Journal of the Japanese Society of Pediatric Surgeons
Online ISSN : 2187-4247
Print ISSN : 0288-609X
ISSN-L : 0288-609X
Volume 46, Issue 7
Displaying 1-46 of 46 articles from this issue
  • Article type: Cover
    2010 Volume 46 Issue 7 Pages Cover1-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • Article type: Cover
    2010 Volume 46 Issue 7 Pages Cover2-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App1-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App2-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App3-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App4-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App5-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • Article type: Index
    2010 Volume 46 Issue 7 Pages Toc1-
    Published: December 20, 2010
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  • Tetsuya Ishimaru, Hiroo Uchida, Hiroshi Kawashima, Chikashi Gotoh, Kao ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1095-1101
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    Purpose: The incidence of complications related to PD catheters is reported to be high. We reviewed our experience on PD catheter-related complications. Methods: Medical records of patients who underwent PD catheter insertion during the period between January 2001 and October 2007 were retrospectively reviewed. Results: Forty-six PD catheter insertions were performed in 41 patients and 17 surgical complications were encountered in 12 patients. The median age of the patients was 110 months (range: 2-210 months). The complications included mechanical obstruction (n=9), exit-site infection (n=3), tunnel infection (n=3), peritonitis (n=1), and pleural effusion (n=1). Mechanical obstruction occurred early in the postoperative period with a median interval of 8 days (range: 0-22 days) and was managed by omentectomy (n=5 mostly laparoscopic), catheter replacement (n=2) or readjustment of catheter tip position (n=2). Infectious complications, including exit-site infection, tunnel infection, and peritonitis, occurred later with a median interval of 265 days (range: 126-701 days). This complication was frequently seen in younger patients with a median age of 14 months (range: 2-200) and was managed by reinsertion (n=3), removal (n=2), or a cuff-shaving procedure (n=2). Conclusions: PD catheter-related complications occurred in as many as 29.3% of patients. Exit-site infection was a late complication of younger children, whereas mechanical obstruction occurred early in the postoperative period. Prophylactic omentectomy may be a reasonable means of preventing the latter complication which was associated with omental wrapping.
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  • Tomoyuki Sato, Masaki Nio, Shintaro Amae, Hiromu Tanaka, Megumi Nakamu ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1102-1107
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    Purpose: We performed conservative therapy with the Vacuum Bell for pectus excavatum. The present paper concerns the short-term clinical effect and safety, and describes the correlation of therapeutic period, patient's character and efficacy. Methods: The study population consisted of 13 patients (7 boys and 6 girls) 15 years of age or younger up to June 2009. The efficacy was assessed according to improvement of the hollow of the sternum. Results: The mean age at the beginning of therapy was 9.6±3.6 years old. The therapeutic and follow-up time was 14.1±8.6 and 15.7±9.9 months on average. The hollow of sternum was 18.3±6.5mm at the beginning, 11.9±6.2mm after 3 months and 13.0±6.6mm after 6 months. The deformity improved significantly by 3 months. But after that the tendency was not clear owing to loss of motivation and/or complication. The sternum of one patient sank again at 6 months after the end of therapy. Although it seems more effective in patients under 10 years old, the difficulties of handling and compliance resulted in no difference. There were no serious complications, expect for mild dermatitis and subcutaneous hematoma. Conclusion: 12 of 13 patients showed good results. The agreeable therapeutic period and the management of relapsed patients remain unclear. But, this therapy is not invasive and its safety enables treatment at home. It is an alternative method for treatment of pectus excavatum.
