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https://www.readbyqxmd.com/read/29446794/migraine-variants-in-children
#1
A David Rothner
Migraine in children can manifest in ways that are markedly different from adult migraines. In children, migraine variants are often unaccompanied by headache and include conditions such as cyclic vomiting and abdominal migraine. Children who experience these conditions are often thought to have a disorder of the gastrointestinal tract, and when evaluation is unremarkable they may be diagnosed as having a conversion reaction. Complicated migraines, on the other hand, are often accompanied by focal neurological symptoms such as ataxia, hemiparesis, or altered level of consciousness that evoke great consternation in the examining clinician...
February 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29428102/liver-trauma-what-current-management
#2
Mohamed Tarchouli, Mohamed Elabsi, Noureddine Njoumi, Mohamed Essarghini, Mahjoub Echarrab, Mohamed Rachid Chkoff
BACKGROUND: The liver is the most commonly damaged organ in abdominal trauma. The management of liver trauma has experienced many changes over the last two decades. Currently there is a trend toward a non-operative treatment warranted by the successful pediatric experience and better results recorded in many trauma centers worldwide. This study aimed to evaluate outcomes of operative and non-operative management of liver trauma in our institution over the last five years. METHODS: The patients with a diagnosis of blunt or penetrating liver injuries, admitted and managed in our hospital from January 2012 to December 2016 were retrospectively studied...
February 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29390566/clinical-features-and-outcomes-of-blunt-splenic-injury-in-children-a-retrospective-study-in-a-single-institution-in-china
#3
Kaiying Yang, Yanan Li, Chuan Wang, Bo Xiang, Siyuan Chen, Yi Ji
Although the spleen is the most commonly injured intra-abdominal organ after blunt trauma, there are limited data available in China. The objectives of this study were to investigate the clinical features and determine the risk factors for operative management (OM) in children with blunt splenic injury (BSI).A review of the medical records of children diagnosed with BSI between January 2010 and September 2016 at West China Hospital of Sichuan University was performed.A total of 101 patients diagnosed with BSI were recruited, including 76 patients transferred from other hospitals...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29367055/characterization-of-the-occult-nature-of-frequently-occurring-pediatric-motor-vehicle-crash-injuries
#4
Andrea N Doud, Samantha L Schoell, Jennifer W Talton, Ryan T Barnard, John K Petty, Joel D Stitzel, Ashley A Weaver
BACKGROUND: Occult injuries are those likely to be missed on initial assessment by first responders and, though initially asymptomatic, they may present suddenly and lead to rapid patient decompensation. No scoring systems to quantify the occultness of pediatric injuries have been established. Such a scoring system will be useful in the creation of an Advanced Automotive Crash Notification (AACN) system that assists first responders in making triage decisions following a motor vehicle crash (MVC)...
January 19, 2018: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/29298250/accessory-spleen-fracture-report-of-a-pediatric-case-and-review-of-the-literature
#5
Eline Chauvet, Vasiliki Spyropoulou, Mehrak Anooshiravani-Dumont, Oliver Sanchez, Laurence Lacroix
Accessory spleen rupture may occur after blunt abdominal trauma or, more rarely, spontaneously. Although only few cases are described in adults, it is even more uncommon in children. We report the case of a 13-year-old boy with traumatic accessory spleen fracture. After a review of the literature, we discuss the diagnostic points that should raise the suspicion for accessory spleen fracture as well as how challenging the diagnosis by computed tomography can be.
January 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29283968/transfer-and-non-transfer-patients-in-isolated-low-grade-blunt-pediatric-solid-organ-injury-implications-for-regionalized-trauma-systems
#6
Robert A Tessler, Vivian H Lyons, Judith C Hagedorn, Monica S Vavilala, Adam Goldin, Saman Arbabi, Frederick P Rivara
BACKGROUND: Regionalization of trauma care is a national priority and hospitalization for blunt abdominal trauma, that may include transfer, is common among children. The objective of this study was to determine whether there were differences in mortality, treatment, or length of stay between patients treated at or transferred to a higher level trauma center and those not transferred and admitted to a lower level trauma center. METHODS: Cohort from Washington state trauma registry from 2000-2014 of patients 16 years or younger with isolated Grade I-III spleen, liver, or kidney injury...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29230341/pancreatic-laceration-in-a-pediatric-patient-an-unexpected-diagnosis
#7
Michelle J Hong, Lauren M Porter, Debra D Esernio-Jenssen, Andrew C Miller, Marna Rayl Greenberg
Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department. The initial differential was gastroenteritis versus appendicitis. An abnormality on the ultrasonography and an elevated lipase level eventually led to an MRI showing a complete transection through the posterior margin of the pancreas. The patient was admitted to pediatric surgery and underwent a successful distal pancreatectomy with preservation of the spleen...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29204237/pediatric-adrenal-trauma-evaluation-and-follow-up-with-contrast-enhanced-ultrasound-ceus
#8
Vasileios Rafailidis, Annamaria Deganello, Maria E Sellars, Erica Makin, Paul S Sidhu
Adrenal trauma is rarely encountered in the pediatric population, often as a component of multi-organ injury and often presenting with hematoma formation. Contrast-enhanced computed tomography (CECT) is the established imaging modality both for initial evaluation and follow-up of patients with blunt abdominal trauma. In children, radiation exposure should be minimized and alternative imaging strategies are needed. Contrast-enhanced ultrasound (CEUS) has recently been successfully used for evaluation of patients with hepatic, renal and splenic injury...
