Nick Bruns

49 statements · 8 topics · summaries given as host listed separately

Featured statements

Lateral decubous positioning has been adopted from the transition from open thoracotomy to vats. It provides ease of exposure and rapid conversion to open thoracotomy. With advancements in vats, this no longer applies.
Bilateral vats was safely completed in the supine position. This provides simplicity, convenience, decreased operative time, and decreased positioning-related morbidity.
The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.
For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.
In a retrospective review of abscess I&D cases discharged same-day from the OR, treatment failure (readmission or repeat I&D within 2 weeks) occurred in only 0.9% of patients.
epidemiological · Intussusception
Among patients with leukocytosis (white count up to 35), only 2 out of 138 had treatment failure after same-day discharge, and only one febrile patient had treatment failure.
epidemiological · Intussusception

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Nick's statements about Colorectal / ARM & Hirschsprung 8 statements

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Hirschsprung Disease Part I with Marc Levitt

Statement The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Statement For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Statement The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Statement A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open

Hirschsprung Disease Part I with Marc Levitt

Statement The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Statement For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Statement The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Statement A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Nick's statements about Enterocolitis 8 statements

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Hirschsprung Disease Part I with Marc Levitt

Statement The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Statement For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Statement The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Statement A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open

Hirschsprung Disease Part I with Marc Levitt

Statement The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Statement For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Statement The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Statement A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Nick's statements about Etiologies (Gastroschisis/NEC/Atresia/Volvulus) 4 statements

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Hirschsprung Disease Part I with Marc Levitt

Statement The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Statement For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Statement The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Statement A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Nick's statements about Hirschsprung disease 8 statements

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Hirschsprung Disease Part I with Marc Levitt

Statement The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Statement For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Statement The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Statement A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open

Hirschsprung Disease Part I with Marc Levitt

Statement The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Statement For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Statement The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Statement A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Nick's statements about Intestinal Rehab 4 statements

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Hirschsprung Disease Part I with Marc Levitt

Statement The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Statement For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Statement The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Statement A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Nick's statements about Intussusception 2 statements

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Intussusception - Soft Tissue Abscess - Pilonidal Cyst - Bleeding Meckel's...

Statement In a retrospective review of abscess I&D cases discharged same-day from the OR, treatment failure (readmission or repeat I&D within 2 weeks) occurred in only 0.9% of patients. Open
Statement Among patients with leukocytosis (white count up to 35), only 2 out of 138 had treatment failure after same-day discharge, and only one febrile patient had treatment failure. Open
Nick's statements about Single Ventricle / HLHS 2 statements

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Intussusception - Soft Tissue Abscess - Pilonidal Cyst - Bleeding Meckel's...

Statement In a retrospective review of abscess I&D cases discharged same-day from the OR, treatment failure (readmission or repeat I&D within 2 weeks) occurred in only 0.9% of patients. Open
Statement Among patients with leukocytosis (white count up to 35), only 2 out of 138 had treatment failure after same-day discharge, and only one febrile patient had treatment failure. Open
Nick's statements about Spontaneous Pneumothorax 13 statements

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Tricks - Supine Positioning For Bilateral VATS

Quotation Lateral decubous positioning has been adopted from the transition from open thoracotomy to vats. It provides ease of exposure and rapid conversion to open thoracotomy. With advancements in vats, this no longer applies. Open
Statement Lateral decubitus positioning has been adopted from the transition from open thoracotomy to VATS and provides ease of exposure and rapid conversion to open thoracotomy, but with advancements in VATS this no longer applies. Open
Quotation Lateral positioning may add unnecessary morbidity, including brachial plexus injury and decubitous ulcers. Open
Statement Lateral positioning may add unnecessary morbidity including brachial plexus injury and decubitus ulcers. Open
Statement The patient is a 17-year-old male with history of asthma who presented with shortness of breath and chest tightness when running, found to have bilateral apical blebs and a large right spontaneous pneumothorax treated with chest tube, later developing a small left spontaneous pneumothorax that resolved with observation. Open
Statement Bilateral VATS with bilateral apical bleb resections and mechanical pleurodesis was performed in the supine position due to the routine nature of the procedure. Open
Statement Port placement for supine VATS included 25mm ports at the 7th intercostal space midclavicular line and 6th intercostal space mid-axillary line, plus a 12mm port at the 4th intercostal space mid-axillary line to accommodate the GIA stapler. Open
Quotation Note both surgeons have adequate working space with their hands unencumbered. Open
Quotation Note the excellent visualization and minimal interference between the instruments. Open
Quotation Bilateral vats was safely completed in the supine position. This provides simplicity, convenience, decreased operative time, and decreased positioning-related morbidity. Open
Statement Bilateral VATS was safely completed in the supine position, providing simplicity, convenience, decreased operative time, and decreased positioning-related morbidity. Open
Quotation So if there's a procedure that requires bilateral vats with low morbidity and a very well-defined pathology such that you won't, um, you know, encounter. Any surprises, I think this is the sort of case that you should consider supines. Open
Statement Patient selection for supine VATS is important; appropriate cases include bilateral VATS with low morbidity and well-defined pathology where you won't encounter surprises. Open

Summaries Nick gave as host · 44 summaries

Recaps of other experts' statements, not Nick's own clinical position.

