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Article ; Online: Subtotal pyloric obstruction by atypical hypertrophic pyloric muscle in a newborn.

Brown, Christopher James / Bonasso, Patrick C / Seifarth, Federico G

BMJ case reports

2023 Volume 16, Issue 10

Abstract: This is a case of a neonate with suspected duodenal atresia on prenatal imaging. However, distal bowel gas was identified postnatally on regular X-rays with a possible pyloric obstructing mass visualised on ultasound. No contrast was visualised passing ... ...

Abstract	This is a case of a neonate with suspected duodenal atresia on prenatal imaging. However, distal bowel gas was identified postnatally on regular X-rays with a possible pyloric obstructing mass visualised on ultasound. No contrast was visualised passing through the stomach on fluoroscopic studies. Operative evaluation revealed an atypical asymmetric hypertrophic pylorus with exophytic lesions of ectopic glandular tissue. Longitudinal open pyloromyotomy was performed which relieved the gastric obstruction resulting in symptomatic relief without any anatomy altering procedure required.
MeSH term(s)	Infant, Newborn ; Female ; Pregnancy ; Humans ; Pylorus/diagnostic imaging ; Pylorus/surgery ; Pylorus/abnormalities ; Pyloric Stenosis, Hypertrophic/diagnostic imaging ; Pyloric Stenosis, Hypertrophic/surgery ; Pyloromyotomy ; Stomach Diseases/surgery ; Muscles
Language	English
Publishing date	2023-10-24
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2023-256002
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Article ; Online: Fatal Hyperammonemic Encephalopathy in a Pediatric Patient After Roux-en-Y Gastric Bypass.

Bonasso, Patrick C / Dassinger, Melvin S

Obesity surgery

2018 Volume 28, Issue 8, Page(s) 2530–2532

Language	English
Publishing date	2018-06-14
Publishing country	United States
Document type	Letter
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-018-3305-x
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Article ; Online: The PEET procedure: Punch Excision of Epithelialized Tracts for gastrocutaneous fistula closure.

Mullens, Cody Lendon / Twist, Joanna / Bonasso, Patrick C / Parrish, Dan W

Journal of pediatric surgery

2021 Volume 56, Issue 10, Page(s) 1900–1903

Abstract: Background: Persistent Gastrocutaneous Fistula (GCF) is common problem encountered in the pediatric population. Several management options for intervening on pediatric persistent GCF have been described and range from open surgical management to medical ...

Abstract	Background: Persistent Gastrocutaneous Fistula (GCF) is common problem encountered in the pediatric population. Several management options for intervening on pediatric persistent GCF have been described and range from open surgical management to medical management. Here we describe a novel adaptation on a previously described technique that utilizes a punch biopsy to excise the GCF we have coined as Punch Excision of Epithelialized Tracts (PEET). Methods: The steps to this procedure include passing a punch biopsy tool over a Foley catheter. The catheter is inserted into the GCF tract, the balloon is inflated, the catheter is retracted against the abdominal wall, and the punch biopsy instrument is pushed through the skin and subcutaneous tissue circumferentially excising the tract. Results: Four patients at our institution have undergone GCF excision using the PEET approach. Mean duration of the GCF in our four patients was 9 months. Mean follow-up after GCF excision using the PEET approach was 7.8 months. No patients in the cohort had any post-operative complications including surgical site wound infection, emergency department visits, or re-hospitalizations related to their surgical care. Conclusion: Based on our preliminary findings in this small patient cohort, we believe the PEET approach for managing persistent pediatric GCF has short-term efficacy and has the potential upside of utilizing fewer hospital resources to perform the procedure in a time-efficient manner.
MeSH term(s)	Child ; Cutaneous Fistula/etiology ; Cutaneous Fistula/surgery ; Device Removal ; Gastric Fistula/etiology ; Gastric Fistula/surgery ; Gastrostomy ; Humans
Language	English
Publishing date	2021-06-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2021.06.002
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Article: Percutaneous access of the superior vena cava in patients with bilateral jugular-subclavian vein occlusion using wire-target access for placement of tunneled hemodialysis catheters: An important new tool for gaining upper body vascular access.

