encisco summarizing the discussion: A study of 30-day outcomes for ARM with perineal or rectovaginal fistulas divided patients into early repair (before 6 days old) and late repair (6-8 weeks), with 66 early and 231 late repairs among 291 patients.
Open
Quick Literature Updates Episode 14
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Ellen Encisco summarizes what Dr. Alex Halpern said: The study by Ahmad et al. examined 384 females with anorectal malformations using the Pediatric Colorectal and Pelvic Learning Consortium database.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: About 46% of females with anorectal malformations had VACTERL association, defined as having the anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: About 27% of patients with anorectal malformations had a gynecologic anomaly.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: Having VACTERL association was associated with more gynecologic anomalies compared to patients without VACTERL association.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: So for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: For females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies.
Open
Summaries Ellen gave as host · Appendicitis 6 summaries
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Quick Literature Updates Episode 11
Host summary
Ellen Encisco summarizing a resource: In recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.
Open
Host summary
Ellen Encisco summarizing a resource: Stronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.
Open
Host summary
Ellen Encisco summarizing a resource: As other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.
Open
Host summary
Ellen Encisco summarizing a resource: There was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.
Open
Host summary
Ellen Encisco summarizing a resource: Stevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.
Open
Host summary
Ellen Encisco summarizing a resource: Stevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.
Open
Summaries Ellen gave as host · Choledochal Cyst 8 summaries
Open the Choledochal Cyst collection →
Outcomes of laparoscopic versus open resection of pediatric choledochal cyst
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Ellen Encisco summarizing a resource: The study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.
Open
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Ellen Encisco summarizing a resource: Patients who underwent open resection were more likely to have a Roux-en-Y hepaticojejunostomy.
Open
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Ellen Encisco summarizing a resource: The majority of patients underwent open resection.
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Ellen Encisco summarizing a resource: Patients who underwent laparoscopic resection were more likely to have a hepaticoduodenostomy.
Open
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Ellen Encisco summarizing a resource: Patients who underwent open resection had higher total costs.
Open
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Ellen Encisco summarizing a resource: Patients who underwent open resection were more likely to have a longer length of hospital stay.
Open
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Ellen Encisco summarizing a resource: Patients who underwent open resection were more likely to have more complications.
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Ellen Encisco summarizing a resource: How do you resect colodocal cysts in pediatric patients?
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Summaries Ellen gave as host · Choledochal Cyst / Biliary 19 summaries
Open the Choledochal Cyst / Biliary collection →
Outcomes of laparoscopic versus open resection of pediatric choledochal cyst
Host summary
Ellen Encisco summarizing a resource: The study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.
Open
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Ellen Encisco summarizing a resource: The majority of patients underwent open resection.
Open
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Ellen Encisco summarizing a resource: Patients who underwent laparoscopic resection were more likely to have a hepaticoduodenostomy.
Open
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Ellen Encisco summarizing a resource: Patients who underwent open resection were more likely to have a Roux-en-Y hepaticojejunostomy.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open resection were more likely to have a longer length of hospital stay.
Open
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Ellen Encisco summarizing a resource: Patients who underwent open resection had higher total costs.
Open
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Ellen Encisco summarizing a resource: Patients who underwent open resection were more likely to have more complications.
Open
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Ellen Encisco summarizing a resource: How do you resect colodocal cysts in pediatric patients?
Open
Journal of pediatric surgery Article Review: April 2023, IPEG issue
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Ellen Encisco summarizing the discussion: The Titanic Index provides an objective way to determine bar number rather than guessing based on eyeballing or age.
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Ellen Encisco summarizing the discussion: Severe outcomes in button battery ingestion were defined as deep mucosal erosion, perforation, mediastinitis, vascular or airway injury or fistula, or esophageal stricture development.
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Ellen Encisco summarizing the discussion: The Boston Children's study included 143 patients under 21 years old from 2008 to 2021, with 24 having severe outcomes.
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Ellen Encisco summarizing the discussion: Three predictive factors for severe button battery outcomes are: battery in esophagus at presentation, battery size ≥2cm, and presence of any symptoms.
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Quick Literature Updates Episode 15
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Ellen Encisco summarizing a resource: The choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.
Open
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Ellen Encisco summarizing a resource: Patients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.
Open
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Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.
Open
Host summary
Ellen Encisco summarizing a resource: The majority of pediatric choledochal cyst patients underwent open resection.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.
Open
Summaries Ellen gave as host · Cholestasis 3 summaries
Open the Cholestasis collection →
Intestinal Rehabilitation, Episode 6: Cholestasis
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Ellen Encisco summarizing the discussion: SMOF lipid emulsion is composed of soybean oil, medium chain triglycerides, olive oil, and fish oil.
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Ellen Encisco summarizing the discussion: Patients on SMOF lipid emulsions can still develop cholestasis due to other factors beyond lipid composition.
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Ellen Encisco summarizing the discussion: A lake drain helps identify proximal bowel and leaves the bowel at appropriate size to make future anastomosis easier without large size mismatch.
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Summaries Ellen gave as host · Colorectal / ARM & Hirschsprung 49 summaries
Open the Colorectal / ARM & Hirschsprung collection →
Journal of Pediatric Surgery Article Review: October 2021
Host summary
Ellen Encisco summarizing the discussion: After one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.
Open
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Ellen Encisco summarizing the discussion: The Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.
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Ellen Encisco summarizing the discussion: The Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.
Open
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Ellen Encisco summarizing the discussion: Despite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.
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Ellen Encisco summarizing the discussion: In typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.
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Intestinal rehabilitation: What is intestinal rehab? - Episode 1
Host summary
Ellen Encisco summarizing the discussion: Mucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.
Open
Host summary
Ellen Encisco summarizing the discussion: Gastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.
Open
Update Course Rewind: Pediatric Colorectal Consortium 2021
Host summary
Ellen Encisco summarizing the discussion: There is literature suggesting a component of psychosocial, psychological dissociation in children on later testing related to anal dilations.
Open
Host summary
Ellen Encisco summarizing the discussion: The number of strictures, number needing anoplasties, and number of redo operations were the same between dilation and no-dilation groups.
Open
Host summary
Ellen Encisco summarizing the discussion: The number of patients who had rectal prolapse is consistent with the literature.
Open
Host summary
Ellen Encisco summarizing the discussion: A study of 30-day outcomes for ARM with perineal or rectovaginal fistulas divided patients into early repair (before 6 days old) and late repair (6-8 weeks), with 66 early and 231 late repairs among 291 patients.
Open
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
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Ellen Encisco summarizing the discussion: In Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005
Open
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Ellen Encisco summarizing the discussion: We were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.
Open
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Ellen Encisco summarizing the discussion: The first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure
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Ellen Encisco summarizing the discussion: Dr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique
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Ellen Encisco summarizing the discussion: All esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning
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Ellen Encisco summarizing the discussion: The first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.
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Ellen Encisco summarizing the discussion: Even if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.
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Ellen Encisco summarizing the discussion: Centralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher
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Ellen Encisco summarizing the discussion: Dr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience
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Ellen Encisco summarizing the discussion: In the stoma cohort, 38 patients had ileostomies and the remaining had colostomies
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Ellen Encisco summarizing the discussion: The most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases
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Ellen Encisco summarizing the discussion: Stomma doesn't mean always a failure. Sometimes it's a necessity. Comes with the nature of the disease.
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Ellen Encisco summarizing the discussion: Sheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease
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Quick Literature Updates Episode 7
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Ellen Encisco summarizing a resource: Wounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.
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Ellen Encisco summarizing a resource: Tendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.
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Quick Literature Updates Episode 14
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The study by Ahmad et al. examined 384 females with anorectal malformations using the Pediatric Colorectal and Pelvic Learning Consortium database.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The study by Ahmad et al. examined 384 females with anorectal malformations using the Pediatric Colorectal and Pelvic Learning Consortium database.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: About 46% of females with anorectal malformations had VACTERL association, defined as having the anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: About 46% of females with anorectal malformations had VACTERL association, defined as having the anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: About 27% of patients with anorectal malformations had a gynecologic anomaly.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: About 27% of patients with anorectal malformations had a gynecologic anomaly.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: Having VACTERL association was associated with more gynecologic anomalies compared to patients without VACTERL association.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: Having VACTERL association was associated with more gynecologic anomalies compared to patients without VACTERL association.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: So for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: For females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: For females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: So for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.
Open
Quick Literature Updates Episode 15
Host summary
Ellen Encisco summarizing a resource: The choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.
Open
Host summary
Ellen Encisco summarizing a resource: The majority of pediatric choledochal cyst patients underwent open resection.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.