Summaries Nick gave as host · Appendicitis 8 summaries

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Hirschsprung Disease Part I with Marc Levitt

Host summary Nick Bruns summarizing the discussion: The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Host summary Nick Bruns summarizing the discussion: For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Host summary Nick Bruns summarizing the discussion: The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Host summary Nick Bruns summarizing the discussion: A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open

Hirschsprung Disease Part I with Marc Levitt

Host summary Nick Bruns summarizing the discussion: The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Host summary Nick Bruns summarizing the discussion: For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Host summary Nick Bruns summarizing the discussion: The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Host summary Nick Bruns summarizing the discussion: A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Summaries Nick gave as host · Colorectal / ARM & Hirschsprung 8 summaries

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Hirschsprung Disease Part I with Marc Levitt

Host summary Nick Bruns summarizing the discussion: The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Host summary Nick Bruns summarizing the discussion: For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Host summary Nick Bruns summarizing the discussion: The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Host summary Nick Bruns summarizing the discussion: A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open

Hirschsprung Disease Part I with Marc Levitt

Host summary Nick Bruns summarizing the discussion: The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Host summary Nick Bruns summarizing the discussion: For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Host summary Nick Bruns summarizing the discussion: The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Host summary Nick Bruns summarizing the discussion: A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Summaries Nick gave as host · Enterocolitis 4 summaries

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Hirschsprung Disease Part I with Marc Levitt

Host summary Nick Bruns summarizing the discussion: The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Host summary Nick Bruns summarizing the discussion: For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Host summary Nick Bruns summarizing the discussion: The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Host summary Nick Bruns summarizing the discussion: A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Summaries Nick gave as host · Etiologies (Gastroschisis/NEC/Atresia/Volvulus) 4 summaries

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Hirschsprung Disease Part I with Marc Levitt

Host summary Nick Bruns summarizing the discussion: The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Host summary Nick Bruns summarizing the discussion: For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Host summary Nick Bruns summarizing the discussion: The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Host summary Nick Bruns summarizing the discussion: A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Summaries Nick gave as host · Hirschsprung disease 4 summaries

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Hirschsprung Disease Part I with Marc Levitt

Host summary Nick Bruns summarizing the discussion: The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Host summary Nick Bruns summarizing the discussion: For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Host summary Nick Bruns summarizing the discussion: The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Host summary Nick Bruns summarizing the discussion: A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Summaries Nick gave as host · Intestinal Rehab 4 summaries

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Hirschsprung Disease Part I with Marc Levitt

Host summary Nick Bruns summarizing the discussion: The negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database. Open
Host summary Nick Bruns summarizing the discussion: For incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%. Open
Host summary Nick Bruns summarizing the discussion: The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue. Open
Host summary Nick Bruns summarizing the discussion: A Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays. Open
Summaries Nick gave as host · Intussusception 6 summaries

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Intussusception - Soft Tissue Abscess - Pilonidal Cyst - Bleeding Meckel's...

Host summary Nick Bruns summarizing the discussion: In a series of 48 intussusception patients discharged from the ED, only one recurred within 48 hours and that patient did not require operation, only repeat reduction. Open
Host summary Nick Bruns summarizing the discussion: 48 patients were sent home from the ED and only one recurred in 48 hours, and that patient did not even need an operation. They just got reduced again. Open
Host summary Nick Bruns summarizing the discussion: When contrast fills the appendix but does not reflux into small bowel after intussusception reduction, this is attributed to ileocecal edema; the recommendation is to observe and repeat the study in a few hours. Open
Host summary Nick Bruns summarizing the discussion: There was a study about 20 years ago in which, uh, they, they attribute it to ileocecal edema that it won't reflux. Open
Host summary Nick Bruns summarizing the discussion: Age over 5 years is the inflection point for pathologic lead point in intussusception, with 30-60% of cases in this age group having a lead point depending on the series. Open
Host summary Nick Bruns summarizing the discussion: The data seems like the inflection point for having a lead point is about over 5 years old, where depending on the series, it's about 30 to 60% have a pathologic lead point if they're over 5. Open
Summaries Nick gave as host · Single Ventricle / HLHS 6 summaries

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Intussusception - Soft Tissue Abscess - Pilonidal Cyst - Bleeding Meckel's...

Host summary Nick Bruns summarizing the discussion: In a series of 48 intussusception patients discharged from the ED, only one recurred within 48 hours and that patient did not require operation, only repeat reduction. Open
Host summary Nick Bruns summarizing the discussion: 48 patients were sent home from the ED and only one recurred in 48 hours, and that patient did not even need an operation. They just got reduced again. Open
Host summary Nick Bruns summarizing the discussion: When contrast fills the appendix but does not reflux into small bowel after intussusception reduction, this is attributed to ileocecal edema; the recommendation is to observe and repeat the study in a few hours. Open
Host summary Nick Bruns summarizing the discussion: There was a study about 20 years ago in which, uh, they, they attribute it to ileocecal edema that it won't reflux. Open
Host summary Nick Bruns summarizing the discussion: The data seems like the inflection point for having a lead point is about over 5 years old, where depending on the series, it's about 30 to 60% have a pathologic lead point if they're over 5. Open
Host summary Nick Bruns summarizing the discussion: Age over 5 years is the inflection point for pathologic lead point in intussusception, with 30-60% of cases in this age group having a lead point depending on the series. Open