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Spontaneous Regression of Thoracic and Extraperitoneal Glial Implants in Child With Gliomatosis Peritonei After Resection of Ovarian Teratoma

Webman, Rachel; Talishinskiy, Toghrul; Raetz, Elizabeth; Lala, Shailee; Tomita, Sandra
Gliomatosis peritonei is a rare condition associated with ovarian teratomas. Even rarer is extraperitoneal gliomatosis. We present a case of extraperitoneal gliomatosis with pleural implants and implants within the flank muscles, which regressed after resection of the primary tumor.
PMID: 25089607
ISSN: 1536-3678
CID: 1606042

Epidural Air in Child with Spontaneous Pneumomediastinum

Tomita, Sandra; Rivera, Rafael; Kuenzler, Keith; Ginsburg, Howard
PMID: 22648190
ISSN: 0939-7248
CID: 180159

Apple peel deformity of the small bowel without atresia in a congenital mesenteric defect

Llore, Nathaly; Tomita, Sandra
Congenital mesenteric defects are rare causes of bowel obstruction. Even rarer are mesenteric defects with an apple peel type of deformity, probably described definitively only once previously. We present a case of a 3year old boy who presented with a septic-like picture of severe metabolic acidosis and lethargy from a bowel obstruction with bowel ischemia. At laparotomy he was found to have bowel infarction due to herniation through a congenital mesenteric defect with an apple peel type of deformity of the bowel without bowel atresia.
PMID: 23331843
ISSN: 0022-3468
CID: 213712

Intestinal perforation in preterm infant as an unusual initial presentation of Hirschsprung's disease

Talishinskiy, T; Tomita, S
Intestinal perforations in preterm infants are often associated with necrotizing enterocolitis or spontaneous ileal perforation. Isolated colonic perforation is a rare presentation of Hirschsprung's disease (HD), especially in premature infants. We report a case of descending colon perforation with pneumoperitoneum at 3 days of life in a 34 week infant which was initially attributed to NEC. This case demonstrates that an isolated colonic perforation, even in the descending colon and preterm infant, can be attributed to Hirschsprung's disease. 2012 Elsevier Ltd. All rights reserved
EMBASE:2013764791
ISSN: 2213-5766
CID: 712822

Colonic stenosis in infant with connective tissue disorder

Lim, IIP; Durbin, J; Tomita, S
Congenital colonic stenosis is an exceptionally rare condition, with less than 15 cases in the literature. Although it has some similarities to small intestinal atresia and small intestinal stenosis, colonic atresia and colonic stenosis has been found in association with other anomalies such as Hirschsprung's disease, craniofacial abnormalities, and musculoskeletal anomalies. In this case report, we present a 6 month old male with suspected Loeys-Dietz syndrome (a connective tissue disorder), who presented with colonic stenosis
ORIGINAL:0009328
ISSN: 2213-5766
CID: 1375512

Managing radiation exposure in children-reexamining the role of ultrasound in the diagnosis of appendicitis

Thirumoorthi, Arul S; Fefferman, Nancy R; Ginsburg, Howard B; Kuenzler, Keith A; Tomita, Sandra S
PURPOSE: To assess the efficacy and accuracy of ultrasonography (US) and selective computed tomography (CT) in the diagnosis of acute appendicitis in children. METHODS: A retrospective review of all ultrasound evaluations for appendicitis from July 1, 2003, to June 30, 2010, was conducted at two urban pediatric centers. Beginning in 2003, a multi-disciplinary diagnostic protocol was implemented to reduce radiation exposure employing US as the initial imaging modality followed by CT for non-diagnostic US studies in patients with an equivocal clinical presentation. The imaging, operative findings, and pathology of 802 patients (365 females, 437 males, age less than 18years) with suspected appendicitis were reviewed. The sensitivity, specificity, predictive value, and negative appendectomy rate of the protocol were analyzed. A telephone survey was conducted of patients discharged without a diagnosis of appendicitis to evaluate the missed appendicitis rate. RESULTS: Of the 601 pediatric appendectomies performed, a total of 275 (46%) were diagnosed by protocol. The selective protocol had a sensitivity of 94.2%, specificity of 97.5%, positive predictive value of 95.2%, and negative predictive value of 97.0%. The negative appendectomy rate was 1.82%, and the missed appendicitis rate was 0%. No patient discharged after only ultrasound evaluation without undergoing surgery reported missed appendicitis on the survey (41.7% response rate). Protocol use increased from 6.7% to 88.3%. US was the sole imaging modality in 630 of all 802 patients (78.6%). CONCLUSIONS: US followed by selective CT for the diagnosis of acute appendicitis is useful and accurate. This has important implications in the reduction of childhood radiation exposure.
PMID: 23217887
ISSN: 0022-3468
CID: 202372

State of the practice for pediatric surgery-career satisfaction and concerns. A report from the American Pediatric Surgical Association Task Force on Family Issues

Katz, Aviva; Mallory, Baird; Gilbert, James C; Bethel, Colin; Hayes-Jordan, Andrea A; Saito, Jacqueline M; Tomita, Sandra S; Walsh, Danielle S; Shin, Cathy E; Wesley, John R; Farmer, Diana
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
PMID: 20920715
ISSN: 1531-5037
CID: 113742

An unusual form of duplicate bladder exstrophy [Case Report]

Tomita, Sandra S; McTiernan, Tracy L; Ginsburg, Howard B
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
PMID: 20385297
ISSN: 1531-5037
CID: 109048

Bilateral Morgagni hernias in patient with cystic fibrosis [Case Report]

Ortiz-Pomales, Yan T; Berndt, Kathryn; Tomita, Sandra
PMID: 19959051
ISSN: 1072-7515
CID: 106470

Congenital cystic adenomatoid malformation and bronchogenic cyst in a 4-month-old infant [Case Report]

Tomita, Sandra S; Wojtczak, Henry; Pickard, Ralph; Vazquez, W David
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
PMID: 20081749
ISSN: 1341-1098
CID: 109021