Etiologies (Gastroschisis/NEC/Atresia/Volvulus)
Also covered as: gastroschisis · necrotizing enterocolitis · malrotation · intestinal atresia · Hirschsprung disease · midgut volvulus · umbilical hernia · omphalocele
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Answers come only from this collection's statement ledger and cite the exact moment · not medical advice
Content of this collection
Foundations
6 items
Pyloric Stenosis
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Dr. Bhargava Mullapudi, Pediatric Surgeon at Cincinnati Children’s, and Dr. Gillian Goddard, Pediatric Surgery Research Fellow at Cincinnati Children's, joins Dr. Rae Hanke to review the essentials of pyloric stenosis in this videocast.Pylo
video · 12:30 · May 2020
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
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We’re starting a new series about intestinal rehabilitation and all of its intricacies. We’re joined by Drs. Michael Helmrath and Paul Wales, leaders of the Intestinal Rehabilitation Program at Cincinnati Children’s. Hosted by: Todd Ponsky,
video · 14:33 · Dec 2021
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
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We’re starting a new series about intestinal rehabilitation and all of its intricacies. We’re joined by Drs. Michael Helmrath and Paul Wales, leaders of the Intestinal Rehabilitation Program at Cincinnati Children’s. Hosted by: Todd Ponsky,
podcast · 14:33 · Dec 2021
Omphalocele & Gastroschisis
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Abdominal wall defects like omphalocele and gastroschisis can lead to potentially complex postnatal care which is why today we are going to discuss some key knowledge points from Dr. Foong-Yen Lim: pediatric surgeon at Cincinnati Children’s
video · 9:32 · Mar 2022
Malrotation with Dr. Meera Kotagal
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In this podcast, we cover the basics of malrotation including embryology, presentation, differentiation, diagnosis, surgical approach, and post operative management with Dr. Meera Kotagal.
Host: Em Tombash
Animations to understand the
podcast · 13:25 · May 2023
Umbilical Disorders with Dr. Rebeccah Brown
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In this podcast, we explore the conditions, and treatment strategies related to umbilical disorders in newborns and young children with Dr. Rebeccah Brown from Cincinnati Children's.
From umbilical coard anatomy and infections like ompha
podcast · 11:27 · Jan 2025
Acute Management
2 items
Necrotizing Enterocolitis
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Dr. Jose Prince discusses necrotizing enterocolitis. His presentation includes management techniques of peritoneal drainage, exploratory laparotomy, diagnostic laparoscopy, complete enterectomy, silo, bowel decompression, and antibiotics as
video · 35:06 · Nov 2018
Intestinal Rehabilitation, Episode 2: Overwhelming intestinal damage, Part 1
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We're back with a new episode from the Intestinal Rehabilitation Center at Cincinnati Children's Hospital. This time we're talking about the management of overwhelming intestinal damage in conditions such as necrotizing enterocolitis and vo
podcast · 13:27 · Feb 2022
Nutritional Management
1 item
Update Course 2022 - UPDATES IN GASTROSCHISIS FEEDING PROTOCOLS - Jason Fraser, Beth Rymeski, and Steven Lee
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In this session we discuss protocols for feeding gastroschisis patients with Drs. Jason Fraser, Beth Rymeski, and Steven Lee.
Articles discussed:
Minimizing Variance in Gastroschisis Management Leads to Earlier Full Feeds in Delayed C
video · 21:09 · Sep 2022
Surgical Management
9 items
Sutureless Gastroschisis Repair: Technique
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This video demonstrates the technique of the sutureless plastic closure for gastroschisis. This can be performed at the bedside in the NICU without a trip to the operating room. This was originally described by Bianchi and then modified by
video · Jan 2019
Gastroschisis: Advanced Practice Providers
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Joyce Slusher, MSN, CNP, presents on perioperative management of gastroschisis for advanced practice providers.
