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An eleven year old girl presents with difficulty swallowing. An esophagram shows a distended esophagus and “beaking” at the gastroesophageal junction. Upper endoscopy demonstrates dilated esophageal body and puckering at the LES and retained saliva in the esophagus. The treating...

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Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "Numerous technical tricks have been advocated to reduce RP after laparoscopic-assisted anorectal pull-through (LAARP): colic washout of the distal loop to...

Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "Children presenting RP and older than 4 years usually have a predisposing condition. These older patients usually present recurrent or persistent RP and tend...

see video link in second post

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A 17 year old girl with a myelomeningocele has a long-standing VP shunt, which was last revised two years ago. Recently, the patient noticed VP shunt tubing extruding from her anus. On physical examination, she has no abdominal tenderness and the shunt tubing was not seen. Imaging including...

Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "A useful rule to assist the surgeon on whether or not a laparoscopic approach can be taken is to draw a line from the tip of the coccyx to the very next...

Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "Trendelenburg positioning may also augment contrast delivery to the intrahepatic bile ducts if initial images are equivocal, and administration of intravenous...

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A 2-year-old boy is referred to your clinic with scrotal asymmetry and a suspected diagnosis of undescended testicle. His mother reports that he was born with a swollen, firm right hemiscrotum that resolved completely after several weeks, and scrotal asymmetry has been present since then...

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see lecture link in second post

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A two day old former 30 week premature 1.2 kg infant underwent resection and ileostomy for ileal atresia. Two hours after surgery, the HR is 140 and mean arterial pressure is 30-32 mm Hg. He is intubated on pressure support, FiO2 21% with oxygen saturation of 98%. Urine output is adequate. Hgb...

Contraction direction of anal continence muscles red line: levator ani blue line: muscle complex green line: para sagital fibers

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