Open
Summaries Ellen gave as host · Congenital Diaphragmatic Hernia 14 summaries
Open the Congenital Diaphragmatic Hernia collection →
Journal of Pediatric Surgery Article Review: November 2021
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Ellen Encisco summarizing the discussion: 40% of patients ultimately required a central venous line within 30 days after ECMO decannulation in the University of Michigan study
Open
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Ellen Encisco summarizing the discussion: 40% of patients ultimately required a central venous line within 30 days after ECMO decannulation in the University of Michigan study
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Ellen Encisco summarizing the discussion: In neonates (babies less than 28 days), the primary reason for needing a central line after ECMO decannulation was access, with many being CDH babies
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Ellen Encisco summarizing the discussion: In neonates (babies less than 28 days), the primary reason for needing a central line after ECMO decannulation was access, with many being CDH babies
Open
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Ellen Encisco summarizing the discussion: In older children or babies, the primary reason for needing a line after ECMO decannulation was hemodialysis
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Ellen Encisco summarizing the discussion: In older children or babies, the primary reason for needing a line after ECMO decannulation was hemodialysis
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Ellen Encisco summarizing the discussion: The Indianapolis partial splenectomy study reviewed cases over 17 years from 2002 to 2019
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Ellen Encisco summarizing the discussion: The Indianapolis partial splenectomy study reviewed cases over 17 years from 2002 to 2019
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Ellen Encisco summarizing the discussion: About 29% of patients required completion splenectomy after partial splenectomy
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Ellen Encisco summarizing the discussion: About 29% of patients required completion splenectomy after partial splenectomy
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Neonatal Gastric Volvulus with Dr. Jason Frischer
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Ellen Encisco summarizing the discussion: On upper GI contrast study in gastric volvulus, contrast probably does not go past the stomach if it makes it into the stomach.
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Ellen Encisco summarizing the discussion: You would probably see that it doesn't go past the stomach if it makes it into the stomach.
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Ellen Encisco summarizing the discussion: In organoaxial volvulus, if contrast gets past the GE junction into the stomach, the greater curvature appears flipped up.
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Ellen Encisco summarizing the discussion: The greater curvature would be flipped up.
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Summaries Ellen gave as host · Congenital Lung Lesions (CPAM) 15 summaries
Open the Congenital Lung Lesions (CPAM) collection →
Journal of Pediatric Surgery Article Review: November 2021
Host summary
Ellen Encisco summarizing the discussion: 40% of patients ultimately required a central venous line within 30 days after ECMO decannulation in the University of Michigan study
Open
Host summary
Ellen Encisco summarizing the discussion: In neonates (babies less than 28 days), the primary reason for needing a central line after ECMO decannulation was access, with many being CDH babies
Open
Host summary
Ellen Encisco summarizing the discussion: In older children or babies, the primary reason for needing a line after ECMO decannulation was hemodialysis
Open
Host summary
Ellen Encisco summarizing the discussion: The Indianapolis partial splenectomy study reviewed cases over 17 years from 2002 to 2019
Open
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Ellen Encisco summarizing the discussion: About 29% of patients required completion splenectomy after partial splenectomy
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Case Based Journal Review - CPAM in 2022
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Ellen Encisco summarizing the discussion: 57% (68 patients) of the 119 cases were managed conservatively, and none of those who could be followed up became symptomatic
Open
Host summary
Ellen Encisco summarizing the discussion: 57% (68 patients) of the 119 cases were managed conservatively, and none of those who could be followed up became symptomatic
Open
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Ellen Encisco summarizing the discussion: Out of 344 prenatally diagnosed lesions, none had malignant pathology when resected
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Ellen Encisco summarizing the discussion: Out of 344 prenatally diagnosed lesions, none had malignant pathology when resected
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Ellen Encisco summarizing the discussion: The risk of malignancy approached 10% for lung masses diagnosed postnatally
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Ellen Encisco summarizing the discussion: The risk of malignancy approached 10% for lung masses diagnosed postnatally
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Ellen Encisco summarizing the discussion: The study was retrospective and looked at about 90 patients undergoing thoracoscopic lung resections
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Ellen Encisco summarizing the discussion: The study was retrospective and looked at about 90 patients undergoing thoracoscopic lung resections
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Ellen Encisco summarizing the discussion: There were no differences in major complications, conversion rates, or readmissions between the three age groups
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Ellen Encisco summarizing the discussion: There were no differences in major complications, conversion rates, or readmissions between the three age groups
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Summaries Ellen gave as host · Congenital Pulmonary Airway Malformation 5 summaries
Open the Congenital Pulmonary Airway Malformation collection →
Case Based Journal Review - CPAM in 2022
Host summary
Ellen Encisco summarizing the discussion: 57% (68 patients) of the 119 cases were managed conservatively, and none of those who could be followed up became symptomatic
Open
Host summary
Ellen Encisco summarizing the discussion: Out of 344 prenatally diagnosed lesions, none had malignant pathology when resected
Open
Host summary
Ellen Encisco summarizing the discussion: The risk of malignancy approached 10% for lung masses diagnosed postnatally
Open
Host summary
Ellen Encisco summarizing the discussion: The study was retrospective and looked at about 90 patients undergoing thoracoscopic lung resections
Open
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Ellen Encisco summarizing the discussion: There were no differences in major complications, conversion rates, or readmissions between the three age groups
Open
Summaries Ellen gave as host · Crohn's Disease 3 summaries
Open the Crohn's Disease collection →
Journal of Pediatric Surgery Article Review: September 2021
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Ellen Encisco summarizing the discussion: The Utah study created a risk score to predict Meckel's diverticulum in patients presenting with hematochezia
Open
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
Host summary
Ellen Encisco summarizing the discussion: Mucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.
Open
Host summary
Ellen Encisco summarizing the discussion: Gastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.
Open
Summaries Ellen gave as host · Early Assessment and Management of Trauma 9 summaries
Open the Early Assessment and Management of Trauma collection →
ATLS 2021 Pediatric Surgery Update
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Ellen Encisco summarizes what Dr. Rich Falcone said: MIST stands for mechanism of injury, injuries identified, signs and symptoms, and treatments.
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Ellen Encisco summarizes what Dr. Rich Falcone said: For needle cricothyroidotomy, a 10 mL syringe with IV catheter can connect to an Ambu bag for ventilation.
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Ellen Encisco summarizes what Dr. Rich Falcone said: Intraosseous (IO) access can be placed in the tibia, humeral head, or distal femur.
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Ellen Encisco summarizes what Dr. Rich Falcone said: Updated ATLS guidelines recommend one crystalloid bolus at 20 cc/kg, and if there is transient or no response, proceed directly to blood products at 10 cc/kg.
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Ellen Encisco summarizes what Dr. Rich Falcone said: The old ATLS protocol was to give 20 cc/kg crystalloid bolus, assess response, give another 20 cc/kg, and only then use blood products.
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Ellen Encisco summarizes what Dr. Rich Falcone said: The old ATLS was you give 20 per kilo, you see how they respond, then you give another 20 per kilo and see how they respond, and then you can just, you know, and only after that can you use blood.
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Ellen Encisco summarizes what Dr. Rich Falcone said: They're very clear on now saying it's one, and if you get either transient or no response, you can go right to blood as the next, as the next step.
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Ellen Encisco summarizes what Dr. Rich Falcone said: For a child to start showing signs of hemorrhagic shock, they would have to lose about 50% of their total blood volume.
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Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: For a child to start showing signs of hemorrhagic shock, they would have to lose about 50% of their total blood volume.
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Summaries Ellen gave as host · Esophageal Atresia 19 summaries
Open the Esophageal Atresia collection →
Case Based Journal Review: Esophageal Atresia in 2022
Host summary
Ellen Encisco summarizes what Dr. Jose Campos said: In a meta-analysis of almost 700 neonates, preserving the azygous vein resulted in significantly lower postoperative pneumonitis compared to division
Open
Host summary
Ellen Encisco summarizes what Dr. Jose Campos said: There was no significant difference in anastomotic leak rate or stricture rate between azygous vein preservation and division
Open
Host summary
Ellen Encisco summarizes what Dr. Jose Campos said: In the Quebec study of 244 patients, the overall anastomotic stricture rate at one year was 30%
Open
Host summary
Ellen Encisco summarizes what Dr. Jose Campos said: 36% of patients with transanastomotic tubes developed strictures compared to 19% without tubes, a difference that remained significant after multivariable analysis
Open
Host summary
Ellen Encisco summarizes what Dr. Jose Campos said: Patients with transanastomotic tubes had 2.72 times higher odds of developing a stricture compared to those without
Open
Host summary
Ellen Encisco summarizes what Dr. Jose Campos said: In the Midwest Pediatric Surgery Consortium study, antibiotics for more than 24 hours and acid suppression showed no difference in strictures or leaks
Open
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
Host summary
Ellen Encisco summarizing the discussion: In Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005
Open
Host summary
Ellen Encisco summarizing the discussion: We were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.
