> -----Original Message-----
> From: Maureen McCollough [SMTP:[log in to unmask]]
> Sent: Monday, March 30, 1998 12:48 PM
> To: Multiple recipients of list PED-EM-L
> Subject: Peds Abd pain
> I am giving a lecture this weekend on Peds Abd Pain and have some
> for the group:
> 1. Intussusception - any centers out there consistently using air
> instead of barium? Any places not using fluoro to check for
> Just clinically?? China has thousands of patients done using air
> with reportedly great results. I see it written up in the literature,
> appears a lot better but haven't found any hospitals here using it
Yes, we consistently use air enemas as our reduction of
choice with good results, failing which, our radiologist may use
contrast barium enemas. It is much safer because in the event of a
perforation the risk of contamination is much less!! It is important to
confirm reflux of contrast (air or barium) into the ileum under flouro
in the classic ileocolic intussusception to confirm full reduction. As I
understand, the failure rates with air contrast enemas are not unique
and are basically the same as for any intussusception. The predictors
for unsuccessful reduction include prolonged symptomology (>12 hours),
frank small bowel obstruction, shock, dehydration and age less than 6
> 2. Appy's - any places consistently doing laprascopic appy's on
> kids?? Some
> centers are getting good results.
Not in our institution on a consistent basis. Diagnostic
laparoscopy is occasionally being done here especially for the female
adolescent with equivocal imaging studies in the setting of undiagnosed
acute RLQ pain.
> 3. Pyloric stenosis - in Japan, they use IV and then oral atropine.
> surgery. They wait for the "spasm" of the stenosis to pass. Takes a
> of weeks. Any body seen it done in the U.S.???
> Also, I've heard of a great one week Peds EM conference given at CHOP
> supposedly in the fall. Some our Peds/EM residents thought it might
> good. Any body know about it??
I think you are referring to the PEM review course on
Sep 13-17th this year, organized by Doug Baker (who is now in CT). you
could check with him. He is on the list.
Hope that helps and good luck with your talk.
[Jay Pershad, M.D.]
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