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  • Hironori Kudo, Motoshi Wada, Hideyuki Sasaki, Takurou Kazama, Kotaro N ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1108-1114
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    Purpose: The aim of this study is to investigate the treatment of intestinal failure-associated liver disease (IFALD). Patients and Methods: Six patients with IFALD were hospitalized between January 2006 and February 2010. Patients were 4 males and the median age was 28 months. Underlying liver pathology was cholestasis and hepatocellular injury in 1 patient, non-alcoholic steatohepatitis (NASH) in 3 and hepatic fibrosis associated with portal hypertension in 1. Median HH15 to LHL15 ratio (H/L15) by technetium 99m-DTPA-galactosyl human serum albumin liver scintigraphy was 0.86. The treatment protocol comprised cyclic parenteral nutrition (PN), a decrease in intravenous calories, infusion of amino acids and lipid, and avoidance of fasting. Furthermore, we introduced intestinal transplantation (ITx), serial transverse enteroplasty (STEP) and Omegaven^[○!R] in 2007, 2008 and 2009, respectively. Treatment outcomes were reviewed retrospectively. Results: Four patients were alive recovering from liver damage at a median follow-up of 13 months. Only 1 patient who had undergone ITx was weaned from PN. Two patients who did not recover from liver damage died of liver failure. Patients with severe hepatic fibrosis or a high value for H/L15 were refractory to treatment. Conclusions: For patients with intestinal failure, nutritional supply should be adjusted strictly to liver condition. If a patient develops IFALD, a proper combination of treatments including careful management of parenteral nutrition, STEP and administration of Omegaven^[○!R] should be promptly initiated. By the severity of intestinal failure and IFALD, an indication for isolated ITx or liver and ITx should be considered.
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  • Yoshiyuki Onitake, Yasuhiro Kitayama
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1115-1118
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    We experienced a 31-month-old boy with serious constipation due to cow's milk protein allergy. The child presented with chronic constipation at the age of 3 months, and use of enema, laxative, and the Chinese herbal remedies Daikenchuto and Shokenchuto were unsuccessful. We subsequently suspected some surgical problems, but a barium enema showed no abnormality. With no improvement 5 months after the first consultation, analysis of the child's history indicated a possibility of milk allergy. Blood tests proved positive for specific IgE milk antibody and DLST. After the diagnosis of cow's milk protein allergy, the child was placed on a dairy restricted diet. Six days later, he passed a stool without an enema, and has been doing well for two years. We conclude that in cases with continued constipation where surgical lesions have been ruled out, dairy allergies should be considered.
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  • Minoru Iwasaki, Masahiko Kondoh, Hajime Honjyoh, Tomoyuki Shirase, His ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1119-1124
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    A clinical case report of pediatric rectal cancer in Japan is extremely rare. The clinical medical strategy has not been sufficiently investigated. We report herein a case of rectal cancer which occurred in a 15-year-old girl. Family history was noncontributory. Physical and laboratory examinations for tumor markers were unremarkable. Some characteristics in the tumor came to be clear based on pit pattern categories via endoscopic views. The tumor proved to be a villous adenoma based on the histopathological evaluation of the biopsy at the initial endoscopic examination. However, the possibility of rectal mucosal cancer was strongly suggested from the information from the pit pattern via endoscopic views, barium enema, and CT scans. An endoscopic submucosal dissection (ESD) was performed based on the size, form, location, and invasive grade of tumor. Histopathological evaluation of the resected specimen diagnosed it as well differentiated adenocarcinoma. The surgical margin of the resected specimen was intact for both horizontal and vertical end tissue. Moreover, the resected specimen had no invasion to vessels or lymph ducts at all. The complete resection of the tumor was performed. It is a significant medical strategy to perform ESD for pediatric rectal cancer in the early stage as a cancer in the mucosal layer. The ESD as minimally invasive surgery is useful and should be put to practical use everywhere.
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  • Shinji Ishii, Minoru Yagi, Yoshiaki Tanaka, Kimio Asagiri, Takahiro As ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1125-1129
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    The patient was born at 37 weeks' gestation after an ultrasound scan at 19 weeks' gestation revealed a possible right-sided abdominal cyst compressing the right diaphragm with hydramnion. MRI at 30 weeks' gestation showed the same findings described above. Passage of a nasogastric tube was unsuccessful after birth. Chest-abdominal x-rays revealed opacification of the right partial hemithorax and large gastric duodenal bubbles with no distal bowel gas. On day 0 of life, duodenoduodenostomy, gastrostomy, and duodenostomy were performed for esophageal atresia and duodenal atresia. In the laparotomy, there was an extremely dilated second portion of the duodenum with distal membranous atresia, and oral side stenosis. On day 24 of age, the esophageal atresia was repaired and hypoplastic lung and elevated right diaphragm were identified. Postoperative bronchofiberscopy showed aplasia of the right middle-lower bronchus. The combined anomalies of pulmonary hypoplasia with esophageal atresia and duodenal atresia are extremely rare. Only 4 cases have been reported in the English literature.