Open
Host summary
Ellen Encisco summarizing the discussion: The first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure
Open
Host summary
Ellen Encisco summarizing the discussion: Dr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique
Open
Host summary
Ellen Encisco summarizing the discussion: All esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning
Open
Host summary
Ellen Encisco summarizing the discussion: The first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.
Open
Host summary
Ellen Encisco summarizing the discussion: Centralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher
Open
Host summary
Ellen Encisco summarizing the discussion: Even if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.
Open
Host summary
Ellen Encisco summarizing the discussion: Dr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience
Open
Host summary
Ellen Encisco summarizing the discussion: In the stoma cohort, 38 patients had ileostomies and the remaining had colostomies
Open
Host summary
Ellen Encisco summarizing the discussion: The most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases
Open
Host summary
Ellen Encisco summarizing the discussion: Stomma doesn't mean always a failure. Sometimes it's a necessity. Comes with the nature of the disease.
Open
Host summary
Ellen Encisco summarizing the discussion: Sheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease
Open
Summaries Ellen gave as host · Etiologies (Gastroschisis/NEC/Atresia/Volvulus) 29 summaries
Open the Etiologies (Gastroschisis/NEC/Atresia/Volvulus) collection →
Journal of Pediatric Surgery Article Review: October 2021
Host summary
Ellen Encisco summarizing the discussion: After one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.
Open
Host summary
Ellen Encisco summarizing the discussion: The Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.
Open
Host summary
Ellen Encisco summarizing the discussion: The Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.
Open
Host summary
Ellen Encisco summarizing the discussion: Despite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.
Open
Host summary
Ellen Encisco summarizing the discussion: In typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.
Open
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
Host summary
Ellen Encisco summarizing the discussion: Mucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.
Open
Host summary
Ellen Encisco summarizing the discussion: Gastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.
Open
Neonatal Gastric Volvulus with Dr. Jason Frischer
Host summary
Ellen Encisco summarizing the discussion: On upper GI contrast study in gastric volvulus, contrast probably does not go past the stomach if it makes it into the stomach.
Open
Host summary
Ellen Encisco summarizing the discussion: You would probably see that it doesn't go past the stomach if it makes it into the stomach.
Open
Host summary
Ellen Encisco summarizing the discussion: In organoaxial volvulus, if contrast gets past the GE junction into the stomach, the greater curvature appears flipped up.
Open
Host summary
Ellen Encisco summarizing the discussion: The greater curvature would be flipped up.
Open
Quick Literature Updates Episode 6
Host summary
Ellen Encisco summarizing a resource: Gunshot wound victims were 7.8 times more likely to die than MVC victims.
Open
Host summary
Ellen Encisco summarizing a resource: Teodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.
Open
Host summary
Ellen Encisco summarizing a resource: Teodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.
Open
Host summary
Ellen Encisco summarizing a resource: In California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.
Open
Host summary
Ellen Encisco summarizing a resource: Gunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.
Open
Quick Literature Updates Episode 11
Host summary
Ellen Encisco summarizing a resource: As other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.
Open
Host summary
Ellen Encisco summarizing a resource: Stevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.
Open
Host summary
Ellen Encisco summarizing a resource: Stronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.
Open
Host summary
Ellen Encisco summarizing a resource: Stevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.
Open
Host summary
Ellen Encisco summarizing a resource: There was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.
Open
Host summary
Ellen Encisco summarizing a resource: In recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.
Open
Quick Literature Updates Episode 16
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: Connecticut Children's Medical Center implemented an algorithm for managing esophageal button batteries in 2019 that includes activating the critical airway response team.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The Brent et al. study compared patients presenting with esophageal button batteries before algorithm implementation (2015-2019) to those after implementation (2019-2022).
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: There was a significant reduction in time from chest X-ray to OR for button battery removal after implementing the new algorithm at Connecticut Children's.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: Based on this data, it looks like the implementation of this algorithm helped the kids get the care they needed faster.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: What does your institution do for oesophageal button batteries?
Open
Update Course Rewind: Omphalocele & Gastroschisis 2020
Host summary
Ellen Encisco summarizing the discussion: Component separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space
Open
Host summary
Ellen Encisco summarizing the discussion: A Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging
Open
Summaries Ellen gave as host · Gastroschisis 16 summaries
Open the Gastroschisis collection →
Quick Literature Updates Episode 6
Host summary
Ellen Encisco summarizing a resource: Teodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.
Open
Host summary
Ellen Encisco summarizing a resource: In California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.
Open
Host summary
Ellen Encisco summarizing a resource: Gunshot wound victims were 7.8 times more likely to die than MVC victims.
Open
Host summary
Ellen Encisco summarizing a resource: Gunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.
Open
Host summary
Ellen Encisco summarizing a resource: Teodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.
Open
Quick Literature Updates Episode 11
Host summary
Ellen Encisco summarizing a resource: Stevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.
Open
Host summary
Ellen Encisco summarizing a resource: As other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.
Open
Host summary
Ellen Encisco summarizing a resource: Stevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.
Open
Host summary
Ellen Encisco summarizing a resource: There was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.
Open
Host summary
Ellen Encisco summarizing a resource: In recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.
Open
Host summary
Ellen Encisco summarizing a resource: Stronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.
Open
Quick Literature Updates Episode 16
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: Connecticut Children's Medical Center implemented an algorithm for managing esophageal button batteries in 2019 that includes activating the critical airway response team.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The Brent et al. study compared patients presenting with esophageal button batteries before algorithm implementation (2015-2019) to those after implementation (2019-2022).
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: There was a significant reduction in time from chest X-ray to OR for button battery removal after implementing the new algorithm at Connecticut Children's.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: Based on this data, it looks like the implementation of this algorithm helped the kids get the care they needed faster.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: What does your institution do for oesophageal button batteries?
Open
Summaries Ellen gave as host · Giant Omphalocele 2 summaries
Open the Giant Omphalocele collection →
Update Course Rewind: Omphalocele & Gastroschisis 2020
Host summary
Ellen Encisco summarizing the discussion: Component separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space
Open
Host summary
Ellen Encisco summarizing the discussion: A Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging
Open
Summaries Ellen gave as host · Hemorrhagic Shock 12 summaries
Open the Hemorrhagic Shock collection →
ATLS 2021 Pediatric Surgery Update
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: MIST stands for mechanism of injury, injuries identified, signs and symptoms, and treatments.
Open
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: For needle cricothyroidotomy, a 10 mL syringe with IV catheter can connect to an Ambu bag for ventilation.
Open
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: Intraosseous (IO) access can be placed in the tibia, humeral head, or distal femur.
Open
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: Updated ATLS guidelines recommend one crystalloid bolus at 20 cc/kg, and if there is transient or no response, proceed directly to blood products at 10 cc/kg.
Open
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: They're very clear on now saying it's one, and if you get either transient or no response, you can go right to blood as the next, as the next step.
Open
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: The old ATLS was you give 20 per kilo, you see how they respond, then you give another 20 per kilo and see how they respond, and then you can just, you know, and only after that can you use blood.
Open
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: The old ATLS protocol was to give 20 cc/kg crystalloid bolus, assess response, give another 20 cc/kg, and only then use blood products.
Open
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: For a child to start showing signs of hemorrhagic shock, they would have to lose about 50% of their total blood volume.
Open
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: For a child to start showing signs of hemorrhagic shock, they would have to lose about 50% of their total blood volume.
Open
ATLS 2021 Pediatric Surgery Update
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: Intraosseous (IO) access can be placed in the tibia, humeral head, or distal femur; sternal IO is avoided in children though used in adults.
Open
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: For a child to show signs of hemorrhagic shock (both tachycardia and hypotension), they must lose about half their total blood volume.
Open
Host summary
Ellen Encisco summarizes what Dr. Rich Falcone said: Over 75% of pediatric trauma deaths are due to head injuries.
Open
Summaries Ellen gave as host · Hirschsprung disease 44 summaries
Open the Hirschsprung disease collection →
Update Course Rewind: 2021 Top Ten Key Takeaways
Host summary
Ellen Encisco summarizing the discussion: In the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up.
Open
Host summary
Ellen Encisco summarizing the discussion: Medical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy.
Open
Host summary
Ellen Encisco summarizing the discussion: Indocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures.
Open
Host summary
Ellen Encisco summarizing the discussion: You can see very well the biliary anatomy is absolutely. Amazing, as you can see, the main biliary tree, the gallbladder, and then the cystic duct.
