Complications of coin ingestion in children, although rare, include esophageal perforation, tracheoesophageal fistula, esophago-aortic fistula, and death. Th e authors describe thoracoscopic removal of a mediastinal c...Complications of coin ingestion in children, although rare, include esophageal perforation, tracheoesophageal fistula, esophago-aortic fistula, and death. Th e authors describe thoracoscopic removal of a mediastinal coin that migrated ext raluminally from the esophagus in a 23-month-old girl. Right-sided thoracoscopic exploration using a 3-trocar technique in a modifi ed prone position was used. Coin location was assisted by manipulation of a tran sorally placed Foley catheter and intraoperative fluoroscopy. The coin was retri eved successfully with no intraoperative or postoperative complications and mini mal postoperative pain. This is the first report of successful thoracoscopic rem oval of a mediastinal coin. Thoracoscopy may be a valuable approach for mediasti nal foreign body removal in children.展开更多
Purpose This study reviews the epidemiology of pediatric firearm deaths in Nor th Carolina and estimates the time from the retail sale of guns to their involve ment in pediatric firearm deaths. Methods The authors rev...Purpose This study reviews the epidemiology of pediatric firearm deaths in Nor th Carolina and estimates the time from the retail sale of guns to their involve ment in pediatric firearm deaths. Methods The authors reviewed autopsy reports f or all children 0 to 14 years of age that died of firearm-related injuries in N orth Carolina from January 1999 through December 2002.Data obtained included de mographic information, firearm type, and manner of death. Data from the Bureau o f Alcohol, Tobacco and Firearms, which traced guns involved in crimes and determ ined the time elapsed from purchase to their involve ment in a crime (ie, time-to-crime were also reviewed). Results During the s tudy period, 40 children died of firearm injuries. Mean age was 7.6 years. Hand guns were responsible for the majority of deaths (59%) followed by shotguns (27 %), rifles (10%), and undetermined cause (10%). Most deaths were homicides (6 7%) followed by unintentional death (18%), suicide (13%), and undetermined ca use (2%). Most crime guns (76%) were purchased legally, and many (40%) had a time-to-crime of less than 3 years. Conclusions Legally purchased firearms pos e a significant threat to children in North Carolina. A more restrictive approac h to the sale of handguns is a logical approach to reducing pediatric firearm-r elated deaths in the United States.展开更多
文摘Complications of coin ingestion in children, although rare, include esophageal perforation, tracheoesophageal fistula, esophago-aortic fistula, and death. Th e authors describe thoracoscopic removal of a mediastinal coin that migrated ext raluminally from the esophagus in a 23-month-old girl. Right-sided thoracoscopic exploration using a 3-trocar technique in a modifi ed prone position was used. Coin location was assisted by manipulation of a tran sorally placed Foley catheter and intraoperative fluoroscopy. The coin was retri eved successfully with no intraoperative or postoperative complications and mini mal postoperative pain. This is the first report of successful thoracoscopic rem oval of a mediastinal coin. Thoracoscopy may be a valuable approach for mediasti nal foreign body removal in children.
文摘Purpose This study reviews the epidemiology of pediatric firearm deaths in Nor th Carolina and estimates the time from the retail sale of guns to their involve ment in pediatric firearm deaths. Methods The authors reviewed autopsy reports f or all children 0 to 14 years of age that died of firearm-related injuries in N orth Carolina from January 1999 through December 2002.Data obtained included de mographic information, firearm type, and manner of death. Data from the Bureau o f Alcohol, Tobacco and Firearms, which traced guns involved in crimes and determ ined the time elapsed from purchase to their involve ment in a crime (ie, time-to-crime were also reviewed). Results During the s tudy period, 40 children died of firearm injuries. Mean age was 7.6 years. Hand guns were responsible for the majority of deaths (59%) followed by shotguns (27 %), rifles (10%), and undetermined cause (10%). Most deaths were homicides (6 7%) followed by unintentional death (18%), suicide (13%), and undetermined ca use (2%). Most crime guns (76%) were purchased legally, and many (40%) had a time-to-crime of less than 3 years. Conclusions Legally purchased firearms pos e a significant threat to children in North Carolina. A more restrictive approac h to the sale of handguns is a logical approach to reducing pediatric firearm-r elated deaths in the United States.
