Faculty Bibliography

BACKGROUND: There has been increasing interest and concern raised in the surgical literature regarding changes in the culture of surgical training and practice, and the impact these changes may have on surgeon stress and the appeal of a career in surgery. We surveyed pediatric surgeons and their partners to collect information on career satisfaction and work-family balance. METHODS: The American Pediatric Surgical Association Task Force on Family Issues developed separate survey instruments for both pediatric surgeons and their partners that requested demographic data and information regarding the impact of surgical training and practice on the surgeon's opportunity to be involved with his/her family. RESULTS: We found that 96% of pediatric surgeons were satisfied with their career choice. Of concern was the lack of balance, with little time available for family, noted by both pediatric surgeons and their partners. CONCLUSION: The issues of work-family balance and its impact on surgeon stress and burnout should be addressed in both pediatric surgery training and practice. The American Pediatric Surgical Association is positioned to play a leading role in this effort

Duplicate bladder exstrophy is a rare variant of the exstrophy/epispadic lesions in which an external patch of exstrophic bladder presents in addition to a closed bladder in a more normal anatomical position, diastasis of the pubis and rectus muscles, and often a form of epispadias. We describe an anomaly of this variant with a fistula to the closed bladder. Careful examination with fluoroscopy and cystoscopy is helpful in defining the anatomy in these variants

Congenital cystic disease of the lung and mediastinum encompasses a continuum of entities, and a histological overlap of many of these anomalies is acknowledged. Moreover, it is possible for different lesions to coexist in the same patient. Careful evaluation prior to surgical resection will alert the surgeon to the possible presence of multiple lesions in one patient

We report a case of infant botulism presenting as primary colonic ileus-mimicking Hirschprung's megacolon. Infant botulism should be considered in any infant with constipation and neurologic abnormalities

Reports of nodular fasciitis among adults are common; however, this condition is relatively rare in the pediatric population. Its clinical and histologic characteristics are similar to malignancies such as sarcoma; thus, it is prudent for the clinician caring for children and adolescents to be aware of the possibility of its occurrence. Nodular fasciitis is a benign mesenchymal tumor. Often presenting as a rapidly enlarging soft tissue mass, clinically, it can easily be mistaken as a sarcoma or other malignancy during clinical evaluation. In addition, the pathologist may recognize its high cellularity, high mitotic index, and infiltrative borders, which, as a result, may lead to erroneous diagnosis as a malignancy. Although more frequently seen in adults, it does occur in the pediatric population and should be considered during evaluation and treatment of soft tissue masses in children and adolescents

Heteropagus twin refers to a type of conjoined twin in which an incomplete smaller (parasitic) twin is attached to and dependent upon an otherwise normal host twin. The majority of cases have complete or partial duplication of the pelvis and/or lower extremities. The case depicted herein is unusual in that only isolated case reports have described an attached amorphous mass without identifiable limbs

An unusual complication of bowel perforation after unit rod posterior spinal fusion and anterior spine release via a retroperitoneal approach is described. This complication has not been previously described. The pediatric surgical specialist should be aware of this consideration in the differential diagnosis of abdominal pain after unit rod posterior spinal fusion

Congenital midline cutaneous lesions should always alert the clinician to the possibility of spinal dysraphism. These lesions can take many different forms. The physician should be cognizant of such lesions in order to avoid potential neurologic complications. We present a patient with a midline sacral hemangioma associated with a congenital enteric sinus cyst, a previously unreported association