Open
Host summary
Ellen Encisco summarizing the discussion: For laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery.
Open
Host summary
Ellen Encisco summarizing the discussion: ICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions.
Open
Host summary
Ellen Encisco summarizing the discussion: The double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin.
Open
Host summary
Ellen Encisco summarizing the discussion: This strikes fear at the heart of of uh ENT surgeons, gastroenterologists, and pediatric surgeons.
Open
Host summary
Ellen Encisco summarizing the discussion: The main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion.
Open
Host summary
Ellen Encisco summarizing the discussion: Sucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures.
Open
Host summary
Ellen Encisco summarizing the discussion: What you need to do is cut down on the damage, the injury that this is doing. Sucralfate or honey can help.
Open
Host summary
Ellen Encisco summarizing the discussion: Children less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion.
Open
Host summary
Ellen Encisco summarizing the discussion: Children over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses.
Open
Host summary
Ellen Encisco summarizing the discussion: Greenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns.
Open
Host summary
Ellen Encisco summarizing the discussion: When black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians.
Open
Host summary
Ellen Encisco summarizing the discussion: Bias exists within medicine and can change outcomes; representation matters and can make a difference.
Open
Host summary
Ellen Encisco summarizing the discussion: recognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do? So I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?
Open
Host summary
Ellen Encisco summarizing the discussion: So let's not just settle to talk about it, but let's figure out what the system level changes are that make a difference and change the outcome.
Open
Update Course Rewind: Pediatric Colorectal Consortium 2021
Host summary
Ellen Encisco summarizing the discussion: There is literature suggesting a component of psychosocial, psychological dissociation in children on later testing related to anal dilations.
Open
Host summary
Ellen Encisco summarizing the discussion: The number of strictures, number needing anoplasties, and number of redo operations were the same between dilation and no-dilation groups.
Open
Host summary
Ellen Encisco summarizing the discussion: The number of patients who had rectal prolapse is consistent with the literature.
Open
Host summary
Ellen Encisco summarizing the discussion: A study of 30-day outcomes for ARM with perineal or rectovaginal fistulas divided patients into early repair (before 6 days old) and late repair (6-8 weeks), with 66 early and 231 late repairs among 291 patients.
Open
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
Host summary
Ellen Encisco summarizing the discussion: In Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005
Open
Host summary
Ellen Encisco summarizing the discussion: We were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.
Open
Host summary
Ellen Encisco summarizing the discussion: The first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure
Open
Host summary
Ellen Encisco summarizing the discussion: Dr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique
Open
Host summary
Ellen Encisco summarizing the discussion: All esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning
Open
Host summary
Ellen Encisco summarizing the discussion: The first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.
Open
Host summary
Ellen Encisco summarizing the discussion: Centralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher
Open
Host summary
Ellen Encisco summarizing the discussion: Even if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.
Open
Host summary
Ellen Encisco summarizing the discussion: Dr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience
Open
Host summary
Ellen Encisco summarizing the discussion: In the stoma cohort, 38 patients had ileostomies and the remaining had colostomies
Open
Host summary
Ellen Encisco summarizing the discussion: The most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases
Open
Host summary
Ellen Encisco summarizing the discussion: Stomma doesn't mean always a failure. Sometimes it's a necessity. Comes with the nature of the disease.
Open
Host summary
Ellen Encisco summarizing the discussion: Sheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease
Open
Quick Literature Updates Episode 7
Host summary
Ellen Encisco summarizing a resource: Tendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.
Open
Host summary
Ellen Encisco summarizing a resource: Wounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.
Open
Quick Literature Updates Episode 15
Host summary
Ellen Encisco summarizing a resource: The choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.
Open
Host summary
Ellen Encisco summarizing a resource: The majority of pediatric choledochal cyst patients underwent open resection.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.
Open
Summaries Ellen gave as host · Inflammatory Bowel Disease 7 summaries
Open the Inflammatory Bowel Disease collection →
Quick Literature Updates Episode 15
Host summary
Ellen Encisco summarizing a resource: The choledochal cyst study used the nationwide readmissions database and identified 577 children who underwent choledochal cyst resection between 2016 and 2018.
Open
Host summary
Ellen Encisco summarizing a resource: The majority of pediatric choledochal cyst patients underwent open resection.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection were more likely to have a Roux-en-Y hepaticojejunostomy.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent laparoscopic choledochal cyst resection were more likely to have a hepaticoduodenostomy.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection were more likely to have a longer length of hospital stay.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection had more complications than those who underwent laparoscopic resection.
Open
Host summary
Ellen Encisco summarizing a resource: Patients who underwent open choledochal cyst resection had higher total costs than those who underwent laparoscopic resection.
Open
Summaries Ellen gave as host · Intestinal Failure 22 summaries
Open the Intestinal Failure collection →
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
Host summary
Ellen Encisco summarizing the discussion: Mucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.
Open
Host summary
Ellen Encisco summarizing the discussion: Gastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.
Open
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
Host summary
Ellen Encisco summarizing the discussion: In the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.
Open
Host summary
Ellen Encisco summarizing the discussion: At birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.
Open
Host summary
Ellen Encisco summarizing the discussion: If one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.
Open
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
Host summary
Ellen Encisco summarizing the discussion: In the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.
Open
Host summary
Ellen Encisco summarizing the discussion: At birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.
Open
Host summary
Ellen Encisco summarizing the discussion: If one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.
Open
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 2
Host summary
Ellen Encisco summarizing the discussion: STEP does not create new bowel but redistributes it to reestablish more normal caliber bowel, which helps improve motility overall.
Open
Host summary
Ellen Encisco summarizing the discussion: About 50% reduction in parental nutrition support can be expected after STEP.
Open
Host summary
Ellen Encisco summarizing the discussion: There is a whole spectrum of findings from ulcers at staple lines, from just having specks of blood in the stool to enough bleeding that kids might have to be transfused every week and a half.
Open
Host summary
Ellen Encisco summarizing the discussion: Staple line ulcers can recur after treatment.
Open
Host summary
Ellen Encisco summarizing the discussion: Teams have tried enteral omega 3 lipid supplements, bacterial overgrowth management with cycled antibiotics or probiotics, 5ASA, budesonide, and immune modulators like Remicade for staple line bleeding, but none have been the perfect remedy.
Open
Host summary
Ellen Encisco summarizing the discussion: The underlying issue in staple line bleeding is not in the bowel but actually in the mesentery.
Open
Host summary
Ellen Encisco summarizing the discussion: Mesenteric inflammation causes scarring and obstructs venous outflow, leading to enlarged veins and venous hypertension on the bowel, and even large lymph nodes from lymphatic obstruction.
Open
Host summary
Ellen Encisco summarizes what Dr. Michael Helmrath said: Dr. Helmrath typically revises the staple line with a hand sewn stitch when mesenteric scarring and venous hypertension are present.
Open
Host summary
Ellen Encisco summarizing the discussion: Doing things in a staged fashion is typical for the intestinal rehabilitation patient population.
Open
Host summary
Ellen Encisco summarizing the discussion: As intestinal rehabilitation patients grow and develop, more issues might arise requiring additional operations.
Open
Host summary
Ellen Encisco summarizing the discussion: Intestinal rehabilitation is a lifelong issue, and surgeons typically follow these patients for a long time.
Open
Intestinal Rehabilitation, Episode 6: Cholestasis
Host summary
Ellen Encisco summarizing the discussion: SMOF lipid emulsion is composed of soybean oil, medium chain triglycerides, olive oil, and fish oil.
Open
Host summary
Ellen Encisco summarizing the discussion: Patients on SMOF lipid emulsions can still develop cholestasis due to other factors beyond lipid composition.
Open
Host summary
Ellen Encisco summarizing the discussion: A lake drain helps identify proximal bowel and leaves the bowel at appropriate size to make future anastomosis easier without large size mismatch.
Open
Summaries Ellen gave as host · Intestinal Rehab 51 summaries
Open the Intestinal Rehab collection →
Journal of Pediatric Surgery Article Review: October 2021
Host summary
Ellen Encisco summarizing the discussion: After one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.
Open
Host summary
Ellen Encisco summarizing the discussion: The Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.
Open
Host summary
Ellen Encisco summarizing the discussion: The Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.
Open
Host summary
Ellen Encisco summarizing the discussion: Despite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.
Open
Host summary
Ellen Encisco summarizing the discussion: In typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.
Open
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
Host summary
Ellen Encisco summarizing the discussion: Mucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.
Open
Host summary
Ellen Encisco summarizing the discussion: Gastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.
Open
Neonatal Gastric Volvulus with Dr. Jason Frischer
Host summary
Ellen Encisco summarizing the discussion: On upper GI contrast study in gastric volvulus, contrast probably does not go past the stomach if it makes it into the stomach.
