%0 Journal Article
%~ PubMed
%A Mitchell, Rebecca J
%A Curtis, Kate
%A Chong, Shanley
%A Holland, Andrew J A
%A Soundappan, S V S
%A Wilson, Kellie L
%A Cass, Daniel T
%T Comparative analysis of trends in paediatric trauma outcomes in New South Wales, Australia.
%B Injury
%D 2013
%C United Kingdom
%I Elsevier Ltd
%V 44
%N 1
%P 97-103
%@ 0020-1383
%X Paediatric trauma centres seek to optimise the care of injured children. Trends in state-wide paediatric care and outcomes have not been examined in detail in Australia. This study examines temporal trends in paediatric trauma outcomes and factors influencing survival and length of stay. A retrospective review was conducted using data from the NSW Trauma Registry during 2003-2008 for children aged 15 years and younger who were severely injured (injury severity score>15). To examine trauma outcomes descriptive statistics and multivariable logistic and linear regression were conducted. There were 1138 children severely injured. Two-thirds were male. Road trauma and falls were the most common injury mechanisms and over one-third of incidents occurred in the home. Forty-eight percent of violence-related injuries were experienced by infants aged less than 1 year. For the majority of children definitive care was provided at a paediatric trauma centre, but less than one-third of children were taken directly to a paediatric trauma centre post-injury. Children who received definitive treatment at a paediatric trauma centre had between 3 and 6 times higher odds of having a survival advantage than if treated at an adult trauma centre. The number of severe injury presentations to the 14 major trauma centres in NSW remains constant. It is possible that injury prevention measures are having a limited effect on severe injury in NSW. This research provides stimulus for change in the provision and co-ordination in the delivery of trauma care for injured children.
%Z FOR Codes: 111403 110323


%0 Journal Article
%~ PubMed
%A Taylor, Nicole D
%A Cass, Daniel T
%A Holland, Andrew Ja
%T Infantile hypertrophic pyloric stenosis: Has anything changed?
%B Journal of Paediatrics and Child Health
%D 2013
%C United Kingdom
%I Wiley-Blackwell Publishing Ltd.
%V 49
%N 1
%P 33-37
%@ 1034-4810
%X 
%Z FOR Codes: 111403


%0 Journal Article
%~ PubMed
%A Sandler, Gideon
%A Soundappan, Soundappan Sv
%A Manglick, Maria P
%A Fahy, Fiona E
%A Ross, Frank
%A Lam, Lawrence
%A Cass, Danny
%T Pediatric "off-road vehicle" trauma: determinants of injury severity and type.
%B Pediatric Emergency Care
%D 2012
%C United States
%I Lippincott Williams & Wilkins
%V 28
%N 12
%P 1328-1333
%@ 1535-1815
%X 
%Z FOR Codes: 111403 110323


%0 Journal Article
%~ PubMed
%A Soundappan, Soundappan S V
%A Holland, Andrew
%A Lam, Lawrence
%A Roy, Gerard
%A Evans, Julie B
%A Adams, Susan
%A Cass, Daniel T
%T Off-Road Vehicle Trauma in Children: A New South Wales Perspective.
%B Pediatric emergency care
%D 2010
%C United States
%I Lippincott Williams & Wilkins
%V 26
%N 12
%P 909-13
%@ 1535-1815
%X There is paucity of data on off-road vehicle injuries in children in Australia. We performed a retrospective study from 1998 to 2003 to analyze the frequency and nature of injuries in children involved in off-road vehicle crashes in the state of New South Wales.
%Z FOR Codes: 110323


%0 Journal Article
%~ PubMed
%A Price, Neil R
%A Soundappan, S V
%A Sparnon, Anthony L
%A Cass, Danny T
%T Swimming pool filter-induced transrectal evisceration in children: Australian experience.
%B The Medical Journal of Australia
%D 2010
%C Australia
%I Australasian Medical Publishing Company Pty. Ltd.
%V 192
%N 9
%P 534-536
%@ 0025-729X
%X 
%Z FOR Codes: 111499