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  • Tatsuya Tazaki, Toru Ichikawa, Hiroaki Yamaoka, Tetsuya Kanehiro, Hiro ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1130-1135
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    A 4-month-old boy was admitted to our hospital because of a high fever and was diagnosed with a urinary tract infection. Ultrasound and contrastenhanced computed tomography showed bilateral hydronephrosis. A voiding cystourethrogram showed bilateral vesicoureteral reflux, but the right renal pelvis was not detected. Although antibiotics were administered, a high white blood cell count and C-reactive protein level persisted. After a right percutaneous nephrostomy was constructed, the urinary tract infection was improved immediately; an antegrade pyelography showed right proximal ureteral stricture. Above all, a surgery for right proximal ureteral stricture was planned. Intraoperative findings indicated a retrocaval ureter, and a dismembered pyeloplasty was performed. However, urinary tract infection recurred one month later, so we also performed surgery for bilateral vesicoureteral reflux. After the second surgery, urinary tract infection did not recur. The incidence of symptomatic retrocaval ureter in children is low because hydronephrosis progresses very slowly. Our patient was suffering from a urinary tract infection because he also had bilateral vesicoureteral reflux that enabled the diagnosis of retrocaval ureter, which is very rare in infants.
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  • Kyoko Mochizuki, Youkatsu Ohhama, Masato Shinkai, Hiroshi Take, Norihi ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1136-1140
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    We examined the therapeutic strategy for two cases of hematometra with anorectal malformations. Case 1: The diagnosis of this patient was anovestibular fistula, double vagina, and double uterus. The patient underwent uterovaginal fenestration by a laparotomy for hematometra due to uterocervical atresia. The fenestration closed spontaneously, and the patient received abdomino-perineal fenestration of the vagina with stent placement. Since the removal of the stent at 7 months after surgery, menstrual blood excretion disorder has not occurred. Case 2: The diagnosis was a persistent cloaca, deficiency of the colon, and double uterus. The patient received double uterovaginal anastomosis with stent placement by a laparotomy for hematometra, hemosalpinx, and uterocervical atresia. After removal of the stent, the hematometra and hemasalpinx on both sides became aggravated. The patient underwent abdomino-perineal fenestration of the right side vagina with stent placement and a left hysterectomy. Since the removal of the stent at 29 months after surgery, menstrual blood excretion disorder has not occurred. Immediate treatment is required for patients with hematometra due to abdominal pain and intrauterine infection. Although stent placement assists in postoperative stenosis of uterovaginal anastomosis or fenestration, there are some problems, including discomfort during stent placement or accidental stent removal. Physicians should therefore carefully determine both the type of stent required and the term of stent placement.
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  • Kenji Okumura, Yoshitaka Goto, Masaaki Yanai, Yasushi Ueno, Huminori Y ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1141-1146
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    A rare case of a 4-year-old boy with intussusception induced by myoepithelial hamartoma of the ileum was presented. The lesion was finally diagnosed by ultrasonogoraphy at 4 years old after he had had repeated episodes of intussusception since 9 months old. In the elective laparotomy, manual reduction of the ileo-ileal intussusception revealed a lesion 40cm proximal from the ileo-cecal valve. A segment of ileum including the lesion was resected. The leading point was a wide-based polypoid lesion, 15mm in diameter. The pathological diagnosis was myoepithelial hamartoma.
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  • Junko Fujino, Kazunori Tahara, Yuki Ishimaru, Makoto Suzuki, Masahiro ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1147-1150
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    A 4-year-old boy was admitted to our hospital due to abdominal distension, vomiting and dehydration. He was intensively treated due to hemolytic uremic syndrome (HUS) caused by enterohemorrhagic, verotoxin-producing Escherichia coli (VTEC) O157 one year ago. A laparotomy was performed with a preoperative diagnosis of a stricture of the transverse colon. A partial resection of the transverse colon including the markedly strictured region and an end-to-end anastomosis was performed. Histopathologically, there were transmural fibrosis and disappearance of the muscularis propria, which was compatible with the previous ischemic changes due to VTEC O157 infection. The patient's postoperative course was uneventful. The presented case again reminded us that a colonic stricture, although rare, does occur in patients with VTEC O157 infection developing HUS.