Open
Host summary
Ellen Encisco summarizing the discussion: You would probably see that it doesn't go past the stomach if it makes it into the stomach.
Open
Host summary
Ellen Encisco summarizing the discussion: In organoaxial volvulus, if contrast gets past the GE junction into the stomach, the greater curvature appears flipped up.
Open
Host summary
Ellen Encisco summarizing the discussion: The greater curvature would be flipped up.
Open
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
Host summary
Ellen Encisco summarizing the discussion: In the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.
Open
Host summary
Ellen Encisco summarizing the discussion: At birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.
Open
Host summary
Ellen Encisco summarizing the discussion: If one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.
Open
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
Host summary
Ellen Encisco summarizing the discussion: In the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.
Open
Host summary
Ellen Encisco summarizing the discussion: At birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.
Open
Host summary
Ellen Encisco summarizing the discussion: If one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.
Open
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 2
Host summary
Ellen Encisco summarizing the discussion: STEP does not create new bowel but redistributes it to reestablish more normal caliber bowel, which helps improve motility overall.
Open
Host summary
Ellen Encisco summarizing the discussion: About 50% reduction in parental nutrition support can be expected after STEP.
Open
Host summary
Ellen Encisco summarizing the discussion: There is a whole spectrum of findings from ulcers at staple lines, from just having specks of blood in the stool to enough bleeding that kids might have to be transfused every week and a half.
Open
Host summary
Ellen Encisco summarizing the discussion: Staple line ulcers can recur after treatment.
Open
Host summary
Ellen Encisco summarizing the discussion: Teams have tried enteral omega 3 lipid supplements, bacterial overgrowth management with cycled antibiotics or probiotics, 5ASA, budesonide, and immune modulators like Remicade for staple line bleeding, but none have been the perfect remedy.
Open
Host summary
Ellen Encisco summarizing the discussion: The underlying issue in staple line bleeding is not in the bowel but actually in the mesentery.
Open
Host summary
Ellen Encisco summarizing the discussion: Mesenteric inflammation causes scarring and obstructs venous outflow, leading to enlarged veins and venous hypertension on the bowel, and even large lymph nodes from lymphatic obstruction.
Open
Host summary
Ellen Encisco summarizes what Dr. Michael Helmrath said: Dr. Helmrath typically revises the staple line with a hand sewn stitch when mesenteric scarring and venous hypertension are present.
Open
Host summary
Ellen Encisco summarizing the discussion: Doing things in a staged fashion is typical for the intestinal rehabilitation patient population.
Open
Host summary
Ellen Encisco summarizing the discussion: As intestinal rehabilitation patients grow and develop, more issues might arise requiring additional operations.
Open
Host summary
Ellen Encisco summarizing the discussion: Intestinal rehabilitation is a lifelong issue, and surgeons typically follow these patients for a long time.
Open
Quick Literature Updates Episode 6
Host summary
Ellen Encisco summarizing a resource: Gunshot wound victims were 7.8 times more likely to die than MVC victims.
Open
Host summary
Ellen Encisco summarizing a resource: In California statewide data, the case fatality rate for gunshot wound victims was higher than that for motor vehicle collisions.
Open
Host summary
Ellen Encisco summarizing a resource: Gunshot wound victims were more likely to require immediate surgery and had increased mortality compared to MVC victims.
Open
Host summary
Ellen Encisco summarizing a resource: Teodoro et al. examined California Department of Public Health data on pediatric gunshot wounds and MVCs from 2006 to 2015.
Open
Host summary
Ellen Encisco summarizing a resource: Teodoro et al. studied pediatric trauma patients presenting to a level one trauma center with gunshot wounds or MVCs between 2009 and 2019.
Open
Quick Literature Updates Episode 7
Host summary
Ellen Encisco summarizing a resource: Wounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.
Open
Host summary
Ellen Encisco summarizing a resource: Tendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.
Open
Intestinal Rehabilitation, Episode 6: Cholestasis
Host summary
Ellen Encisco summarizing the discussion: SMOF lipid emulsion is composed of soybean oil, medium chain triglycerides, olive oil, and fish oil.
Open
Host summary
Ellen Encisco summarizing the discussion: Patients on SMOF lipid emulsions can still develop cholestasis due to other factors beyond lipid composition.
Open
Host summary
Ellen Encisco summarizing the discussion: A lake drain helps identify proximal bowel and leaves the bowel at appropriate size to make future anastomosis easier without large size mismatch.
Open
Quick Literature Updates Episode 11
Host summary
Ellen Encisco summarizing a resource: Stevens et al. examined CDC Wonder database data between 1999 and 2020 for pediatric firearm and automobile fatalities.
Open
Host summary
Ellen Encisco summarizing a resource: As other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.
Open
Host summary
Ellen Encisco summarizing a resource: Stronger gun laws were associated with decreased fatality rates, with a 55% lower firearm fatality rate for states with the strongest gun laws compared to those with the weakest gun laws.
Open
Host summary
Ellen Encisco summarizing a resource: In recent years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children.
Open
Host summary
Ellen Encisco summarizing a resource: Stevens et al. used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to assess state gun law scores.
Open
Host summary
Ellen Encisco summarizing a resource: There was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws.
Open
Quick Literature Updates Episode 16
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: Connecticut Children's Medical Center implemented an algorithm for managing esophageal button batteries in 2019 that includes activating the critical airway response team.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The Brent et al. study compared patients presenting with esophageal button batteries before algorithm implementation (2015-2019) to those after implementation (2019-2022).
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: There was a significant reduction in time from chest X-ray to OR for button battery removal after implementing the new algorithm at Connecticut Children's.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: Based on this data, it looks like the implementation of this algorithm helped the kids get the care they needed faster.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: What does your institution do for oesophageal button batteries?
Open
Update Course Rewind: Omphalocele & Gastroschisis 2020
Host summary
Ellen Encisco summarizing the discussion: Component separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space
Open
Host summary
Ellen Encisco summarizing the discussion: A Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging
Open
Summaries Ellen gave as host · Intussusception 11 summaries
Open the Intussusception collection →
Case-Based Journal Review- Intussusception in 2022
Host summary
Ellen Encisco summarizing a resource: I would only accept radiology because you have to do an intervention after that. So if it's positive, you have to do an intervention, whether it is enema reduction or surgery.
Open
Host summary
Ellen Encisco summarizing a resource: In resource-limited settings without 24-hour radiology, unnecessary laparotomies are sometimes performed for intussusception diagnosis in the middle of the night.
Open
Host summary
Ellen Encisco summarizing a resource: The 2% difference in success rates between hydrostatic and air reduction is not clinically significant enough to justify changing established practice.
Open
Host summary
Ellen Encisco summarizing a resource: Sedation for pneumatic reduction showed slightly better success rate but higher recurrence rate (5.1% vs 1.3%, non-significant) and more perforations (3 vs 0, non-significant) in a 2017 Pediatric Anesthesia study.
Open
Host summary
Ellen Encisco summarizing a resource: If sedation shows no increased perforation risk compared to no sedation, then sedating children for comfort during reduction is justified.
Open
Host summary
Ellen Encisco summarizing a resource: I share that same feeling. I feel like I lie when I'm saying the number I have in my mind, but actually my number is 10%. That's the number I tell residents, not the number I tell families, 10%.
Open
Host summary
Ellen Encisco summarizing a resource: Both recent studies show lower recurrence rates (3.7-13.5%) than the traditionally quoted 15-20% that surgeons have been telling families.
Open
Host summary
Ellen Encisco summarizing a resource: Increasing tolerance for recurrence risk benefits the vast majority of children by avoiding unnecessary admission and its associated complications.
Open
Host summary
Ellen Encisco summarizing a resource: Increasing our recurrence or failure tolerance, it benefits the vast majority of children with lower chances of getting a complication.
Open
Journal of Pediatric Surgery Article Review: The Disruption Score
Host summary
Ellen Encisco summarizing the discussion: It's called Shifting Paradigms, the Top 100 Most Disruptive Papers in core Pediatric Surgery Journals.
Open
Summaries Ellen gave as host · Lectures, Courses and Honors 18 summaries
Open the Lectures, Courses and Honors collection →
Update Course Rewind: 2021 Top Ten Key Takeaways
Host summary
Ellen Encisco summarizing the discussion: In the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up.
Open
Host summary
Ellen Encisco summarizing the discussion: Medical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy.
Open
Host summary
Ellen Encisco summarizing the discussion: Indocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures.
Open
Host summary
Ellen Encisco summarizing the discussion: You can see very well the biliary anatomy is absolutely. Amazing, as you can see, the main biliary tree, the gallbladder, and then the cystic duct.
