Colorectal Quiz: Episode 46 - Hirschsprung Disease

We’re back with 20th episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field. These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points. Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".Host: Em Gootee0:00 Introduction0:41 Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia: thoracoscopic versus open repair1:35 Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients2:39 Indocyanine green (ICG) fluorescent cholangiography during laparoscopic cholecystectomy using RUBINA™ technology: preliminary experience in two pediatric surgery centers3:47 Outrohttps://pmc.ncbi.nlm.nih.gov/articles/PMC11233350/ Shibuya S, Paraboschi I, Giuliani S, Tsukui T, Matei A, Olivos M, Inoue M, Clarke SA, Yamataka A, Zani A, Eaton S, De Coppi P. Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia: thoracoscopic versus open repair. Pediatr Surg Int. 2024 Jul 9;40(1):182. doi: 10.1007/s00383-024-05760-7. Erratum in: Pediatr Surg Int. 2024 Aug 31;40(1):247. doi: 10.1007/s00383-024-05832-8. PMID: 38980431; PMCID: PMC11233350.https://pubmed.ncbi.nlm.nih.gov/38960901/ Ziegler AM, Svoboda D, Lüken-Darius B, Heydweiller A, Kahl F, Falk SC, Rolle U, Theilen TM. Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients. Pediatr Surg Int. 2024 Jul 3;40(1):172. doi: 10.1007/s00383-024-05745-6. PMID: 38960901; PMCID: PMC11222185. https://pubmed.ncbi.nlm.nih.gov/34231069/ Esposito C, Alberti D, Settimi A, Pecorelli S, Boroni G, Montanaro B, Escolino M. Indocyanine green (ICG) fluorescent cholangiography during laparoscopic cholecystectomy using RUBINA™ technology: preliminary experience in two pediatric surgery centers. Surg Endosc. 2021 Nov;35(11):6366-6373. doi: 10.1007/s00464-021-08596-7. Epub 2021 Jul 6. PMID: 34231069; PMCID: PMC8523512.Don't forget to like and subscribe to see more entertaining medical educational videos!See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and special guest Dr. Julia Grabowski from Lurie Children’s dive deep into the diagnosis and management of anal stenosis in infants. They walk through the case of a 10-month-old presenting with constipation and distention, leading to a discussion on clinical exams, imaging, biopsy pitfalls, and surgical strategies.Key Highlights:Physical Exam Essentials: Why a thorough digital rectal exam is critical and when to use a Hegar dilator vs. relying on feel.Distinguishing Anal Stenosis vs. Hirschsprung Disease: How misdiagnoses occur and why biopsies can be misleading if not done correctly.Surgical Management: Principles of preserving the anterior anal canal to protect continence during posterior sagittal approaches.Megarectosigmoid Management: Why most dilated rectums improve after addressing the obstruction and when a Malone procedure can prevent the need for resection.Special Considerations: The importance of spinal and pelvic MRI to rule out associated presacral masses before surgery.This episode underscores the importance of a meticulous clinical approach, interdisciplinary review, and cautious surgical planning in treating children with suspected anal stenosis.

This year was the 12th Annual Pediatric Surgery Update Course, where top hospital experts from around the world discussed this year’s changes in practices and innovation. Rewatch the event to learn more about the future of pediatric surgery and be at the forefront of medical excellence. In this clip, Drs. Em Gootee, Ramy Shaaban, Carlos Colunga, with Todd Ponsky as moderator, speaks on the top AI tools of 2024.Topics to be discussed:• AI: TOP 10 websites & tools for everyday usage

