Journal of Pediatric Surgery Article Review: October 2021
With Dr. Brittany Johnson & Dr. Nigel Hall & Dr. Richard Wood · hosted by Dr. Ellen Cisco & Dr. Rod Gerardo & Dr. Todd Ponsky · StayCurrentMD
Cued at 12:29 · stops at 13:14 · press play
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
More about child physical abuse
same diagnosisOnly a few other public items share this diagnosis — nothing to add yet.
Only a few other public items share this expert — go deeper there →
Video
Pediatric Surgical Oncology Research Collaborative (PSORC): Studying Rare Pediatric Tumors
56 s · Published May 2026
Video
Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
1 min · Published May 2026
Video
Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
1 min · Published May 2026
Video
Pooling Patients to Study Rare Pediatric Tumors: An Introduction to PSORC
56 s · Published May 2026
Video
The fetal frontier: A review of current and emerging fetal therapies for genetic diseases
44 s · Published May 2026
Video
Indocyanine green assists with sentinel lymph node mapping in pediatric and adolescent patients
1 min · Published May 2026
What the experts said
The Texas Children's Hospital study tracked non-accidental trauma patients using their trauma database, examining hospital course, injuries, consults, discharge instructions, and one-year follow-up compliance with recommended visits.
Follow-up rates for child physical abuse victims were actually quite high, with patients not following up as recommended but rates not being low, representing an opportunity as families are trying to make appointments.
Pediatric surgery could adopt the model used for children with complex medical conditions where all appointments are scheduled on one day to decrease burden on families.
The 85% follow-up rate in child abuse victims is surprising and encouraging.
The UK NEC study was a secondary analysis of prospectively collected observational data from all 27 pediatric surgery centers in the UK, representing a whole population-based study over one year.
Primary outcomes in the NEC study were death or parenteral nutrition requirement at 28 days after surgery, examining the relationship between surgical indication, timing from presentation to surgery, and outcomes.
Of approximately 130 babies with surgical NEC, about half had bowel perforation; of the remaining half, one-third were critically ill and proceeded quickly to surgery, while two-thirds eventually had surgery for failed medical treatment.
Babies with NEC who had surgery for failed medical treatment had the longest time from presentation to operation and the worst outcomes compared to those operated for perforation or clinical deterioration.
In NEC, it is easy to make surgical decisions when there is free air, but without definitive protocol for other presentations, surgeons hedge and delay daily about whether to operate.
The Nationwide Children's Hospital bowel management program started recording outcomes in a standardized way in 2015 using standardized definitions and patient-reported outcome and experience measures.
The bowel management study measured outcomes at one year rather than one week because one-week outcomes represent an artificial environment, and one-year measurement demonstrates sustained changes within the patient's normal environment.
In the bowel management program, children who achieved continence had significantly improved quality of life, while those who remained incontinent had no quality of life improvement.
In the bowel management study, 70% of children achieve good outcomes, allowing focus on understanding and improving outcomes for the remaining 30%.
Many surgeons who see the value of bowel management programs lack the volume or resources to build formal programs, making it reasonable to refer patients to nearby established programs.
There is variability in the use of ultrasound versus MRI for detecting tethered cord in anorectal malformation patients, and radiographs are not a good substitute.
Complete metadata for medical education content includes title, description, summary, keywords, duration, content type, specialty area, target audience level, and language.
We currently do not have objective clinical markers, whether clinical features or novel biomarkers, to help make earlier surgical decisions in NEC.
After one year in the bowel management program, 30% of patients still struggled with fecal incontinence despite intensive resources.
The Italian anorectal malformation study was a retrospective review of 350 patients between 1999 and 2019, representing one of the largest series.
The Italian study demonstrated a close relationship between spinal cord abnormalities and spinal bone anomalies in anorectal malformation patients.
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.
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.
The Italian study provides sufficient evidence to convince clinicians who are not doing routine spinal cord and spine assessment in anorectal malformation patients that they should be more serious with imaging.