Gastroparesis
Everything in the library about gastroparesis — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Surgical Management
1 item
Gastric Neurostimulators: Update Course 2017
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At the 5th Annual Stay Current Pediatric Surgery Update Course in 2017, Dr. Reinaldo Garcia-Naviero discusses gastric neuromodulators in pediatric patients. Along with the panel, he covers initial evaluation and treatment of dyspepsia, pH i
video35:22 · Sep 2018
Evidence & Research
2 items
Top Ten Things to Remember from the 2017 Stay Current Annual Update Course...
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This podcast recording highlights the things to remember from the recent Stay Current Annual Pediatric Surgery Update Course 2017 (also available in video format), with top ten topics including: gastric stimulation, cardiac sympathectomy, d
podcast25:04 · Sep 2018
Top Ten Things to Remember: Update Course 2017
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This video highlights the things to remember from the recent Stay Current Annual Pediatric Surgery Update Course 2017, with the top ten topics including: gastric stimulation, cardiac sympathectomy, diaphragmatic pacing, abdominal wall recon
video25:04 · Sep 2018
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Top Ten Things to Remember from the 2017 Stay Current Annual Update Course...
Gastric stimulation for pediatric gastroparesis can be tested temporarily via endoscopic placement before permanent laparoscopic or open implantation
host_summaryTodd Ponsky0:00 ↗
Reynaldo Garcia from Akron Children's Hospital presented gastric stimulation results showing significant symptom improvement in patients with persistent nausea and vomiting unresponsive to medical therapy
host_summaryTodd Ponsky0:00 ↗
Cardiac sympathectomy for CPVT (catecholaminergic polymorphic ventricular tachycardia) and hypertrophic cardiomyopathy involves high thoracoscopic approach to the lower stellate ganglion to prevent fatal arrhythmias
host_summaryTodd Ponsky0:00 ↗
Sophia Abdulhai and John Clark presented cardiac sympathectomy technique using clips and scissors for partial stellate ganglion resection, avoiding electrocautery to prevent Horner's syndrome
host_summaryTodd Ponsky0:00 ↗
Sympathectomy provides 100% compliance for arrhythmia management as patients cannot skip the intervention once performed
host_summaryTodd Ponsky0:00 ↗
Ray Anders from University Hospitals of Cleveland demonstrated diaphragm pacing for spinal cord injury, transverse myelitis, acute flaccid myelitis, and brain stem tumors, with youngest implant at one year of age
host_summaryTodd Ponsky3:00 ↗
Diaphragm pacing requires intact phrenic nerve and motor neurons; diaphragm contraction with neurostimulation must be confirmed before implantation
host_summaryTodd Ponsky3:00 ↗
Dave Carpata from Cleveland Clinic stated biologic mesh is not appropriate for bridging gaps in ventral hernia repair, only for temporary solution or reinforcement
host_summaryTodd Ponsky3:00 ↗
The best mesh for ventral hernia repair is macroporous monofilament lightweight polypropylene synthetic mesh such as Marlex, which performs well in contaminated fields in retromuscular space
host_summaryTodd Ponsky3:00 ↗
Retrorectus repair with mesh is superior to laparoscopic underlay for ventral hernia repair
host_summaryTodd Ponsky3:00 ↗
Posterior component separation has less wound morbidity than anterior component separation while providing space for wide mesh overlap and minimal fixation
host_summaryTodd Ponsky3:00 ↗
David Lanning from Virginia Commonwealth presented gastroesophageal disconnection (esophageal division with Roux-en-Y jejunal interposition) for severe reflux after failed Nissen fundoplication
host_summaryTodd Ponsky3:00 ↗
Gastroesophageal disconnection may be appropriate as primary repair for high-risk patients predicted to fail fundoplication
host_summaryTodd Ponsky3:00 ↗
Laparoscopic gastroesophageal disconnection can take 6 to 8 hours
host_summaryTodd Ponsky3:00 ↗
Patients who took full feeds by mouth preoperatively can continue oral feeding after gastroesophageal disconnection
host_summaryTodd Ponsky3:00 ↗
Chris Druck published a five-variable prediction rule identifying low-risk population for intra-abdominal injury after blunt trauma to guide CT scan decisions
host_summaryTodd Ponsky7:00 ↗
Patients with only abdominal pain after trauma have approximately 5% risk of abdominal injury and nearly 0% chance of requiring intervention
host_summaryTodd Ponsky7:00 ↗
Patients with abnormal physical exam findings such as handlebar injury have approximately 15% chance of abdominal injury
host_summaryTodd Ponsky7:00 ↗
The low-risk group (55% of trauma population) has less than 5% risk of any injury and less than 0.3% risk of injury requiring acute intervention
host_summaryTodd Ponsky7:00 ↗
Patients without abdominal wall trauma, tenderness or distention, with normal chest X-ray, no abdominal pain complaints, normal AST, and normal pancreatic enzymes probably do not need CT scan and can be sent home
host_summaryTodd Ponsky7:00 ↗
The ATOMAC prospective multi-institutional solid organ injury protocol de-emphasizes injury grade in favor of clinical predictive factors
host_summaryTodd Ponsky7:00 ↗
Patients with solid organ injury who do not respond to 20 cc/kg crystalloid bolus should receive 10-20 cc/kg blood bolus rather than second crystalloid bolus
host_summaryTodd Ponsky7:00 ↗
Patients requiring 40 cc/kg blood (4 units) or with hemoglobin less than 7 after blood transfusion should go to the operating room as this indicates non-operative management failure
host_summaryTodd Ponsky7:00 ↗
Stable solid organ injury patients can be admitted to the floor with vitals every 2-4 hours and hemoglobin at 6 hours, and discharged the next day if they never required blood transfusion
host_summaryTodd Ponsky7:00 ↗
Sean Saint Peter's group demonstrated stable solid organ injury patients can be discharged much more quickly than traditional prolonged admissions based on injury grade
host_summaryTodd Ponsky7:00 ↗
Mike Rubin from Akron Children's Hospital recommends chest CT for suspected airway foreign bodies in unclear cases, with nearly 100% sensitivity for detecting radiolucent and radiopaque foreign bodies
host_summaryTodd Ponsky13:00 ↗
CT scan for suspected airway foreign body eliminates unnecessary bronchoscopies in children with respiratory virus symptoms
host_summaryTodd Ponsky13:00 ↗
Oral contrast is unnecessary for suspected bowel obstruction CT scans as intraluminal fluid serves as adequate contrast
host_summaryTodd Ponsky13:00 ↗
Eliminating oral contrast speeds up CT acquisition time and prevents nausea and vomiting in bowel obstruction patients
host_summaryTodd Ponsky13:00 ↗
Unsuccessful intussusception reduction should be reattempted if there is movement to the ileocecal valve, with second attempts mostly successful
host_summaryTodd Ponsky13:00 ↗
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