Bonasso, Patrick C / Budi, Stevan / Jones, Brendan / Pillai, Lakshmikumar

Journal of vascular surgery cases and innovative techniques

2020 Volume 6, Issue 1, Page(s) 156–159

Abstract: This study presents the technique of percutaneous wire-target access of the superior vena cava (SVC) in patients with bilateral jugular-subclavian vein occlusion requiring a tunneled hemodialysis catheter. A 3-year retrospective review of five patients ... ...

Abstract	This study presents the technique of percutaneous wire-target access of the superior vena cava (SVC) in patients with bilateral jugular-subclavian vein occlusion requiring a tunneled hemodialysis catheter. A 3-year retrospective review of five patients was performed. The femoral vein is accessed percutaneously and a 5F sheath inserted. This is followed by placement of a pigtail catheter (wire-target) in the SVC with cavography. The SVC is percutaneously cannulated at the level of the pigtail under fluoroscopy, and a guidewire is passed into the vena cava with confirmation by injection of contrast material. A tunneled hemodialysis catheter is then placed. The wire-target technique of SVC access can be used safely and effectively to establish upper body catheter access when traditional techniques are not possible.
Language	English
Publishing date	2020-03-03
Publishing country	United States
Document type	Journal Article
ISSN	2468-4287
ISSN	2468-4287
DOI	10.1016/j.jvscit.2020.01.010
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Article ; Online: The History of Multimodal Treatment of Wilms' Tumor.

Nakayama, Don K / Bonasso, Patrick C

The American surgeon

2016 Volume 82, Issue 6, Page(s) 487–492

Abstract: Multimodal therapy-surgery, radiation therapy, and chemotherapy-the foundation of modern cancer treatment, has led to dramatic improvements in survival. How the three disciplines coalesced to conquer Wilms' tumor is a compelling story that includes two ... ...

Abstract	Multimodal therapy-surgery, radiation therapy, and chemotherapy-the foundation of modern cancer treatment, has led to dramatic improvements in survival. How the three disciplines coalesced to conquer Wilms' tumor is a compelling story that includes two of history's greatest discoveries, X-rays and antibiotics. By the mid-20th century both fields had matured to where dedicated clinicians and creative scientists could apply them to Wilms' tumor and achieve successive improvements in survival. William Ladd was able to achieve a zero operative mortality by 1940, but was left with a 32 per cent survival with surgery alone. Robert Gross and Edwin Neuhauser combined surgery and radiotherapy and achieve 47 per cent survival rate in 1950. Sidney Farber and his colleagues added an antibiotic, dactinomycin, to the treatment regimen and reached 80 per cent survival rate in 1966. The National Wilms' Tumor Study, organized in 1968, was a multidisciplinary effort of surgeons, radiotherapists, and pediatric oncologists across the country. By the 1990s, the National Wilms' Tumor Study achieved survival rates above 95 per cent while minimizing long-term effects through shortening courses of chemotherapy and radiation. The story of Wilms' tumor serves as a paragon for all types of cancer, in both children and adults.
MeSH term(s)	Combined Modality Therapy/history ; History, 19th Century ; History, 20th Century ; Humans ; Kidney Neoplasms/history ; Kidney Neoplasms/mortality ; Kidney Neoplasms/therapy ; Wilms Tumor/history ; Wilms Tumor/mortality ; Wilms Tumor/therapy
Language	English
Publishing date	2016-06
Publishing country	United States
Document type	Historical Article ; Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
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Article ; Online: Gallbladder varices in a pediatric patient after roux-en-Y gastric bypass.

Mehl, Steven C / Bonasso, Patrick C / Dassinger, Melvin S

Journal of pediatric surgery

2018 Volume 53, Issue 12, Page(s) 2511–2513

Abstract: This is a case with associated radiologic images for a pediatric patient who developed portomesenteric and splenic vein thrombosis (PMSVT) after Roux-en-Y gastric bypass with subsequent development of portal cavernoma and gallbladder varices (GBV). This ... ...