video · 43:21 · Jan 2019
Staged Closure of Gastroschisis with Spring-loaded Silo
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This video appears in a new pediatric surgery textbook, Clinical Pediatric Surgery: A Case-Based Interactive Approach," by Dr. Sherif Emil. The book is an innovative educational resource that focuses on judgment and decision-making in pedia
video · 27:29 · Feb 2020
Staged Closure of Gastroschisis with Spring-loaded Silo
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This video appears in a new pediatric surgery textbook, Clinical Pediatric Surgery: A Case-Based Interactive Approach," by Dr. Sherif Emil. The book is an innovative educational resource that focuses on judgment and decision-making in pedia
video · 27:11 · Feb 2020
Sutureless Closure of Gastroschisis - APSA Practice Gaps 2019
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At the 7th Annual Pediatric Surgery Update Course, Dr. Saleem Islam discusses sutureless closure of gastroschisis, one of the 2019 practice gaps identified by the American Pediatric Surgical Association’s Professional Development Committee.
video · 21:04 · Mar 2020
Duodeno-duodenostomy for Duodenal Atresia
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In this video, duodeno-dudenostomy diamond anastomsis for duodenal atresia is demonstrated. The patient is a 2 day old boy that is presented with greenish vomiting since birth. Exploration revealed complete duodenal atresia type three and m
video · 7:04 · Jun 2021
Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients
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Anna-Maria Ziegler, Daniel Svoboda, Britta Lüken-Darius, Andreas Heydweiller, Fritz Kahl, Sophie Christine Falk, Udo Rolle, Till-Martin Theilen
Purpose: Abdominal wall closure in patients with giant omphalocele (GOC) and complicated gast
video · 0:56 · Nov 2024
Malrotation Infant
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Surgical technique video demonstrating laparoscopic Ladd procedure in an infant with malrotation presenting with bilious vomiting. Shows systematic division of Ladd bands, duodenal mobilization, bowel derotation, and appendectomy using 3mm
video · 9:22 · May 2026
Update Course Rewind 2025: Updates in NEC Management
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Narrated by Lizzy Lee, PA-C & Maggie Koenig, this podcast, a rewind from the 2025 Pediatric Surgery Update Course, delves into crucial updates in Necrotizing Enterocolitis (NEC) management. Leading pediatric surgeons Drs. Augusto Zani, Simo
video · 11:03 · Jul 2026
Complications
1 item
Conservative Management of Necrotizing Enterocolitis in Newborns: Incidence and Management of Intestinal Strictures
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Rach Mena, Gabriela Guillén, Sergio Lopez-Fernandez, Marta Martos Rodríguez, César W Ruiz, Alicia Montaner-Ramon, Manuel López, José A Molino
Background: Necrotizing enterocolitis (NEC) is one of the main causes of acute abdomen in neona
video · 0:50 · Jan 2025
Evidence & Research
24 items
91% Decrease in Mortality with Gastroschisis Bundle!
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By adopting a gastroschisis bundle protocol, a group from Hospital Infantil de México Federico Gomez was able to reduce their mortality from 22% to just 2%! Congratulations to Cristian Zalles-Vidal, Jaime Nieto-Zermeño, and the other author
video · 3:12 · Dec 2018
Immediate vs Silo Closure for Gastroschisis
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Dr. Ponsky reviews his takeaways from the JPS article, “Immediate Versus Silo Closure for Gastroschisis: Results of a Large Multicenter Study.”Link to full article: https://gcmd.co/2PItKT3
video · 0:26 · Dec 2019
Biliary Atresia, Appendicitis, Intestinal Failure, and Anesthetic...