We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the first quarter of 2025, January, February and March issues. This time we're talking to editors Drs. Romeo Ignacio, Patrick Chung and Mark Davenport joined by authors Drs. Oluyinka Olutoye, Howard Jen, Jordan Rook and Liam McCarthy.Host: Em Gootee, MDArticles:Gadde R, Xia J, Hameedi S, Saulsbery A, Schafer C, Sbragia L, Olutoye OO. Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC) - Validation in a Large Animal Model. J Pediatr Surg. 2025 Jan;60(1):161957. doi: 10.1016/j.jpedsurg.2024.161957. Epub 2024 Sep 24. PMID: 39368858.https://pubmed.ncbi.nlm.nih.gov/39368858/Rook JM, Lee LK, Wagner JP, Sullins VF, Lee SL, Shekherdimian S, DeUgarte DA, Dichter CE, Jen HC. Six Years of Quality Improvement in Pectus Excavatum Repair: Implementation of Intercostal Nerve Cryoablation and ERAS Protocols for Patients Undergoing Nuss Procedure. J Pediatr Surg. 2025 Feb;60(2):161634. doi: 10.1016/j.jpedsurg.2024.07.019. Epub 2024 Jul 20. PMID: 39117536.https://pubmed.ncbi.nlm.nih.gov/39117536/Parkinson E, Robb A, McCarthy L. Long-term Survival of Bladder Augmentation is Influenced by its Shape and Mucosal Lining. J Pediatr Surg. 2025 Mar;60(3):162051. doi: 10.1016/j.jpedsurg.2024.162051. Epub 2024 Nov 1. PMID: 39572279.https://pubmed.ncbi.nlm.nih.gov/39572279/

We’re back with nineteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".Host: Em Gooteehttps://pubmed.ncbi.nlm.nih.gov/38272766/Fall F, Hu YY, Walker S, Baertschiger R, Gaffar I, Saltzman D, Stylianos S, Shapiro J, Wieck M, Buchmiller T, Brandt ML, Tracy T, Heiss K, Berman L. Peer Support to Promote Surgeon Well-being: The APSA Program Experience. J Pediatr Surg. 2024 Sep;59(9):1665-1671. doi: 10.1016/j.jpedsurg.2023.12.022. Epub 2024 Jan 6. PMID: 38272766.https://pubmed.ncbi.nlm.nih.gov/38914091/Basurto D, Watananirun K, Cordier AG, Otaño J, Carriere D, Scuglia M, de Luna Freire Vargas AM, Prat J, Russo FM, Debeer A, Peralta CFA, De Coppi P, Gratacós E, Benachi A, Deprest J. Tracheomalacia and tracheomegaly in infants and children with congenital diaphragmatic hernia managed with and without fetoscopic endoluminal tracheal occlusion (FETO): a multicentre, retrospective cohort study. Lancet Child Adolesc Health. 2024 Aug;8(8):580-588. doi: 10.1016/S2352-4642(24)00109-3. Epub 2024 Jun 21. PMID: 38914091.https://pubmed.ncbi.nlm.nih.gov/38015091/Pio L, Brisse HJ, Alaggio R, Zambaiti E, Stenman J, Giuliani S, Montano V, Hinojosa AS, Hoel AT, Pevere A, Abu-Zaid A, Franchi-Abella S, Abdelhafeez AH, Davidoff AM, Losty PD. Image-guided core-needle or surgical biopsy for neuroblastoma diagnosis in children: A systematic review and meta-analysis from the International Society of Pediatric Surgical Oncology (IPSO). Pediatr Blood Cancer. 2024 Feb;71(2):e30789. doi: 10.1002/pbc.30789. Epub 2023 Nov 27. PMID: 38015091.

In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and special guests Dr. Chris Gayer and Dr. Sarah Ulrich tackle the complexities of managing megarectosigmoid in a 13-year-old patient with a history of cloaca. They explore the intricacies of diagnosis, anatomy, and long-term management for a child struggling with soiling despite a well-positioned rectum and no anatomical stricture.Key Highlights:Case Discussion: A deep dive into a patient with severe rectal dilation despite a perineal repair and normal bladder function.Diagnostic Strategy: The role of MRI, EUA, contrast enema, and sacral assessment to understand anatomy and guide treatment.Treatment Options: From Malone procedures to tapering and resection—what’s the right next step?Surgical Pearls: When to preserve the rectum and when to consider redoing the entire repair.This episode is packed with expert commentary, clinical pearls, and plenty of humor (including a colorectal-themed joke from a young patient).