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  • Masayuki Obatake, Takayuki Tokunaga, Takuya Yoshida, Kyoko Mochizuki, ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1151-1155
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    We report a case where anal plugs (APs) were used for FI management. A 10-year-old boy with rectourethral fistula underwent sigmoid colostomy on the first day of his life. At 9 months of age, he underwent sacroperineal anoplasty. The sigmoid colostomy was closed one month later, and a few days later fecal discharge via the urethra was observed. Contrast enema revealed recurrence of the RUF. Reoperations for the RUF were performed at the ages of 3 and 5 years, but were unsuccessful. At 7 years and 5 months of age, he was referred to our institute because of refractory RUF with repeated urinary tract infections. He underwent an endorectal pull-through operation using a combined abdominal and posterior sagittal approach. The RUF was completely closed, but he suffered from intractable FI. We planned to create a stoma or administer a Malone antegrade continence enema, but the patient and his mother refused to undergo another surgery. We started to use the Conveen AP to minimize discomfort and odors caused by incontinence. The first time he used an AP, he pulled it out halfway through because of anal discomfort. He gradually adapted to the anal discomfort, could keep the AP in for a whole day, and managed to successfully control his incontinence. However, the APs are not a general or permanent treatment for intractable FI in children with anal malformation. APs enable patients to be relieved of anxiety associated with FI.
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  • Suguru Fukahori, Hironaga Yoshimoto, Ryuta Takase, Naoko Mizoguchi, Sh ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1156-1159
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    A 729g boy was born at 25 weeks and 4 days' gestation by emergency caesarean section because of fetal distress. This infant showed a failure to pass meconium. On day 4, the infant presented with a sudden gross distention of the abdomen. Abdominal X-ray examination showed a massive pneumoperitoneum. An emergency operation was performed in accordance with a preoperative diagnosis of gastrointestinal perforation. At laparotomy, a perforation point was identified on the anterior surface of the lesser curvature of the stomach and ileo-ileal intussusception was found incidentally. After gastrorrhaphy, the intussusception lesion was resected and a primary anastomosis was completed. The postoperative course was complicated with an ileal anastomotic leakage, which resolved after reoperation. Thereafter he recovered uneventfully and was discharged in the seventh month of life. In the present case, it might be indicated that several interesting factors associated with ischemic change and increased intragastric pressure caused by the uncoordination of the gastroesophageal motility and mechanical ventilation induced the perforation of the gastric wall.
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  • Hideki Nagae, Naoto Urushihara, Takanori Matsuoka, Koji Fukumoto, Hiro ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1160-1163
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    Traumatic complete transection of the pancreatic duct is rare in children. We report a case of traumatic transection of the pancreatic duct. A 7-year-old girl with pancreatic injury was transferred to our hospital. Computed tomography demonstrated a complete transection of the pancreas. However, she complained of abdominal pain without muscle guarding and her general condition was stable. Therefore, conservative treatment was selected. Fourteen days after the injury, she underwent external drainage of a pancreatic pseudocyst. Leaking of pancreatic juice continued, and ERCP showed complete transection of the main pancreatic duct and leak. Subsequently, a Roux-en-Y distal pancreatojejunostomy (Letton-Wilson procedure) was performed 72 days after the injury. She is doing well, and pancreatic function has been well preserved 17 months after the operation.