Open
Host summary
Ellen Encisco summarizing the discussion: For laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery.
Open
Host summary
Ellen Encisco summarizing the discussion: ICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions.
Open
Host summary
Ellen Encisco summarizing the discussion: The double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin.
Open
Host summary
Ellen Encisco summarizing the discussion: This strikes fear at the heart of of uh ENT surgeons, gastroenterologists, and pediatric surgeons.
Open
Host summary
Ellen Encisco summarizing the discussion: The main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion.
Open
Host summary
Ellen Encisco summarizing the discussion: Sucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures.
Open
Host summary
Ellen Encisco summarizing the discussion: What you need to do is cut down on the damage, the injury that this is doing. Sucralfate or honey can help.
Open
Host summary
Ellen Encisco summarizing the discussion: Children less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion.
Open
Host summary
Ellen Encisco summarizing the discussion: Children over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses.
Open
Host summary
Ellen Encisco summarizing the discussion: Greenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns.
Open
Host summary
Ellen Encisco summarizing the discussion: When black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians.
Open
Host summary
Ellen Encisco summarizing the discussion: Bias exists within medicine and can change outcomes; representation matters and can make a difference.
Open
Host summary
Ellen Encisco summarizing the discussion: recognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do? So I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?
Open
Host summary
Ellen Encisco summarizing the discussion: So let's not just settle to talk about it, but let's figure out what the system level changes are that make a difference and change the outcome.
Open
Summaries Ellen gave as host · Long-gap Esophageal Atresia 13 summaries
Open the Long-gap Esophageal Atresia collection →
Journal of Pediatric Surgery Article Review: February 2023, BAPS issue
Host summary
Ellen Encisco summarizing the discussion: In Poland, thoracoscopic esophageal atresia repair has been performed exclusively since 2005
Open
Host summary
Ellen Encisco summarizing the discussion: We were happy that our first procedure was successful. When we did another one, it was much easier. Of course, at the beginning, the first procedure took us almost 4 hours. Right now it's a 1 hour procedure, but of course it's very difficult, but we are very happy to have no conversion.
Open
Host summary
Ellen Encisco summarizing the discussion: The first thoracoscopic esophageal atresia procedure took almost 4 hours, but with experience it became a 1-hour procedure
Open
Host summary
Ellen Encisco summarizing the discussion: Dr. Patkowski's team has had no conversions from thoracoscopic to open approach since beginning the technique
Open
Host summary
Ellen Encisco summarizing the discussion: All esophageal atresia cases in Dr. Patkowski's center have been managed by one team using only the thoracoscopic approach since the beginning
Open
Host summary
Ellen Encisco summarizing the discussion: The first, you need experience in endoscopic surgery. And then just you need time, and you must be very experienced in endoscopic suturing. You must be very slow. If you do it slowly, you will do it fast.
Open
Host summary
Ellen Encisco summarizing the discussion: Centralizing care for esophageal atresia patients is important even if transportation costs are higher, because complication costs are much higher
Open
Host summary
Ellen Encisco summarizing the discussion: Even if this is a higher cost, but probably the costs of complications are much, much more higher than transportation.
Open
Host summary
Ellen Encisco summarizing the discussion: Dr. Patkowski's center handles 15 to 20 esophageal atresia cases per year, which provides sufficient volume for good experience
Open
Host summary
Ellen Encisco summarizing the discussion: In the stoma cohort, 38 patients had ileostomies and the remaining had colostomies
Open
Host summary
Ellen Encisco summarizing the discussion: The most common indication for initial stoma in Hirschsprung disease was washout failure, accounting for nearly 40% of cases
Open
Host summary
Ellen Encisco summarizing the discussion: Stomma doesn't mean always a failure. Sometimes it's a necessity. Comes with the nature of the disease.
Open
Host summary
Ellen Encisco summarizing the discussion: Sheffield primarily performs Duhamel pull-throughs while Cincinnati primarily performs Swenson procedures for Hirschsprung disease
Open
Summaries Ellen gave as host · Meckel's Diverticulum 4 summaries
Open the Meckel's Diverticulum collection →
Journal of Pediatric Surgery Article Review: September 2021
Host summary
Ellen Encisco summarizing the discussion: The Utah study created a risk score to predict Meckel's diverticulum in patients presenting with hematochezia
Open
Journal of Pediatric Surgery Article Review: September 2021
Host summary
Ellen Encisco summarizing the discussion: In the Chinese randomized trial, the early feeding group started feeds at 2 days compared to 6 days for the traditional feeding group.
Open
Host summary
Ellen Encisco summarizing the discussion: The Chinese trial found no significant difference between early and traditional feeding groups in length of stay, time to full feeds, postoperative complications, 30-day mortality, or 30-day readmissions.
Open
Host summary
Ellen Encisco summarizing the discussion: The Meckel diverticulum study examined patients under age 18 who presented with hematochezia and determined which presenting factors predict Meckel diverticulum, creating a risk score.
Open
Summaries Ellen gave as host · Motility / Pseudo-obstruction 2 summaries
Open the Motility / Pseudo-obstruction collection →
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
Host summary
Ellen Encisco summarizing the discussion: Mucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.
Open
Host summary
Ellen Encisco summarizing the discussion: Gastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.
Open
Summaries Ellen gave as host · Necrotizing Enterocolitis 5 summaries
Open the Necrotizing Enterocolitis collection →
Journal of Pediatric Surgery Article Review: October 2021
Host summary
Ellen Encisco summarizing the discussion: After one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.
Open
Host summary
Ellen Encisco summarizing the discussion: The Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.
Open
Host summary
Ellen Encisco summarizing the discussion: The Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.
Open
Host summary
Ellen Encisco summarizing the discussion: Despite correlation between spinal bone and cord abnormalities, many patients without sacral or vertebral anomalies still had spinal cord abnormalities, making MRI necessary for screening.
Open
Host summary
Ellen Encisco summarizing the discussion: In typical US practice for anorectal malformations, ultrasound shortly after birth is usually sufficient to look for spinal cord abnormalities, whereas the Italian practice finds MRI necessary.
Open
Summaries Ellen gave as host · Osteosarcoma 18 summaries
Open the Osteosarcoma collection →
Update Course Rewind: 2021 Top Ten Key Takeaways
Host summary
Ellen Encisco summarizing the discussion: In the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up.
Open
Host summary
Ellen Encisco summarizing the discussion: Medical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy.
Open
Host summary
Ellen Encisco summarizing the discussion: Indocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures.
Open
Host summary
Ellen Encisco summarizing the discussion: You can see very well the biliary anatomy is absolutely. Amazing, as you can see, the main biliary tree, the gallbladder, and then the cystic duct.
Open
Host summary
Ellen Encisco summarizing the discussion: For laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery.
Open
Host summary
Ellen Encisco summarizing the discussion: ICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions.
Open
Host summary
Ellen Encisco summarizing the discussion: The double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin.
Open
Host summary
Ellen Encisco summarizing the discussion: This strikes fear at the heart of of uh ENT surgeons, gastroenterologists, and pediatric surgeons.
Open
Host summary
Ellen Encisco summarizing the discussion: The main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion.
Open
Host summary
Ellen Encisco summarizing the discussion: Sucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures.
Open
Host summary
Ellen Encisco summarizing the discussion: What you need to do is cut down on the damage, the injury that this is doing. Sucralfate or honey can help.
Open
Host summary
Ellen Encisco summarizing the discussion: Children less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion.
Open
Host summary
Ellen Encisco summarizing the discussion: Children over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses.
Open
Host summary
Ellen Encisco summarizing the discussion: Greenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns.
Open
Host summary
Ellen Encisco summarizing the discussion: When black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians.
Open
Host summary
Ellen Encisco summarizing the discussion: Bias exists within medicine and can change outcomes; representation matters and can make a difference.
Open
Host summary
Ellen Encisco summarizing the discussion: recognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do? So I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?
Open
Host summary
Ellen Encisco summarizing the discussion: So let's not just settle to talk about it, but let's figure out what the system level changes are that make a difference and change the outcome.
Open
Summaries Ellen gave as host · Pectus Excavatum 19 summaries
Open the Pectus Excavatum collection →
Novel index to estimate the cephalocaudal extent of the excavation in pectus excavatum - JPS article
Host summary
Ellen Encisco summarizing a resource: The Haller index and correction index are the currently primarily used indices for pectus excavatum and tell us about the severity of the deformity.
Open
Host summary
Ellen Encisco summarizing a resource: The Titanic index takes into account the extent of the pectus excavatum deformity.
Open
Host summary
Ellen Encisco summarizing a resource: The Titanic index is calculated as the percentage of the sternum that lies behind the anterior costal line as seen on CT scans.