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Audio Journal with Dr. Von Allmen about using Corticosteroids After Hepatoportoenterostomy for Bile Drainage, Dr. Whit Holcomb about surgical site infections (SSI) are an important source of morbidity and mortality. and feasibility and safe
podcast · 44:19 · Dec 2020
Gastroschisis and sutureless abdominal wall closure
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Dr. Rod Gerardo and Dr. Todd Ponsky talk to Dr. Jason Fraser about the paradigm shift in gastroschisis management that is still in flux. Plus a deep dive into Dr. Fraser's recent publication: "Sutureless vs sutured abdominal wall closure fo
podcast · 12:17 · Jan 2021
Journal of Pediatric Surgery Article Review: October 2021
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We're back with the October issue of JPS article highlights. This time we're talking to JPS Editor Dr. Paul Tam and authors Dr. Brittany Johnson, Dr. Nigel Hall, Dr. Richard Wood, and Dr. Giacomo Esposito. Hosts: Ellen Encisco & Rod Gerardo
podcast · 19:10 · Nov 2021
Journal of Pediatric Surgery Article Review: January 2022 APSA Issue
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We're back with the January issue of JPS article highlights. This time we're talking to editor Dr. Cassandra Kelleher and authors Drs. Gail Besner, Shahrazad Joharifard and Sarah Stokes with Dr. Todd Ponsky. Hosts: Ellen Encisco, Em Tombash
podcast · 13:09 · Feb 2022
Update Course 2021: TOP PUBLICATIONS IN NON - PED SURG JOURNALS
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Dr. Jose Campos and his team, Sociedad Chilena Cirugia Pediatrica curate the best pediatric surgical articles in non-core pediatric surgery journals and in this session, they describe their 5 favorites from the past year. The conversation i
video · 22:13 · May 2022
Update Course 2022 - TOP PUBLICATIONS IN NON- PED SURG JOURNALS - Jose Campos
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In this session, Dr. Jose Campos leads us through the top publications that are not in the Journal of Pediatric Surgery.
Articles referenced:
1. IMPPACT (Intravenous Monotherapy for Postoperative Perforated Appendicitis in Children T
video · 27:50 · Sep 2022
Update Course 2022 - APSA PDC UPDATES - Mary Edwards, Paul Jeziorczak, Craig Lillehei, and Charles Snyder,
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In this session, members of the APSA Professional Development Committee (PDC) discussed the latest top articles and practice updates. We were joined by Drs. Mary Edwards, Paul Jeziorczak, Craig Lillehei, and Charles Snyder.
Topics discus
video · 64:30 · Sep 2022
Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema
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New article you should know about by Dr. Cecilia Gigena
"Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enem
video · 0:56 · Apr 2023
Quick Literature Updates Episode 6
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We’re back with sixth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most int
video · May 2023
Quick Literature Updates Episode 10
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We’re back with tenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. This episode, we will review three articles covering the most
video · Jul 2023
Quick Literature Updates Episode 11
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We’re back with eleventh episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. This episode, we will review three articles covering the mo
video · Jul 2023
Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus
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Another article you should know by Cecilia Gigena
"Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus"
Authors: Tim Hundscheid, M.D., Wes Onland, M.D., Ph.D., Elisabeth M.W. Kooi, M.D., Ph.D., Daniel C. Vijlbrief, M
video · 1:14 · Aug 2023
Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study
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New article review by Alex Halpern, MD!
Full text: https://www.jpedsurg.org/article/S0022-3468(24)00077-0/fulltext
Background: Enteral feeding is an essential part of the management of infants with gastroschisis. We hypothesized that
video · 0:56 · Aug 2024
Journal of Pediatric Surgery Article Review: 2nd Quarter (Apr-Jun) 2024
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We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the second quarter of 2024, April, May, and June issues. This time we're talking to editors Drs. Mary Bri
podcast · 17:03 · Sep 2024
Journal of Pediatric Surgery Article Review: 3rd Quarter (Jul-Sep) 2024
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We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the third quarter of 2024, July, August and September issues. This time we're talking to editors Drs. Col
podcast · 19:28 · Oct 2024
Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations
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Mark B Slidell, Jarod McAteer, Doug Miniati, Stig Sømme, Derek Wakeman, Kristy Rialon, Don Lucas, Alana Beres, Henry Chang, Brian Englum, Akemi Kawaguchi, Katherine Gonzalez, Elizabeth Speck, Gustavo Villalona, Afif Kulaylat, Rebecca Rentea
video · 0:55 · Jan 2025
Quick Literature Updates Episode 16
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We’re back with sixteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most inte
video · 4:21 · Jan 2025
STAT trial: stoma or intestinal anastomosis for necrotizing enterocolitis: a multicentre randomized controlled trial
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Simon Eaton, Niloofar Ganji, Mandela Thyoka, Maher Shahroor, Augusto Zani, Hazel Pleasants-Terashita, Ali El Ghazzaoui, Jayaram Sivaraj, Stavros Loukogeorgakis, Paolo De Coppi, Sandra Montedonico, Sanja Sindjic-Antunovic, Marija Lukac, Jame
video · 0:57 · Apr 2025
Journal of Pediatric Surgery Article Review: 1st Quarter (Jan-Mar) 2025
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We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the first quarter of 2025, January, February and March issues. This time we're talking to editors Drs. Ro
podcast · 16:35 · May 2025
Quick Literature Updates Ep 22
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We’re back with 22nd episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesti
video · 4:23 · Oct 2025
Quick Literature Updates Ep 27
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We’re back with 27th episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesti
video · 4:20 · Feb 2026
Availability, utilization, and barriers to bowel ultrasound for necrotizing enterocolitis...