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  • Yukihiro Sanada, Koichi Mizuta, Taizen Urahashi, Satoshi Egami, Minoru ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1164-1170
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    In patients who become jaundice-free following a Kasai portoenterostomy (KP) for biliary atresia (BA), the present issue remains the optimal timing for liver transplantation (LT). In the present case, we reported the timing of LT for BA patients with portal hypertension. The patient was a 14-year-old female patient with BA. The patient became jaundice-free following KP, but suffered from progressive portal hypertension. Although the patient underwent endoscopic variceal ligation and partial spleen embolization for portal hypertension, semi-emergent living donor liver transplantation was performed because she suffered from uncontrollable gastrointestinal bleeding from the Roux-Y jejunum. There is a possibility that symptomatic treatment can lead to the development of other collateral veins, because portal hypertension after KP is either progressive or maintainable unless liver cirrhosis can be improved. Even if the patients with BA become jaundice-free following KP, the evaluation of esophageal and gastrointestinal varices should be performed, and LT should be prepared for the patients who suffer from portal hypertension because of uncontrollable gastrointestinal bleeding.
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  • Yukihiro Sanada, Koichi Mizuta, Koshi Matsumoto, Taizen Urahashi, Sato ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1171-1177
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    In infant patients with a low body weight who develop liver failure following a Kasai portoenterostomy for biliary atresia (BA), a sufficient increase in body weight is desirable prior to undergoing liver transplantation (LT) because of a high risk of postoperative complications. In the present case, we report the successful semi-emergent living donor liver transplantation for BA in an infant patient with acute liver failure. The patient was an 11-month-old female patient with BA. Her body weight was 5.2kg. The patient suffered from acute liver failure and progressive portal hypertension due to uncontrollable infection during the waiting period for LT. Thereafter, intubation and artificial ventilation was performed because of the onset of respiratory failure due to abdominal distension with hepatomegaly and splenomegaly. Therefore, a semi-emergent living donor liver transplantation was performed because an increase in body weight was not desirable. It is important for infant BA patients with a low body weight to be assessed for multiple biliary cyst, uncontrollable infection, hypercytokinemia and progressive splenomegaly. If their conditions are fulfilled, we should consider that as a clear indication for the need to perform semi-emergent LT because of a high risk of perioperative complications.
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  • Kyoko Mochizuki, Masayuki Oobatake, Taiichiro Kosaka, Takayuki Tokunag ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1178-1182
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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    A baby girl born at 37 weeks weighing 1,826g had Gross A long-gap esophageal atresia (3 vertebrae gap). At 33 weeks, the prenatal sonogram detected the presence of polyhydramnios together with an absent fetal stomach bubble. The MRI showed a dilatation of the blind-ending esophagus. A chest and abdominal x-ray showed the orogastric tube coiled in the upper esophagus and a gasless bowel. Gastrostomy and gradual stretching with pressure bougienage (Howard technique) were carried out. On day 31, lower esophageal end was perforated through pressure bougienage, therefore external traction (modified Foker technique) was applied. Daily traction on both esophageal ends was started on day 4 postoperatively. On day 49 an esophageal anastomosis was achieved with minimal tension. Six months later she is doing well tolerating full oral feedings and gaining weight. External traction using modified Foker technique induced elongation in the esophageal segments within days and allowed a primary repair of the long-gap.
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    Article type: Article
    2010 Volume 46 Issue 7 Pages 1183-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1183-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1183-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1183-1184
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese]
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1184-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1184-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1184-1185
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese]
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1185-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1185-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1185-1186
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • [in Japanese], [in Japanese], [in Japanese]
    Article type: Article
    2010 Volume 46 Issue 7 Pages 1186-
    Published: December 20, 2010
    Released on J-STAGE: January 01, 2017
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  • Article type: Index
    2010 Volume 46 Issue 7 Pages 1187-1190
    Published: December 20, 2010
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  • Article type: Index
    2010 Volume 46 Issue 7 Pages 1191-1193
    Published: December 20, 2010
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  • Article type: Index
    2010 Volume 46 Issue 7 Pages 1194-1199
    Published: December 20, 2010
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  • Article type: Index
    2010 Volume 46 Issue 7 Pages 1199-
    Published: December 20, 2010
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App6-
    Published: December 20, 2010
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App7-
    Published: December 20, 2010
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App8-
    Published: December 20, 2010
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App9-
    Published: December 20, 2010
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App10-
    Published: December 20, 2010
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  • Article type: Appendix
    2010 Volume 46 Issue 7 Pages App11-
    Published: December 20, 2010
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  • Article type: Cover
    2010 Volume 46 Issue 7 Pages Cover3-
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