Open
Host summary
Ellen Encisco summarizing a resource: The study was a retrospective review of patients at an institution in Argentina who had undergone minimally invasive repair of pectus excavatum.
Open
Host summary
Ellen Encisco summarizing a resource: The Titanic index might be more helpful for helping determine how many bars a patient is going to need for repair.
Open
Host summary
Ellen Encisco summarizing a resource: The study found a weak correlation between the Titanic index and the other indices (Haller and correction index).
Open
Host summary
Ellen Encisco summarizing a resource: The threshold they established here was 66.5%, meaning that patients with a higher titanic index than that probably needed more than 2 bars.
Open
Host summary
Ellen Encisco summarizing a resource: The threshold established was 66.5%, meaning that patients with a higher Titanic index than that probably needed more than 2 bars.
Open
Journal of pediatric surgery Article Review: April 2023, IPEG issue
Host summary
Ellen Encisco summarizing the discussion: The Titanic Index provides an objective way to determine bar number rather than guessing based on eyeballing or age.
Open
Host summary
Ellen Encisco summarizing the discussion: Severe outcomes in button battery ingestion were defined as deep mucosal erosion, perforation, mediastinitis, vascular or airway injury or fistula, or esophageal stricture development.
Open
Host summary
Ellen Encisco summarizing the discussion: The Boston Children's study included 143 patients under 21 years old from 2008 to 2021, with 24 having severe outcomes.
Open
Host summary
Ellen Encisco summarizing the discussion: Three predictive factors for severe button battery outcomes are: battery in esophagus at presentation, battery size ≥2cm, and presence of any symptoms.
Open
Quick Literature Updates Episode 13
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The Haller index and correction index are currently primarily used indices for pectus excavatum and tell us about the severity of the deformity.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: This new index, or the Titanic index as they're calling it, takes into account the extent of the deformity.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The Titanic index is the percentage of the sternum that lies behind the anterior costal line as seen on CT scans.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: There is a weak correlation between the Titanic index and the other indices (Haller and correction indices).
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The Titanic index might be more helpful for determining how many bars a patient is going to need for pectus excavatum repair.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: A Titanic index threshold of 66.5% was established, meaning patients with a higher index than that probably needed more than 2 bars for pectus excavatum repair.
Open
Summaries Ellen gave as host · Peritoneal Dialysis Access 6 summaries
Open the Peritoneal Dialysis Access collection →
Quick Literature Updates Episode 13
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The Haller index and correction index are currently primarily used indices for pectus excavatum and tell us about the severity of the deformity.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: This new index, or the Titanic index as they're calling it, takes into account the extent of the deformity.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The Titanic index is the percentage of the sternum that lies behind the anterior costal line as seen on CT scans.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: The Titanic index might be more helpful for determining how many bars a patient is going to need for pectus excavatum repair.
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: There is a weak correlation between the Titanic index and the other indices (Haller and correction indices).
Open
Host summary
Ellen Encisco summarizes what Dr. Alex Halpern said: A Titanic index threshold of 66.5% was established, meaning patients with a higher index than that probably needed more than 2 bars for pectus excavatum repair.
Open
Summaries Ellen gave as host · Pulmonary Hypertension 2 summaries
Open the Pulmonary Hypertension collection →
Update Course Rewind: Omphalocele & Gastroschisis 2020
Host summary
Ellen Encisco summarizing the discussion: A Texas report described component separation use in nine children aged seven days to 10 years, mostly for omphaloceles and giant defects, achieving fascial closure in the vast majority with some mesh use for bridging
Open
Host summary
Ellen Encisco summarizing the discussion: Component separation technique involves separating tissue at the external oblique about a centimeter beyond the rectus sheath on both sides, dissecting between external and internal oblique, and optionally making an incision on the anterior rectus sheath for another centimeter of space
Open
Summaries Ellen gave as host · Rectal Bladder Neck Fistula 4 summaries
Open the Rectal Bladder Neck Fistula collection →
Update Course Rewind: Pediatric Colorectal Consortium 2021
Host summary
Ellen Encisco summarizing the discussion: There is literature suggesting a component of psychosocial, psychological dissociation in children on later testing related to anal dilations.
Open
Host summary
Ellen Encisco summarizing the discussion: The number of strictures, number needing anoplasties, and number of redo operations were the same between dilation and no-dilation groups.
Open
Host summary
Ellen Encisco summarizing the discussion: The number of patients who had rectal prolapse is consistent with the literature.
Open
Host summary
Ellen Encisco summarizing the discussion: A study of 30-day outcomes for ARM with perineal or rectovaginal fistulas divided patients into early repair (before 6 days old) and late repair (6-8 weeks), with 66 early and 231 late repairs among 291 patients.
Open
Summaries Ellen gave as host · Sarcoma (Ewing/Rhabdo) 50 summaries
Open the Sarcoma (Ewing/Rhabdo) collection →
Update Course Rewind: 2021 Top Ten Key Takeaways
Host summary
Ellen Encisco summarizing the discussion: In the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up.
Open
Host summary
Ellen Encisco summarizing the discussion: Medical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy.
Open
Host summary
Ellen Encisco summarizing the discussion: Indocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures.
Open
Host summary
Ellen Encisco summarizing the discussion: You can see very well the biliary anatomy is absolutely. Amazing, as you can see, the main biliary tree, the gallbladder, and then the cystic duct.
Open
Host summary
Ellen Encisco summarizing the discussion: For laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery.
Open
Host summary
Ellen Encisco summarizing the discussion: ICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions.
Open
Host summary
Ellen Encisco summarizing the discussion: The double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin.
Open
Host summary
Ellen Encisco summarizing the discussion: This strikes fear at the heart of of uh ENT surgeons, gastroenterologists, and pediatric surgeons.
Open
Host summary
Ellen Encisco summarizing the discussion: The main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion.
Open
Host summary
Ellen Encisco summarizing the discussion: Sucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures.
Open
Host summary
Ellen Encisco summarizing the discussion: What you need to do is cut down on the damage, the injury that this is doing. Sucralfate or honey can help.
Open
Host summary
Ellen Encisco summarizing the discussion: Children less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion.
Open
Host summary
Ellen Encisco summarizing the discussion: Children over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses.
Open
Host summary
Ellen Encisco summarizing the discussion: Greenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns.
Open
Host summary
Ellen Encisco summarizing the discussion: When black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians.
Open
Host summary
Ellen Encisco summarizing the discussion: Bias exists within medicine and can change outcomes; representation matters and can make a difference.
Open
Host summary
Ellen Encisco summarizing the discussion: recognizing that we all have biases and not being defensive when someone says there's bias in that because we all have bias. We know that we all have bias. And so the question is, what are your biases and how do they affect what you do? So I would push everyone. To say, as you're thinking about this work, as you, as you live in this space, you know, what are you doing about it?
Open
Host summary
Ellen Encisco summarizing the discussion: So let's not just settle to talk about it, but let's figure out what the system level changes are that make a difference and change the outcome.
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Case-Based Journal Review- Intussusception in 2022
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Ellen Encisco summarizing a resource: I would only accept radiology because you have to do an intervention after that. So if it's positive, you have to do an intervention, whether it is enema reduction or surgery.
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Ellen Encisco summarizing a resource: In resource-limited settings without 24-hour radiology, unnecessary laparotomies are sometimes performed for intussusception diagnosis in the middle of the night.
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Ellen Encisco summarizing a resource: The 2% difference in success rates between hydrostatic and air reduction is not clinically significant enough to justify changing established practice.
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Ellen Encisco summarizing a resource: Sedation for pneumatic reduction showed slightly better success rate but higher recurrence rate (5.1% vs 1.3%, non-significant) and more perforations (3 vs 0, non-significant) in a 2017 Pediatric Anesthesia study.
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Ellen Encisco summarizing a resource: If sedation shows no increased perforation risk compared to no sedation, then sedating children for comfort during reduction is justified.
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Ellen Encisco summarizing a resource: I share that same feeling. I feel like I lie when I'm saying the number I have in my mind, but actually my number is 10%. That's the number I tell residents, not the number I tell families, 10%.
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Ellen Encisco summarizing a resource: Both recent studies show lower recurrence rates (3.7-13.5%) than the traditionally quoted 15-20% that surgeons have been telling families.
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Ellen Encisco summarizing a resource: Increasing tolerance for recurrence risk benefits the vast majority of children by avoiding unnecessary admission and its associated complications.
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Ellen Encisco summarizing a resource: Increasing our recurrence or failure tolerance, it benefits the vast majority of children with lower chances of getting a complication.