In this 2024 Update Course Rewind session, pediatric surgeons Dr. Justin Huntington and Dr. Ben Ham explore the emerging use of autofluorescence and ICG angiography during thyroid surgery. These imaging technologies are helping identify and assess parathyroid gland perfusion, with the goal of reducing hypocalcemia and improving long-term outcomes—especially in pediatric patients.Classified as a Black Diamond (early adopter practice), this approach is still gaining traction in pediatric centers, but adult trials are already showing promise.Key Highlights:What is Autofluorescence? A no-injection technique that uses natural gland fluorescence to locate parathyroids during surgery.ICG Angiography: Assessing real-time perfusion of glands to determine viability and reimplantation need.Clinical Impact: Reduced rates of post-op hypocalcemia, improved identification of glands in surgical specimens, and more targeted decision-making.Challenges in Practice: Equipment bulkiness, variable image quality, and limited adoption in lower-volume pediatric centers.While further pediatric data are needed, this episode shows how new technologies may shape the future of thyroid surgery—especially in safeguarding parathyroid function.

In this 2024 Update Course Rewind, pediatric surgeons Drs. Regan Williams and Katie Russell share new updates on the management of thoracic aortic injuries. Classified as a “Black Diamond” practice—indicating unproven approaches for early adopters—this session reviews how Thoracic Endovascular Aortic Repair (TEVAR) is emerging as a less invasive and effective treatment option in pediatric patients, especially adolescents.Host: Lizzy Lee, PA-CKey Takeaways:Prioritize stabilization and life-threatening injuries before addressing thoracic aortic injury.Thoracic aortic injuries in children are rare and can be easily missed—maintain a high index of suspicion.A widened mediastinum on chest X-ray should prompt a CT chest to evaluate for vascular injury.Decisions should be guided by patient age, injury severity, and available expertise at your institution.Collaboration with vascular surgeons or interventional radiologists is essential for optimal care.

In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, Kristy Rialon, and Lily Cheng explore the diagnostic and surgical challenges of Hirschsprung disease, featuring a neonatal patient with Trisomy 21. Through a step-by-step case discussion, they highlight how early recognition, biopsy strategy, and patient-specific surgical planning can dramatically improve outcomes.Key Highlights:Patient Case Study: A newborn with Trisomy 21, bilious emesis, and delayed meconium passage sparks a thorough workup for Hirschsprung disease.Diagnosis: The team breaks down how rectal irrigations and full-thickness biopsies confirm aganglionosis and rule out other causes.Surgical Strategy: A discussion on when to perform a pull-through, mapping biopsies, and choosing between colostomy and ileostomy.Long-Term Management: Addressing the role of Botox for internal sphincter relaxation and educating families on home care and irrigations.This episode emphasizes the value of thoughtful, team-based decision-making and patient-tailored care in managing Hirschsprung disease. Don’t forget to download the StayCurrentMD app to view supporting visuals and expert resources—and subscribe for more pediatric surgery insights!

In this special episode from the QUAD Conference hosted by Cincinnati Children’s, Lizzy Lee takes us inside one of the world’s largest and most advanced multidisciplinary programs for children with complex airway and digestive conditions: the Aerodigestive and Esophageal Center (ADEC).You'll hear from a diverse team of specialists—including speech-language pathologists, ENTs, GI, pulmonologists, and pediatric surgeons—who collaborate to manage complex conditions like esophageal atresia, TEF, chronic aspiration, GERD, and swallowing disorders.Key Highlights:Speech Pathology: VFSS, FEES, manometry, and innovative approaches to swallowing therapyPulmonology: Airway clearance, aspiration management, bronchoscopy, and ventilator weaningENT Perspective: Stratifying airway risk and managing vocal fold and structural anomaliesGastroenterology: Managing GERD, motility, EOE, and feeding disordersSurgical Insight: Feeding access, tracheopexy, and complex lung or airway repairsThe episode is a masterclass in how cross-specialty teamwork leads to better diagnostics, better surgeries, and better long-term outcomes for children with aerodigestive disorders.