Abstract	This is a case with associated radiologic images for a pediatric patient who developed portomesenteric and splenic vein thrombosis (PMSVT) after Roux-en-Y gastric bypass with subsequent development of portal cavernoma and gallbladder varices (GBV). This case highlights both the importance of post-operative prophylactic anti-coagulation after gastric bypass and detailed imaging following a diagnosis of PMSVT. This case is relevant for pediatric surgeons as they are performing this operation more frequently with the increase in pediatric obesity.
MeSH term(s)	Adolescent ; Anticoagulants/therapeutic use ; Female ; Gallbladder/blood supply ; Gallbladder/surgery ; Gastric Bypass/adverse effects ; Humans ; Magnetic Resonance Imaging ; Phlebography ; Portal System/diagnostic imaging ; Portal System/pathology ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/etiology ; Ultrasonography ; Varicose Veins/diagnostic imaging ; Varicose Veins/etiology ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/etiology
Chemical Substances	Anticoagulants
Language	English
Publishing date	2018-08-25
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2018.08.005
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Article ; Online: An Evaluation of Pediatric Gastrocutaneous Fistula Closure Through the Punch Excision of Epithelized Tract Procedure.

Stephenson, Krista J / Bonasso, Patrick C / Vasquez, Isabel L / Burford, Jeffrey M / Wyrick, Deidre L / Bhavaraju, Avi / Dassinger, Melvin S

The American surgeon

2022 Volume 88, Issue 8, Page(s) 1822–1826

Abstract: Background: Persistent gastrocutaneous fistulae frequently complicate gastrostomy tube placement. A minimally invasive technique for tract closure employing balloon catheter retraction and punch excision of the epithelized tract (PEET) was recently ... ...

Abstract	Background: Persistent gastrocutaneous fistulae frequently complicate gastrostomy tube placement. A minimally invasive technique for tract closure employing balloon catheter retraction and punch excision of the epithelized tract (PEET) was recently reported. We hypothesized the PEET technique of closure would lead to decreased complications without an increased incidence of recurrence. Methods: We conducted a single-center retrospective cohort study evaluating children who underwent gastrocutaneous fistula (GCF) closure 1/1/2018-12/31/2021, comparing patients who underwent the PEET procedure to those repaired with layered closure. Procedure duration and outcomes were additionally compared to the 2018-2019 National Surgical Quality Improvement Program (NSQIP) Participant Use File (PUF) database. Results: Sixty-two children underwent operative GCF closure, including 25 with PEET and 37 traditional layered closure. Procedural time was significantly decreased employing PEET (14 vs 26 minutes, P < .0001), less than half the national median by the NSQIP PUF database of 292 GCF closures (14 vs 34.5 minutes, P < .0001). Those repaired with the PEET method experienced no episodes of recurrence, surgical site infection, readmission, reoperation, or mortality within 30 days of the procedure. Conversely, in traditional closure, there was a 24.3% complication rate, including 7 surgical site infections, 1 readmission, and 2 unplanned reoperations. National procedural complication rate by NSQIP PUF was 5.5%, with a 4.8% rate of surgical site infection, .3% reoperation incidence, and .3% mortality. Discussion: Our study suggests GCF closure employing the PEET procedure is a safe, more efficient method of tract closure than the traditional layered closure technique.
MeSH term(s)	Child ; Cutaneous Fistula/etiology ; Cutaneous Fistula/surgery ; Gastric Fistula/etiology ; Gastric Fistula/surgery ; Gastrostomy/methods ; Humans ; Postoperative Complications/etiology ; Retrospective Studies ; Surgical Wound Infection
Language	English
Publishing date	2022-04-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348221084945
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Article ; Online: Blue Rubber Bleb Nevus Syndrome: A Rare Case of Gastrointestinal Hemorrhage Necessitating Bowel Resection.

Shewmake, Connor N / Stephenson, Krista J / Bonasso, Patrick C / Odiase, Elaine / Richter, Gresham T / Bhavaraju, Avi V / Dassinger, Melvin S

The American surgeon

2022 Volume 89, Issue 6, Page(s) 2934–2936

Abstract: Blue Rubber Bleb Nevus Syndrome is a congenital rarity that manifests as vascular malformations throughout the body, including the gastrointestinal tract. With fewer than 300 cases reported, the etiology and clinical course is poorly understood; however, ...