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Dr. Lizzy Lee from Cincinnati Children's discusses a national multidisciplinary survey on the availability and use of bowel ultrasound (BUS) for diagnosing necrotizing enterocolitis (NEC). The study found that while BUS is available in many
video · 0:55 · Jul 2026
Case-Based Learning
12 items
Abdominal Wall Defects
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Dr. Jacob Langer discusses various abdominal wall defects through case presentation.Topics of discussion include atresia, gastroschisis, fascial defects, staged closure by silo, and ruptured omphalocele.
video · 37:50 · Nov 2018
Malrotation
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Dr. Soldes discusses the classifications of malrotation through the presentation of case presentations. Discussion topics include Ladd's procedure, volvulus, non-bilious emesis, redundant duodenum, gastroesophageal reflux, and laparoscopy.
video · 42:31 · Nov 2018
Tricks - Total Colonic Aganglionosis Associated with Malrotation & Multiple...
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Dr. Sahned Jaafar presents a difficult case of total colonic aganglionosis with malrotation and Hirschsprungs disease. The presentation is followed by a comprehensive discussion of surgical approaches to this case.
video · 15:41 · Nov 2018
Bilateral Wilm's Tumor - Complex Gastroschisis - Complex Ileal Atresia:...
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Dr. Anthony Sandler discusses bilateral Wilm's tumors, complex gastroschisis, and complex ileal atresia.
video · 29:44 · Nov 2018
Malrotation Rapid Fire Session: Update Course 2015
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During the 3rd Annual Stay Current in Pediatric Surgery Update Course in 2015, Dr. Kenneth Azarow,Dr. Kenneth Azarow, Surgeon-in-Chief for Doernbecher Children’s Hospital, presents on malrotation-volvulus. Topics discussed includemalrotatio
video · 8:59 · Jan 2019
Compiled Sandler Rapid Fire Sessions: Update Course 2015
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Dr. Anthony Sandler from Children's National Medical Center leads the discussion in a rapid fire format for multiple cases, including management of Wilms tumor, gastroschisis, and complex ileal atresia.
video · 29:44 · Jan 2019
Total Colonic Hirschsprung Disease with Malrotation: Difficult Cases
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Dr. Sahned Jaafar presents a difficult case of total colonic aganglionosis Hirschsprung disease with malrotation. The presentation is followed by a comprehensive discussion of surgical approaches to this case.
video · 13:15 · Jan 2019
Abdominal Wall Defects: Update Course 2013
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Dr. Jacob Langer discusses various abdominal wall defects through case presentation.Topics of discussion include atresia, gastroschisis, fascial defects, staged closure by silo, and ruptured omphalocele.
video · 37:40 · Jan 2019
NEC: Update Course 2013
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Dr. Jose Prince discusses necrotizing enterocolitis. His presentation includes management techniques of peritoneal drainage, exploratory laparotomy, diagnostic laparoscopy, complete enterectomy, silo, bowel decompression, and use of antibio
video · 34:22 · Jan 2019
Gastroschisis - Clinical Practice Updates
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This clip from the 2020 Pediatric Surgery Update Course features, Miguel Guelfand, MD; Shawn St. Peter, MD; and Saleem Islam, MD; presenting challenging cases for review by our panelists.