December 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/29200143/the-predictors-for-positive-yield-abdominal-computed-tomography-in-pediatric-abdominal-trauma
#9
Abdulrahman M Alzahem, Soundappan S V Soundappan, Daniel T Cass
OBJECTIVES: Abdominal computed tomography (ACT) use in the initial evaluation of pediatric abdominal trauma is liberal in most instances. The aim of this study was to identify the predictors for a positive yield ACT scan in this population. METHODS: A prospective, cohort, single-center observational study was conducted at Children's Hospital at Westmead, New South Wales, from January 2008 to June 2015 on 240 pediatric abdominal trauma patients who had abdominal computed tomography...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29198896/computed-tomographic-imaging-in-the-pediatric-patient-with-a-seatbelt-sign-still-not-good-enough
#10
Tammy R Kopelman, Ramin Jamshidi, Paola G Pieri, Karole Davis, James Bogert, Sydney J Vail, Daniel Gridley, Melissa A Singer Pressman
PURPOSE: Considering the improvements in CT over the past decade, this study aimed to determine whether CT can diagnose HVI in pediatric trauma patients with seatbelt signs (SBS). METHODS: We retrospectively identified pediatric patients with SBS who had abdominopelvic CT performed on initial evaluation over 5 1/2years. Abnormal CT was defined by identification of any intra-abdominal abnormality possibly related to trauma. RESULTS: One hundred twenty patients met inclusion criteria...
October 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29174941/is-delayed-phase-computed-tomography-imaging-necessary-after-blunt-renal-trauma-in-children
#11
Molly E Fuchs, Nicholas Beecroft, Daniel G Dajusta, Daryl J McLeod
OBJECTIVE: To characterize the utilization of delayed phase computed tomography (CT) imaging in blunt renal trauma and determine if the omission of delayed phase CT imaging affected clinical outcomes in children. MATERIALS AND METHODS: A prospectively collected trauma database was reviewed between 2006 and 2016 to identify patients aged ≤21 years with a diagnosis of renal injury from blunt trauma. Demographic characteristics, injury grade, Injury Severity Score, non-kidney organ injuries, radiologic studies, and clinical course were reviewed...
November 23, 2017: Urology
https://www.readbyqxmd.com/read/29162367/arterial-reconstructions-for-chronic-lower-extremity-ischemia-in-preadolescent-and-adolescent-children
#12
Jonathan L Eliason, Dawn M Coleman, Adam Gumushian, James C Stanley
OBJECTIVE: Chronic lower extremity ischemia in pediatric patients is uncommon. The intent of this study was to better define the arterial reconstructive options and their long-term durability in preadolescent and adolescent children having clinically relevant arterial occlusions affecting the lower extremity. METHODS: The medical records of 33 consecutive pediatric patients who underwent lower extremity revascularization for chronic ischemia at the University of Michigan from 1974 to 2016 were reviewed...
November 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29145243/obstructive-internal-hernia-caused-by-mesodiverticular-bands-in-children-two-case-reports-and-a-review-of-the-literature
#13
Mirko Bertozzi, Berardino Melissa, Elisa Magrini, Giuseppe Di Cara, Susanna Esposito, Antonino Apignani
INTRODUCTION: The mesodiverticular band (MDB) is an embryologic remnant of the vitelline circulation, which carries the arterial supply to the Meckel diverticulum. In the event of an error of involution, a patent or nonpatent arterial band persists and extends from the mesentery to the apex of the antimesenteric diverticulum. This creates a snare-like opening through which bowel loops may herniate and become obstructed. This report describes 2 rare cases of small bowel occlusion owing to an internal hernia caused by a MDB...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29107481/physical-examination-is-the-best-predictor-of-the-need-for-abdominal-surgery-in-children-following-motor-vehicle-collision
#14
Natalie A Drucker, Lucas McDuffie, Eric Groh, Jodi Hackworth, Teresa M Bell, Troy A Markel
BACKGROUND: Exploratory laparotomy in children after motor vehicle collision (MVC) is rare. In the absence of definitive hemorrhage or free abdominal air on radiographic imaging, predictors for operative exploration are conflicting. OBJECTIVE: The purpose of this study was to explore objective findings that may aid in determining which children require operative abdominal exploration after MVC. METHODS: Data from 2010-2014 at an American College of Surgeons-certified level 1 pediatric trauma center were retrospectively reviewed...