%0 Journal Article
%~ PubMed
%A D'Cruz, Rachel
%A Soundappan, Soundappan S V
%A Cass, Daniel T
%A Smith, Grahame
%T Catheter balloon-related urethral trauma in children.
%B Journal of Paediatrics and Child Health
%D 2009
%C United Kingdom, Australia
%I Wiley-Blackwell Publishing Ltd.
%V 45
%N 10
%P 564-566
%@ 1034-4810
%X AIM: To review urethral injuries arising from incorrect balloon inflation in children undergoing urinary catheterisation. METHOD: Retrospective review from 1995-2006. Children who sustained catheter-related injury at The Children''s Hospital at Westmead were identified through medical records database and reviewed. RESULTS: Six patients were identified over the 11-year period. All six were boys. Age ranged from <1 month to 16 years. All but one occurred in hospital. All injuries were confirmed by urethrogram. Bulbar and prostatic urethra was involved in an equal number of children studied. Three patients required suprapubic catheters. Follow-up imaging revealed healing without stricture in all patients. CONCLUSION: Balloon-related urethral trauma can be avoided by educating health-care professionals on proper placement and confirmation of position of catheter. Though there were no long-term complications noted, a temporary suprapubic diversion may be needed.
%Z FOR Codes: 1114


%0 Journal Article
%~ PubMed
%A Jiwane, Ashish
%A Soundappan, S V S
%A Pitkin, John
%A Cass, Daniel T
%T Successful treatment of recurrent epididymo-orchitis: Laparoscopic excision of the prostatic utricle.
%B Journal of Indian Association of Pediatric Surgeons
%D 2009
%C India
%I Medknow Publications and Media Pvt. Ltd.
%V 14
%N 1
%P 29-30
%@ 1998-3891
%X Prostatic utricle presenting with recurrent epididymo-orchitis is not uncommon. Excision of prostatic utricle is the treatment of choice. The various techniques described in literature suffer from the disadvantages of incomplete excision due to poor view. We report the successful laparoscopic excision of prostatic utricle in childhood.
%Z FOR Codes: 111403 110323


%0 Journal Article
%~ PubMed
%A Sandler, Gideon
%A Soundappan, Soundappan S V
%A Cass, Danny
%T Appendicitis and low-flow priapism in children.
%B Journal of Pediatric Surgery
%D 2008
%C United States
%I WB Saunders Co.
%V 43
%N 11
%P 2091-2095
%@ 0022-3468
%X Priapism is a sustained erection that is maintained for over 4 hours in the absence of sexual stimulation [Postgrad Med J. 2006;82(964):89-94; J Urol. 2003;170:1318-1324]. Distinction is made between low- and high-flow variants [J Urol. 2003;170:1318-1324; Cardiovasc Intervent Radiol. 2002;25(4):326-329]. Low-flow priapism (LFP) and acute appendicitis are rarely associated. Including ours, there are 4 cases reported in the literature, all of which have occurred in children. The complications of LFP are potentially serious and include loss of the phallus altogether. Treatment of LFP is should be prompt and is the same irrespective of the etiology.
%Z FOR Codes: 111403


%0 Journal Article
%A Holland, Andrew
%A Abubacker, M
%A Smith, Grahame
%A Cass, Daniel
%T Beyond the Abstract - Management of Urethrocutaneous Fistula Following Hypospadias Repair
%B UroToday
%D 2008
%C United States
%I UroToday Inc.
%V 18 November
%N 
%P 0
%@ 1939-4810
%X 
%Z FOR Codes: 110312 111403


%0 Journal Article
%~ PubMed
%A Marchant, Jeanette
%A Cheng, Nicholas
%A Lam, Lawrence
%A Fahy, Fiona
%A Sounndapound, S V
%A Cass, Danny
%A Browne, Gary
%T Bystander basic life support: an important link in the chain of survival for children suffering a drowning or near-drowning episode.
%B The Medical Journal of Australia
%D 2008
%C Australia
%I Australasian Medical Publishing Company Pty. Ltd
%V 188
%N 8
%P 484-485
%@ 1326-5377
%X Eight children suffered drowning or near-drowning in Sydney pools over an 11-day period in January 2007. Four received basic life support (BLS) within 5 minutes of immersion and survived with good functional neurological outcomes. The other four were not discovered for >/= 5 minutes and all died. This cluster serves as a reminder that timely effective bystander BLS is crucial to survival and good clinical outcomes in near-drowning episodes.
%Z FOR Codes: 110305


%0 Journal Article
%~ PubMed
%A Holland, A J A
%A Soundappan, S V S
%A Cass, D T
%T Comment on: "Missed injury and the tertiary trauma survey" [Injury 2008; 39:107-114].
%B Injury
%D 2008
%C United Kingdom
%I Elsevier
%V 40
%N 1
%P 110
%@ 1879-0267
%X 
%Z FOR Codes: 111403