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Case Based Journal Review - CPAM in 2022
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Ellen Encisco summarizing the discussion: 57% (68 patients) of the 119 cases were managed conservatively, and none of those who could be followed up became symptomatic
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Ellen Encisco summarizing the discussion: 57% (68 patients) of the 119 cases were managed conservatively, and none of those who could be followed up became symptomatic
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Ellen Encisco summarizing the discussion: Out of 344 prenatally diagnosed lesions, none had malignant pathology when resected
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Ellen Encisco summarizing the discussion: Out of 344 prenatally diagnosed lesions, none had malignant pathology when resected
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Ellen Encisco summarizing the discussion: The risk of malignancy approached 10% for lung masses diagnosed postnatally
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Ellen Encisco summarizing the discussion: The risk of malignancy approached 10% for lung masses diagnosed postnatally
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Ellen Encisco summarizing the discussion: The study was retrospective and looked at about 90 patients undergoing thoracoscopic lung resections
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Ellen Encisco summarizing the discussion: The study was retrospective and looked at about 90 patients undergoing thoracoscopic lung resections
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Ellen Encisco summarizing the discussion: There were no differences in major complications, conversion rates, or readmissions between the three age groups
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Ellen Encisco summarizing the discussion: There were no differences in major complications, conversion rates, or readmissions between the three age groups
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Case Based Journal Review: Esophageal Atresia in 2022
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Ellen Encisco summarizes what Dr. Jose Campos said: In a meta-analysis of almost 700 neonates, preserving the azygous vein resulted in significantly lower postoperative pneumonitis compared to division
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Ellen Encisco summarizes what Dr. Jose Campos said: In a meta-analysis of almost 700 neonates, preserving the azygous vein resulted in significantly lower postoperative pneumonitis compared to division
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Ellen Encisco summarizes what Dr. Jose Campos said: There was no significant difference in anastomotic leak rate or stricture rate between azygous vein preservation and division
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Ellen Encisco summarizes what Dr. Jose Campos said: There was no significant difference in anastomotic leak rate or stricture rate between azygous vein preservation and division
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Ellen Encisco summarizes what Dr. Jose Campos said: In the Quebec study of 244 patients, the overall anastomotic stricture rate at one year was 30%
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Ellen Encisco summarizes what Dr. Jose Campos said: In the Quebec study of 244 patients, the overall anastomotic stricture rate at one year was 30%
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Ellen Encisco summarizes what Dr. Jose Campos said: 36% of patients with transanastomotic tubes developed strictures compared to 19% without tubes, a difference that remained significant after multivariable analysis
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Ellen Encisco summarizes what Dr. Jose Campos said: 36% of patients with transanastomotic tubes developed strictures compared to 19% without tubes, a difference that remained significant after multivariable analysis
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Ellen Encisco summarizes what Dr. Jose Campos said: Patients with transanastomotic tubes had 2.72 times higher odds of developing a stricture compared to those without
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Ellen Encisco summarizes what Dr. Jose Campos said: Patients with transanastomotic tubes had 2.72 times higher odds of developing a stricture compared to those without
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Ellen Encisco summarizes what Dr. Jose Campos said: In the Midwest Pediatric Surgery Consortium study, antibiotics for more than 24 hours and acid suppression showed no difference in strictures or leaks
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Ellen Encisco summarizes what Dr. Jose Campos said: In the Midwest Pediatric Surgery Consortium study, antibiotics for more than 24 hours and acid suppression showed no difference in strictures or leaks
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Summaries Ellen gave as host · Short Bowel Syndrome 7 summaries
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Intestinal rehabilitation: What is intestinal rehab? - Episode 1
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Ellen Encisco summarizing the discussion: Mucosal defects in enteropathies lead to hypersecretion and profuse fluid losses, preventing nutrient absorption.
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Ellen Encisco summarizing the discussion: Gastroschisis can involve all three categories: short bowel from nonviable tissue, inflammation affecting absorption, and motility issues.
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Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
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Ellen Encisco summarizing the discussion: In the 1980s and 1990s, babies with intestinal failure had poor outcomes primarily due to liver progression to inflammation and fibrosis associated with parenteral nutrition, lipids, and phytosterols.
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Ellen Encisco summarizing the discussion: At birth, neonatal bowel is usually not dilated enough to apply the STEP procedure.
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Ellen Encisco summarizing the discussion: If one part of the stepped bowel becomes dilated, the STEP segments can rotate away from each other separately, causing twisting and functional obstruction.
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Quick Literature Updates Episode 7
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Ellen Encisco summarizing a resource: Tendon et al. conducted a prospective randomized control trial between 2017 and 2018 comparing three skin closure methods: sutures with tissue adhesive, sutures with adhesive tape, and sutures alone.
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Ellen Encisco summarizing a resource: Wounds were assessed at two weeks, six weeks, and more than six months after operation by surveying clinicians and parents.
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Summaries Ellen gave as host · Tracheoesophageal Fistula 6 summaries
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Case Based Journal Review: Esophageal Atresia in 2022
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Ellen Encisco summarizes what Dr. Jose Campos said: In a meta-analysis of almost 700 neonates, preserving the azygous vein resulted in significantly lower postoperative pneumonitis compared to division
Open
Host summary
Ellen Encisco summarizes what Dr. Jose Campos said: There was no significant difference in anastomotic leak rate or stricture rate between azygous vein preservation and division
Open
Host summary
Ellen Encisco summarizes what Dr. Jose Campos said: In the Quebec study of 244 patients, the overall anastomotic stricture rate at one year was 30%
Open
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Ellen Encisco summarizes what Dr. Jose Campos said: 36% of patients with transanastomotic tubes developed strictures compared to 19% without tubes, a difference that remained significant after multivariable analysis
Open
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Ellen Encisco summarizes what Dr. Jose Campos said: Patients with transanastomotic tubes had 2.72 times higher odds of developing a stricture compared to those without
Open
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Ellen Encisco summarizes what Dr. Jose Campos said: In the Midwest Pediatric Surgery Consortium study, antibiotics for more than 24 hours and acid suppression showed no difference in strictures or leaks
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Summaries Ellen gave as host · Trauma 3 summaries
ATLS 2021 Pediatric Surgery Update
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Ellen Encisco summarizes what Dr. Rich Falcone said: Intraosseous (IO) access can be placed in the tibia, humeral head, or distal femur; sternal IO is avoided in children though used in adults.
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Ellen Encisco summarizes what Dr. Rich Falcone said: For a child to show signs of hemorrhagic shock (both tachycardia and hypotension), they must lose about half their total blood volume.
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Ellen Encisco summarizes what Dr. Rich Falcone said: Over 75% of pediatric trauma deaths are due to head injuries.
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Summaries Ellen gave as host · Trisomy 21 8 summaries
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Quick Literature Updates Episode 14
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Ellen Encisco summarizes what Dr. Alex Halpern said: 384 females with anorectal malformations were studied from the Pediatric Colorectal and Pelvic Learning Consortium database
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Ellen Encisco summarizes what Dr. Alex Halpern said: About 27% of patients with anorectal malformations had a gynecologic anomaly
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Ellen Encisco summarizes what Dr. Alex Halpern said: About 46% of females with anorectal malformations had VACTERL association (anorectal malformation plus two of: vertebral, cardiac, tracheoesophageal, renal, or limb anomaly)
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Ellen Encisco summarizes what Dr. Alex Halpern said: Having VACTERL association was associated with more gynecologic anomalies compared to those without VACTERL
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Ellen Encisco summarizes what Dr. Alex Halpern said: The association between VACTERL and gynecologic anomalies was especially true when renal anomalies were found
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Ellen Encisco summarizes what Dr. Alex Halpern said: The association between VACTERL and gynecologic anomalies was especially true when patients had recto vestibular or rectal perineal fistulas
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Ellen Encisco summarizes what Dr. Alex Halpern said: So for females with inner rectum malformations and veal association, especially renal anomalies, we should look carefully for gynecologic anomalies.
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Ellen Encisco summarizes what Dr. Alex Halpern said: For females with anorectal malformations and VACTERL association, especially renal anomalies, clinicians should look carefully for gynecologic anomalies
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Summaries Ellen gave as host · Umbilical Hernia 3 summaries
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Umbilical Pathologies Bonus Episode
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Ellen Encisco summarizes what Dr. Mira Kotigal said: if the ultrasound shows one of those things, the next step is usually operative exploration.
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Ellen Encisco summarizes what Dr. Mira Kotigal said: When ultrasound shows patent urachus or patent omphalomesenteric duct, the next step is usually operative exploration.
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Ellen Encisco summarizes what Dr. Mira Kotigal said: On physical exam, an umbilical polyp has a stalk and can be moved around more freely, whereas granulomatous tissue is more stuck on at the base of the belly button.
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