Highlighted Topics Include:
- Omphalocele
- Pul
video · Sep 2020
Malrotation and Volvulus with Trinity
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Surgical technique video demonstrating laparoscopic reduction of midgut volvulus with Ladd procedure in a 12-year-old with chronic symptoms and acute obstruction. Shows systematic band division, bowel derotation, mesenteric widening, and ap
video · 8:02 · May 2026
Gastroschisis
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This clip from the 2020 Pediatric Surgery Update Course features, Miguel Guelfand, MD; Shawn St. Peter, MD; and Saleem Islam, MD; presenting challenging cases for review by our panelists.Highlighted Topics Include:- Omphalocele- Pulmanary h
video · Jun 2026
In-Depth Reviews
16 items
Malrotation - Volvulus - Meconium Ileus - Solid Organ Injury: Update Course 2015
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Dr. Kenneth Azarow,Surgeon-in-Chief for Doernbecher Children’s Hospital,presents on malrotation-volvulus, meconium ileus, andsolid organ injury. Topics covered by Dr. Azarow include malrotation and heterotaxy, non rotation, right and leftat
video · 27:04 · Nov 2018
Necrotizing Enterocolitis with Dr. Gail Besner
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Discussion between Dr. Todd Ponsky and Dr. Gail Besner about necrotizing enterocolitis
podcast · 46:29 · Jan 2019
Abdominal Wall Defects with Dr. Jacob Langer
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Dr Jacob Langer discusses abdominal wall defects with Dr. Todd Ponsky.Edited by Ian C. Glenn, MD and Sophia Abdulhai, MDAn interactive discussion about gastroschisis and omphalocele between Todd Ponsky, MD and Jacob "Jack" Langer, MD. Dr. L
podcast · 52:45 · Jan 2019
7th Annual Pediatric Surgery Update Course 2019 - FULL SHOW
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8:10am - APSA PDC TOP 10 - Review of 2018 Top Ten, Antibiotic stewardship, New concept in small bowel obstruction, Adherence to the Surviving Sepsis campaign guidelines and New APSA Trauma committee solid organ injury protocol10am - APSA PD
video · 285:42 · Jul 2020
Gastroesophageal Reflux Disease
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This podcast is a multidisciplinary discussion on a controversial topic, management of pediatric Gastroesophageal Reflux Disease, amongst Dr. Todd Ponsky, Dr. Rachel Rosen, and Dr. George "Whit" Holcomb.Dr. Rachel Rosen is Director of the A
podcast · 81:04 · Dec 2020
Intestinal Failure with Dr. Brad Warner
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Discussion with Dr. Brad W. Warner about intestinal failureWhat is intestinal failure?An umbrella term for when the small bowel is unable to digest and absorb an adequate amount of nutrients to sustain a patient through enteral means alone.
podcast · 52:46 · Dec 2020
Necrotizing Enterocolitis with Dr. Gail Besner
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Discussion between Dr. Todd Ponsky and Dr. Gail Besner about necrotizing enterocolitisHistory:Patients will often present with abdominal distention, high gastric residuals and bloody stools.First make sure the problem is in the abdomen.Pat
podcast · 46:29 · Dec 2020
Hirschsprung Disease Part I with Marc Levitt
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Dr. Marc Levitt and Dr. Todd Ponsky discuss Hirschsprung disease.Dr. Ponsky: Welcome to "Stay Current” in pediatric surgery, I’m Todd Ponsky, a pediatric surgeon at Akron Children’s Hospital and today we’re going to be focusing on Hirschspr
podcast · 59:20 · Dec 2020
Abdominal Wall Defects with Dr. Jacob Langer
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Dr Jacob Langer discusses abdominal wall defects with Dr. Todd Ponsky.Edited by Ian C. Glenn, MD and Sophia Abdulhai, MDAn interactive discussion about gastroschisis and omphalocele between Todd Ponsky, MD and Jacob "Jack" Langer, MD. Dr. L
podcast · 52:45 · Dec 2020
Umbilical Cord Defects with Dr. Kenneth Azarow
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This podcast discusses the work up and management of umbilical cord defects. Dr. Todd A. Ponsky is an associate professor of surgery and pediatrics and pediatric surgeon at Akron Children's Hospital. Dr. Kenneth S. Azarow is surgeon-in-chie
podcast · 30:16 · Dec 2020
Omphalocele and Gastroschisis With Dr. Foong-Yen Lim
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Omphalocele and Gastroschisis are abdominal wall defects that develop in-utero and surgically treated post-birth. Join Dr. Foong-Yen Lim, Surgical Director of the Cincinnati Children’s Fetal Care Center, and Dr. Todd Ponsky to discuss the p
podcast · 9:31 · Feb 2022
Stay Current Throwbacks Necrotizing Enterocolitis with Dr. Gail Besner
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Today is #NECday so we went back to a conversation between Dr. Todd Ponsky and Dr. Gail Besner about necrotizing enterocolitis. Enjoy this Stay Current Throwback on NEC. https://pubmed.ncbi.nlm.nih.gov/34506326/
podcast · 47:54 · May 2022
Update Course 2021: UPDATE COURSE 2020: REVIEW OF LAST YEAR'S IMPORTANT T OPICS
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General surgery residentRodrigo Gerardo, MD reviews the highlights from the 2020 Update Course including MMP7 for diagnosing biliary atresia, complex gastroschisis, and so much more.