%0 Journal Article
%~ PubMed
%A Sandler, Gideon
%A Patrick, Emily
%A Cass, Danny
%T Long standing balanitis xerotica obliterans resulting in renal impairment in a child.
%B Pediatric surgery international
%D 2008
%C British Med Assoc House,Tavistock Square, London, England, Wc1H 9Jr
%I British Med Journal Publ Group
%V 24
%N 8
%P 961-4
%@ 0179-0358
%X Balanitis xerotica obliterans (BXO) is the most common cause of pathological phimosis in boys. Presented here is the case of a previously well 13-year-old boy who developed obstructive renal impairment (serum creatinine = 190 micromol/l) at least in part from phimosis due to BXO. A circumcision and, 2.5 months later, meatal dilatation were done. Nine months after his initial presentation, his serum creatinine returned to a permanently elevated nadir of 119 mumol/l. Presentation with the complications of phimosis can be delayed in teenage boys because they may feel embarrassed to come forward. Circumcision remains the definitive treatment of BXO induced phimosis though if the penile meatus is involved, more complex surgery is sometimes required. Topical steroids are useful for residual disease. Follow-up is very important due to the frequent involvement of the skin of the glans. In the very long term there is an increased chance of penile malignancy, which can occur even after circumcision.
%Z FOR Codes: 111403


%0 Journal Article
%~ PubMed
%A Holland, A
%A Abubacker, M
%A Smith, G
%A Cass, D
%T Management of urethrocutaneous fistula following hypospadias repair.
%B Pediatric surgery international
%D 2008
%C Germany
%I Springer
%V 24
%N 
%P 1047-51
%@ 0179-0358
%X Urethrocutaneous fistulas complicating hypospadias repair appear a common problem. There appears less data in the literature regarding the risk and management of recurrent fistulas. A retrospective review of urethrocutaneous fistulas complicating hypospadias repair was performed to evaluate their aetiology, management and outcome. Between 1993 and 2003, 1,753 patients had a hypospadias repair at our institution. Overall 123 (7%) boys developed a fistula, although detailed information was available on 117 patients only. Median age was 3.5 years at the time of fistula repair; 13% had anterior, 57% had middle and 30% had posterior hypospadias. The most common primary surgical procedure was a Durham Smith two-stage repair in 29% (n = 34), followed by a Tubularised Incised Plate urethroplasty in 19% (n = 22) and an Onlay in 14% (n = 16). Thirty-one (27%) patients developed a recurrent fistula, 9 (29%) of which recurred following a second repair. None recurred after a third repair. The risk of a recurrent fistula after an initial distal fistula repair was 12.5% and after a posterior fistula was 62% (chi(2) = 15.4, P = 0.001). Use of a stent, suture type, numbers of fistula and closure attempts did not influence the recurrence rate. Undiagnosed distal obstruction was thought to be related to 27 of 117 first fistula repairs (23%) and 4 of 31 second fistula repairs (13%). The risk of recurrent urethrocutaneous fistula was increased in those boys with a posterior fistula, following a simple repair or when there was evidence of distal urethral obstruction.
%Z FOR Codes: 110312


%0 Journal Article
%~ PubMed
%A Sandler, Gideon
%A Chennapragada, S Murthy
%A Soundappan, Soundappan S V
%A Cass, Danny
%T Pediatric high-flow priapism and super-selective angiography-an Australian perspective.
%B Journal of Pediatric Surgery
%D 2008
%C United States
%I WB Saunders Co.
%V 43
%N 10
%P 1898-1901
%@ 1531-5037
%X High-flow priapism is an uncommon entity in the pediatric and adolescent population. It is usually caused by perineal trauma. Here we describe the experience of our institution in this condition over the past 10 years, the various treatment options available, and the successful application of super-selective angiographic embolization as our treatment modality of choice. Included here is the case of a 4-year-old boy (case 3) who, to our knowledge, is the youngest patient described with this condition in the literature.
%Z FOR Codes: 111403


%0 Journal Article
%~ PubMed
%A Soundappan, S V S
%A Martin, Hugh
%A Cass, Daniel T
%T Unusual neck sinus-first or second cleft?
%B Journal of pediatric surgery
%D 2008
%C United States
%I WB Saunders Co.
%V 43
%N 7
%P e5-7
%@ 0022-3468
%X A sinus tract presenting with an opening around the angle of mandible is suggestive of first cleft remnant. We present the case of a 4-year-old boy with a recurrent discharging sinus around the angle of the right mandible whose internal opening was near the tonsil on imaging. Complete excision was performed with facial nerve monitoring. We discuss technical aspects of the surgery and possible embryology.
%Z FOR Codes: 111403


