Journal of Pediatric Surgery Article Review: May 2023, CAPS Issue
With Dr. Sonia Butterworth & Dr. Jacob Langer & Dr. Greta Bercher & Dr. Katerina Dukleska · hosted by Dr. Cecilia Gena & Dr. Tom Bash · StayCurrentMD
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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Quick Literature Updates Episode 15
4 min · Published Jan 2024
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The use of postoperative calibrations in Hirschsprung disease
59 s · Published Nov 2024
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Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
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Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
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How to Administer a Rectal Irrigation at Home
5 min · Published Jun 2023
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Hirschsprung Disease in Brief
Dr. Todd Ponsky · 10 min · Published Oct 2021
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Pediatric Surgical Oncology Research Collaborative (PSORC): Studying Rare Pediatric Tumors
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Pooling Patients to Study Rare Pediatric Tumors: An Introduction to PSORC
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The fetal frontier: A review of current and emerging fetal therapies for genetic diseases
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Indocyanine green assists with sentinel lymph node mapping in pediatric and adolescent patients
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Tricuspid valve surgery in transposition of the great arteries with a systemic right ventricle
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Early Tricuspid Valve Surgery for Heart Failure in Congenital Heart Disease
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What the experts said
Three risk factors for Hirschsprung-associated IBD are trisomy 21, a history of enterocolitis following pull-through surgery, and long segment disease.
Biologic therapy is most likely to be effective for treating Hirschsprung-associated IBD.
Hirschsprung's associated IBD is very poorly defined, presents in a number of different ways, and the reason why it happens is unknown.
Hirschsprung's enterocolitis that persists past age 5, or that is unresponsive to typical treatment under age 5, should prompt consideration of Hirschsprung-associated IBD diagnosis.
Complicated appendicitis was defined as: all perforated appendicitis, clear purulent peritonitis, or small bowel obstruction from appendicitis.
Median symptom duration between onset and emergency presentation was 1 day pre-COVID and 2 days during pandemic, representing a clinically significant difference despite lack of statistical significance.
Patients during COVID-19 had an increased rate of perforation compared to pre-pandemic, stayed in hospital longer, and had increased risks of complications.
During COVID-19, the government of Ontario made it mandatory that all patients below 18 years of age had to be treated at a pediatric hospital.
The institution already had a CART (critical airway response team) that activated all stakeholders except gastroenterology, which was added for the button battery protocol.
Even the pre-protocol time of 73 minutes for button battery removal was a very impressive target.
Button battery ingestions are not common events.
With the reduced time to removal, a decrease in at least major complications for button battery patients is anticipated over time.
The Hirschsprung-associated IBD study was a retrospective study from 2000 to 2021 at 17 institutions with 55 patients.
50% of Hirschsprung-associated IBD patients had long segment disease.
Enterocolitis was reported in 68% of Hirschsprung patients after pull-through.
The most common presentation for Hirschsprung-associated IBD was colonic or small bowel inflammation resembling IBD.
The COVID-19 appendicitis study assessed patients from February 2018 to June 2019 (pre-pandemic control) and mid-February 2020 to June 2021 (COVID period).
The study included 1100 patients total: 44% in pre-pandemic control group and 56% in COVID-19 group.
A larger proportion of complicated appendicitis occurred during COVID-19 compared to pre-pandemic period.
Symptom duration at presentation and length of stay were not significantly different between pre-pandemic and COVID-19 groups.
The button battery study evaluated whether implementation of a clinical algorithm shortened time from diagnosis to removal of esophageal button battery.
The algorithm was based on the national database algorithm and implemented in October 2019.
After implementing the critical airway response team algorithm, time from chest X-ray to button battery removal was reduced from 73 minutes to 35 minutes.