video · 23:20 · May 2022
Neonatal Gastric Volvulus with Dr. Jason Frischer
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Gastric volvulus is a rare pathology for the pediatric surgical patient and when it happens, you want to be ready for potential surgical intervention. In this episode, Dr. Jason Frischer discusses the basics of diagnosis and management for
podcast · 11:17 · Jun 2022
Update Course Rewind: 2022 Top Ten Key Takeaways
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The 10th annual Pediatric Surgery Update Course was held as a webinar on August 30, 2022. We had a lot of lively discussion and engaging presentations on the latest updates in pediatric surgery. In this video we are reviewing the top ten ke
video · Jun 2023
Update Course Rewind: Omphalocele & Gastroschisis 2020
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Abdominal wall defects like omphalocele and gastroschisis can present in interesting ways. At last year
podcast · 15:18 · Jun 2026
Emerging & Future Directions
2 items
Dr. Colleen Nofi - Best of the Best in Pediatric Surgery 2025
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Watch APSA's Dr. Colleen Nofi’s presentation on “Extracellular Cirp Exacerbates Necrotizing Enterocolitis” at the 2025 Best of the Best in Pediatric Surgery event!
Moderators: Drs. Todd Ponsky, Dan von Allmen, and Meera Kotagal
video · 8:06 · Mar 2025
Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC) - Validation in a Large Animal Model
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Rahul Gadde, Jason Xia, Sophia Hameedi, Angela Saulsbery, Carly Schafer, Lourenço Sbragia, Oluyinka O Olutoye
Background: Necrotizing enterocolitis (NEC) remains a devastating intestinal disease that affects 5-7% of preterm neonates. Rem
video · 0:59 · Apr 2025
Patient & Family Education
1 item
What is Gastroschisis? An ERNICA animation for parents and families
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Animation video [in English]. Target audience: Parents and families. The video could also be used as an explanatory tool by healthcare professionals.
For further details about this condition, possible complications and specialised care,
video · 2:59 · Dec 2023
Long-Term Care
1 item
Educational Outcomes in School-Aged Children With a History of Simple and Complex Gastroschisis are Poor Compared to Controls
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Osamuyi Asemota, Gabrielle Derraugh, Matthew Levesque, Anna C Shawyer, Suyin A Lum Min, Richard Keijzer
Background: Research on long-term cognitive outcomes of children with gastroschisis is limited and inconsistent. This study aimed to
video · 0:53 · Apr 2025
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Every statement below comes from the recorded discussions, with its speaker and moment.
