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-C

Key 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 therapy
• Pulmonology: Airway clearance, aspiration management, bronchoscopy, and ventilator weaning
• ENT Perspective: Stratifying airway risk and managing vocal fold and structural anomalies
• Gastroenterology: Managing GERD, motility, EOE, and feeding disorders
• Surgical Insight: Feeding access, tracheopexy, and complex lung or airway repairs

The 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.

Dr. José Campos is back, this time helping us review some of the latest literature on the management of Inguinal Hernia in children. In this podcast, we're reviewing a hernia case with Dr. Todd Ponsky and incorporating literature from the last few years.

Host: Em Gootee

Articles in the order we mentioned if you want to follow along:

https://pubmed.ncbi.nlm.nih.gov/38530261/

HIP Trial Investigators; Blakely ML, Krzyzaniak A, Dassinger MS, Pedroza C, Weitkamp JH, Gosain A, Cotten M, Hintz SR, Rice H, Courtney SE, Lally KP, Ambalavanan N, Bendel CM, Bui KCT, Calkins C, Chandler NM, Dasgupta R, Davis JM, Deans K, DeUgarte DA, Gander J, Jackson CA, Keszler M, Kling K, Fenton SJ, Fisher KA, Hartman T, Huang EY, Islam S, Koch F, Lainwala S, Lesher A, Lopez M, Misra M, Overbey J, Poindexter B, Russell R, Stylianos S, Tamura DY, Yoder BA, Lucas D, Shaul D, Ham PB 3rd, Fitzpatrick C, Calkins K, Garrison A, de la Cruz D, Abdessalam S, Kvasnovsky C, Segura BJ, Shilyansky J, Smith LM, Tyson JE. Effect of Early vs Late Inguinal Hernia Repair on Serious Adverse Event Rates in Preterm Infants: A Randomized Clinical Trial. JAMA. 2024 Mar 26;331(12):1035-1044. doi: 10.1001/jama.2024.2302. PMID: 38530261; PMCID: PMC10966421.

https://pubmed.ncbi.nlm.nih.gov/34856625/

Dreuning KMA, Derikx JPM, Ouali A, Janssen LMJ, Tulder MWV, Twisk JWR, Haverman L, van Heurn LWE. One-Stop Surgery: An Innovation to Limit Hospital Visits in Children. Eur J Pediatr Surg. 2022 Oct;32(5):435-442. doi: 10.1055/s-0041-1740158. Epub 2021 Dec 2. PMID: 34856625; PMCID: PMC9481276.

https://pubmed.ncbi.nlm.nih.gov/36307301/

Fraser JD, Duran YK, Deans KJ, Downard CD, Fallat ME, Gadepalli SK, Hirschl RB, Lal DR, Landman MP, Leys CM, Mak GZ, Markel TA, Minneci PC, Sato TT, St Peter SD; Midwest Pediatric Surgery Consortium. Natural history and consequence of patent processus vaginalis: An interim analysis from a multi-institutional prospective observational study. J Pediatr Surg. 2023 Jan;58(1):142-145. doi: 10.1016/j.jpedsurg.2022.09.012. Epub 2022 Oct 3. PMID: 36307301.

https://pubmed.ncbi.nlm.nih.gov/21259030/

Zendejas B, Onkendi EO, Brahmbhatt RD, Greenlee SM, Lohse CM, Farley DR. Contralateral metachronous inguinal hernias in adults: role for prophylaxis during the TEP repair. Hernia. 2011 Aug;15(4):403-8. doi: 10.1007/s10029-011-0784-2. Epub 2011 Jan 23. PMID: 21259030.

In this Update Course Rewind, Drs. Dan von Allmen, John Racadio, and Timothy Lautz, alongside IR technologist Amanda Wallingford, discuss how strong collaboration between surgery and interventional radiology is transforming patient care at Cincinnati Children’s and beyond. From ultrasound-guided lymph node localization to cone beam CT in a hybrid OR, this session highlights the power of shared expertise and image-guided surgery.

Key Highlights:

• Use of cone beam CT, ultrasound, and fluoroscopy to improve surgical precision
• Hybrid OR vs. traditional OR: benefits and workarounds
• Real-life examples: neuroblastoma surgery, vascular malformations, pulmonary nodule localization
• Preview of emerging tech like augmented reality and holographic overlays for surgical planning

This session is marked as a “Blue Square”—a promising newer practice that’s showing significant results and potential. Watch to learn how breaking down silos between teams can elevate outcomes across specialties.

We’re back with eighteenth 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 Gootee

https://pubmed.ncbi.nlm.nih.gov/39083294/

Pilkington M, Nelson G, Pentz B, Marchand T, Lloyd E, Chiu PPL, de Beer D, de Silva N, Else S, Fecteau A, Giuliani S, Hannam S, Howlett A, Lee KS, Levin D, O'Rourke L, Stephen L, Wilson L, Brindle ME. Enhanced Recovery After Surgery (ERAS) Society Recommendations for Neonatal Perioperative Care. JAMA Surg. 2024 Sep 1;159(9):1071-1078. doi: 10.1001/jamasurg.2024.2044. PMID: 39083294.

https://pubmed.ncbi.nlm.nih.gov/38493027/

Moore EJ, Sawyer SM, King SK, Tien MY, Trajanovska M. Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review. J Pediatr Surg. 2024 Jun;59(6):1028-1036. doi: 10.1016/j.jpedsurg.2024.02.012. Epub 2024 Feb 23. PMID: 38493027.

https://pubmed.ncbi.nlm.nih.gov/36658074/

Zeng G, Zhang Q, Song B, Feng X, Sun J, Mo X, Wu KH. Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation: A Propensity Score Matching Retrospective Cohort Study. J Pediatr Surg. 2023 Oct;58(10):1963-1968. doi: 10.1016/j.jpedsurg.2022.11.013. Epub 2022 Nov 29. PMID: 36658074.

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