October 26, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29097861/biliary-complications-after-hepatic-trauma-in-children
#15
Riccardo Guanà, Carbonaro Giulia, Andrea Brunati, Salvatore Garofalo, Jurgen Schleef
Aim of the Study: In pediatric patients with liver trauma and hemodynamic stability, conservative treatment is acknowledged as the gold standard. Patients and Methods: We conducted a retrospective analysis of 116 consecutive pediatric patients (<14-year-old) observed at our institution for closed abdominal trauma from January 2010 to January 2016. Among these, 16 patients (13%) had hepatic trauma Grade II or more, according to Moore liver trauma injury score...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29053055/successful-surgical-repair-and-recovery-in-a-2-week-old-infant-after-birth-related-cervical-fracture-dislocation
#16
Sara Saleh, Kyle I Swanson, Taryn Bragg
Cervical spine injuries are the most common spine injuries in the pediatric population. The authors present the youngest known patient who underwent cervical spine fusion to repair birth trauma-induced cervical fracture dislocation, resulting in spondyloptosis and spinal cord injury. A 2-week-old boy was found to have spondyloptosis and spinal cord injury after concerns arose from reduced movement of the extremities. The patient's birth was complicated by undiagnosed abdominal dystocia, which led to cervical distraction injury...
October 20, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28987312/incidental-findings-on-pediatric-abdominal-computed-tomography-at-a-pediatric-trauma-center
#17
Youanna Daoud, Alexander Philip, Gal Altberg, Hadassa Leader, Jeremy Neuman, Barry Hahn
BACKGROUND: The increasing availability and use of computed tomography (CT) in pediatric abdominal trauma has increased the detection of incidental findings. While some of these findings are benign, others may require further evaluation for possible clinical importance. OBJECTIVES: This study aimed to identify the frequency and type of incidental findings and their need for follow-up on abdominal CT in patients at a pediatric trauma center. METHODS: This was a retrospective, observational study on trauma patients ≤21 years of age who presented to the emergency department between January 1, 2004 and July 31, 2016 and underwent CT scans of the abdomen and pelvis...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28980061/applications-of-contrast-enhanced-ultrasound-in-the-pediatric-abdomen
#18
Aikaterini Ntoulia, Sudha A Anupindi, Kassa Darge, Susan J Back
Contrast-enhanced ultrasound (CEUS) is a radiation-free, safe, and in specific clinical settings, highly sensitive imaging modality. Over the recent decades, there is cumulating experience and a large volume of published safety and efficacy data on pediatric CEUS applications. Many of these applications have been directly translated from adults, while others are unique to the pediatric population. The most frequently reported intravenous abdominal applications of CEUS in children are the characterization of focal liver lesions, monitoring of solid abdominal tumor response to treatment, and the evaluation of intra-abdominal parenchymal injuries in selected cases of blunt abdominal trauma...
October 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28930954/acute-procedural-interventions-after-pediatric-blunt-abdominal-trauma-a-prospective-multicenter-evaluation
#19
MULTICENTER STUDY
Chase A Arbra, Adam M Vogel, Jingwen Zhang, Patrick D Mauldin, Eunice Y Huang, Kate B Savoie, Matthew T Santore, KuoJen Tsao, Tiffany G Ostovar-Kermani, Richard A Falcone, M Sidney Dassinger, John Recicar, Jeffrey H Haynes, Martin L Blakely, Robert T Russell, Bindi J Naik-Mathuria, Shawn D St Peter, David P Mooney, Chinwendu Onwubiko, Jeffrey S Upperman, Christian J Streck
BACKGROUND: Pediatric intra-abdominal injuries (IAI) from blunt abdominal trauma (BAT) rarely require emergent intervention. For those children undergoing procedural intervention, our aim was to understand the timing and indications for operation and angiographic embolization. METHODS: We prospectively enrolled children younger than 16 years after BAT at 14 Level I Pediatric Trauma Centers over a 1-year period. Patients with IAI who received an intervention (IAI-I) were compared with those who did not receive an intervention using descriptive statistics and univariate analysis; p less than 0...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28917584/pneumatoceles-in-pediatric-blunt-trauma-common-and-benign
#20
Lindsey B Armstrong, David P Mooney
INTRODUCTION: Traumatic pneumatoceles are reported to be rare in children and to have an uncertain clinical significance. We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance. METHODS: After obtaining approval from the IRB, data were extracted from the trauma registry of a level 1 pediatric trauma center on children diagnosed with a pulmonary contusion (International Classification of Diseases-9th edition diagnosis codes: 861...
August 7, 2017: Journal of Pediatric Surgery
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