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
Intestinal failure is defined as insufficient gut function to absorb enough nutrients, fluids, and calories to support survival and, in children, growth
clinicalPaul Wales2:05 ↗
For a patient to be defined as having intestinal failure, they must have inadequate intestinal function necessitating parenteral support for at least 60 days
guidelineRod Gerardo2:24 ↗
An intestinal rehabilitation program is a multidisciplinary collaborative patient care paradigm that brings coordinated care for children with intestinal failure through comprehensive management of their specialized nutrition and associated needs
clinicalPaul Wales3:03 ↗
Short bowel syndrome is by far the most common category of intestinal failure in pediatric patients
epidemiologicalPaul Wales4:50 ↗
Causes of short bowel syndrome include congenital anomalies such as intestinal atresia, malrotation, volvulus, gastroschisis, and long segment Hirschsprung's disease
clinicalPaul Wales5:06 ↗
Acquired diseases of the newborn such as necrotizing enterocolitis can cause short bowel syndrome
clinicalPaul Wales5:18 ↗
Motility disorders occur when the bowel is unable to push contents through in a coordinated way due to abnormalities of the muscle itself or the nerves that control that muscle
clinicalPaul Wales5:45 ↗
Congenital enteropathies are conditions where the patient has all of their bowel but the mucosa does not work, leading to hypersecretion and profuse fluid losses
clinicalPaul Wales6:17 ↗
Some patients will have elements of two or three categories of intestinal failure in the way they present
clinicalPaul Wales7:11 ↗
A child with gastroschisis could have short bowel because it was not all viable, inflammation affecting absorption, and motility issues
clinicalEllen Encisco7:22 ↗
Older pediatric patients can develop intestinal failure from inflammatory bowel disease or Crohn's disease where they have lost gut as a result of complications
clinicalPaul Wales7:56 ↗
Trauma, malignancy, and vascular thrombosis leading to gut loss are diagnoses seen more in older patients or adult series and less in pediatrics
epidemiologicalPaul Wales8:04 ↗
There are three time points where families reach intestinal rehabilitation programs: prenatal diagnosis, postnatal acquired problems, and later presentations after discharge
clinicalMichael Helmrath8:53 ↗
Prenatal diagnoses that lead to intestinal rehabilitation typically include atresia with cystic fibrosis and gastroschisis
clinicalMichael Helmrath9:15 ↗
Postnatal acquired problems leading to intestinal rehabilitation include volvulus and necrotizing enterocolitis
clinicalEllen Encisco9:29 ↗
Dietitians play a key role in understanding the nutritional needs of children in intestinal rehabilitation
opinionMichael Helmrath11:52 ↗
Social work is a key component of the intestinal rehabilitation team
opinionMichael Helmrath12:01 ↗
The survival overall in big intestinal rehabilitation programs is usually over 90% long-term survival
epidemiologicalRod Gerardo12:34 ↗
Children with intestinal failure who survive long-term now develop chronic comorbidities including renal dysfunction, metabolic bone disease, neurocognitive issues, and quality of life issues
clinicalPaul Wales12:46 ↗
Earlier recognition and taking advantage of the biology of the gut to adapt are time dependent
clinicalMichael Helmrath2:40 ↗
Intestinal rehabilitation streamlines care and improves communication with families and between care providers and team members
opinionPaul Wales3:55 ↗
Intestinal rehabilitation comes down to key factors that drive the process: nutrition in the gut, nutrition in the body, and healing
clinicalMichael Helmrath4:07 ↗
Pattern recognition from multiple eyes on a baby who have seen them over time is important in intestinal rehabilitation
opinionMichael Helmrath4:19 ↗
Intestinal Rehabilitation, Episode 2: Overwhelming intestinal damage, Part 1
The inflection point of bowel loss requiring prolonged TPN is about 50%
clinicalMichael Helmrath9:27 ↗
Intestinal transplant is not experimental therapy but part of the continuum of therapy for a child with short bowel syndrome
guidelinePaul Wales2:38 ↗
Babies born with duodenal atresia or very proximal jejunal atresia are born with elevated direct or conjugated bilirubins
clinicalPaul Wales6:14 ↗
A 30-week-old baby's gut is in a highly developmental phase and its ability to regenerate is much more profound than a full term baby and certainly a one year old baby
clinicalMichael Helmrath7:34 ↗
The distal bowel, the ileum, can be salvaged by ileocecal blood flow
clinicalMichael Helmrath8:04 ↗
Bowel regeneration with proximal control occurs over 6, 8, 12 weeks based on the liver getting better
clinicalMichael Helmrath8:17 ↗
When the liver is inflamed and has high bilirubin, it's in a catabolic state
clinicalMichael Helmrath5:57 ↗