Abstract	Blue Rubber Bleb Nevus Syndrome is a congenital rarity that manifests as vascular malformations throughout the body, including the gastrointestinal tract. With fewer than 300 cases reported, the etiology and clinical course is poorly understood; however, the literature suggests
MeSH term(s)	Female ; Humans ; Nevus, Blue/complications ; Nevus, Blue/diagnosis ; Nevus, Blue/genetics ; Gastrointestinal Neoplasms/complications ; Gastrointestinal Neoplasms/surgery ; Skin Neoplasms/complications ; Skin Neoplasms/surgery ; Vascular Malformations/complications ; Vascular Malformations/diagnosis ; Vascular Malformations/surgery ; Gastrointestinal Hemorrhage/surgery ; Gastrointestinal Hemorrhage/complications
Language	English
Publishing date	2022-04-17
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348221084949
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Article ; Online: The Sepsis Bundle Effect: An Evaluation of Culture Results and Utilization in Pediatric Appendicitis.

Stephenson, Krista J / Shewmake, Connor N / Spray, Beverly J / Burford, Jeffrey M / Bonasso, Patrick C / Dassinger, Melvin S

The American surgeon

2022 Volume 89, Issue 11, Page(s) 4310–4315

Abstract: Introduction: Sepsis prevention pathways, which often include blood and urine cultures, are common in children's hospitals. Fever and tachycardia, signs often seen in patients with appendicitis, frequently trigger these pathways. We hypothesized that ... ...

Abstract	Introduction: Sepsis prevention pathways, which often include blood and urine cultures, are common in children's hospitals. Fever and tachycardia, signs often seen in patients with appendicitis, frequently trigger these pathways. We hypothesized that cultures were frequently obtained in children with appendicitis. Materials and methods: We conducted a single-center retrospective cohort study evaluating children with image-confirmed appendicitis from 4/1/2019 to 10/1/2020, coinciding with the initiation of sepsis prevention pathways. Factors associated with culture acquisition, as well as culture results, treatment, and outcomes were evaluated. Results: Six hundred and fifty eight children presented with acute appendicitis during the 1.5-year period, with a median age of 10.67 years (interquartile range (IQR) 8.17-14.08). Cultures were obtained in 22.9%, including blood culture (BCx) in 8.1% and urine culture (UCx) in 17.9%. Culture acquisition decreased by 17.6% after sepsis protocol initiation. Blood culture acquisition correlated with fever ( Discussion: The findings of this cohort suggest a low incidence of positive culture as well as lack of impact on clinical management in image-proven appendicitis and the initiation of a sepsis bundle without automatic culture acquisition may result in decreased culture attainment.
MeSH term(s)	Humans ; Child ; Female ; Appendicitis/complications ; Appendicitis/diagnosis ; Appendicitis/surgery ; Retrospective Studies ; Appendectomy ; Sepsis/diagnosis ; Sepsis/etiology ; Incidence ; Fever/etiology
Language	English
Publishing date	2022-06-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348221109495
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Article: Re-fracture of Distal Radius and Hardware Repair in the Setting of Trauma.

Lucke-Wold, Brandon P / Bonasso, Patrick C / Jacob, Glen

Medical student research journal

2017 Volume 5, Page(s) 2–7

Abstract: Distal radius fractures are one of the most common fractures in the elderly. Falls and motor vehicle collisions lead to increased risk for this type of fracture. A seventy-three year-old female had a previous history of distal radius fracture with repair ...

Abstract	Distal radius fractures are one of the most common fractures in the elderly. Falls and motor vehicle collisions lead to increased risk for this type of fracture. A seventy-three year-old female had a previous history of distal radius fracture with repair by open reduction and internal fixation. She was involved in a motor vehicle collision that re-fractured the distal radius. The plate was bent and required removal, which is a very rare but potentially serious complication. Surgery was done to fix the open reduction and internal fixation with volar locking plates while removing damaged hardware. Only a select few cases have reported hardware failure as a cause of complications. Among those cases, high-energy activities and maintained stress on the hardware were likely causes. Distal radius fractures are the most common upper extremity fracture in the elderly. We highlight a unique case of re-fracture in the setting of trauma with prior hardware failure and describe the strategy for hardware repair.
Language	English
Publishing date	2017-05-25
Publishing country	United States
Document type	Journal Article
ISSN	2159-3647
ISSN	2159-3647
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