%0 Journal Article
%~ PubMed
%A Alzahem, Abdulrahman M
%A Soundappan, Soundappan S V
%A Jefferies, Heather
%A Cass, Daniel T
%T Ingested magnets and gastrointestinal complications.
%B Journal of paediatrics and child health
%D 2007
%C Via Bradano 3/C, Rom
%I Pensiero Scientifico Editor
%V 43
%N 6
%P 497-498
%@ 1440-1754
%X Multiple magnet ingestion is an unexpected health hazard in children that can lead to significant gastrointestinal morbidity. The magnets are attracted to each other across the bowel wall and this may lead to pressure necrosis, resulting in perforation, fistula formation, and/or intestinal obstruction. We report herein a case of small bowel obstruction following ingestion of two magnets. The public and clinicians should be aware of the health hazard of such devices.
%Z FOR Codes:


%0 Journal Article
%~ PubMed
%A Jones, Vinci S
%A Soundappan, Soundappan V S
%A Cohen, Ralph C
%A Pitkin, John
%A La Hei, Erick R
%A Martin, Hugh C
%A Cass, Daniel T
%T Posttraumatic small bowel obstruction in children.
%B Journal of pediatric surgery
%D 2007
%C United States
%I WB Saunders Co.
%V 42
%N 8
%P 1386-1388
%@ 1531-5037
%X BACKGROUND: The diagnosis of intestinal injuries in children after blunt abdominal trauma can be difficult and delayed. Most children who suffer blunt abdominal trauma are managed nonoperatively, making the diagnosis of intestinal injuries more difficult. We sought to gain information about children who develop intestinal obstruction after blunt abdominal trauma by reviewing our experience. METHODS: Review of records from a pediatric tertiary care center over an 11.5-year period revealed 5 patients who developed small bowel obstruction after blunt trauma to the abdomen. The details of these patients were studied. RESULTS: All patients were previously managed nonoperatively for blunt abdominal trauma. Intestinal obstruction developed 2 weeks to 1 year (median, 21 days) after the trauma. Abdominal x-ray, computerized tomography scan, or barium meal studies were used to establish the diagnosis. The pathology was either a stricture, an old perforation, or adhesions causing the intestinal obstruction. Laparotomy with resection and anastomosis was curative. CONCLUSIONS: Posttraumatic small bowel obstruction is a clinical entity that needs to be watched for in all patients managed nonoperatively for blunt abdominal trauma.
%Z FOR Codes:


%0 Journal Article
%~ PubMed
%A Soundappan, S V S
%A Holland, Andrew J A
%A Fahy, Fiona
%A Manglik, Patricia
%A Lam, Lawrence T
%A Cass, Daniel T
%T Transfer of pediatric trauma patients to a tertiary pediatric trauma centre: appropriateness and timeliness.
%B The Journal of Trauma
%D 2007
%C United States
%I Lippincott Williams & Wilkins
%V 62
%N 5
%P 1229-1233
%@ 0022-5282
%X OBJECTIVE: To study the appropriateness of, and time taken, to transfer pediatric trauma patients in New South Wales to The Children''s Hospital at Westmead (CHW), a pediatric trauma center. METHODS: All trauma patients transferred to CHW from June 2003 to July 2004 were included in the study. Indications and time periods relevant to the transfer of the patient from the referring institute were retrieved and analyzed. Pediatric and adult retrieval services were compared. RESULTS: Three hundred ninety-eight patients were transferred to CHW, of whom 332 were from the metropolitan region. Falls and burns were the commonest mechanism of injury. Burn was the commonest indication for transfer (107 of 398). Mean Injury Severity Score was eight. Nearly half the patients had minor injuries (Injury Severity Score<9). Patients spent an average of 5 hours at the referring hospital. Pediatric retrieval ambulances had significantly longer mean transfer times than did nonpediatric ambulance services with a total time spent of about 2.64 hours versus 1.30 hours, respectively. For aeromedical transfers, on the other hand, the difference between pediatric retrieval services and nonpediatric air ambulances was not significant. CONCLUSIONS: The majority of the patients transferred had minor injuries. Pediatric trauma patients spend considerable time in their referring hospitals. Pediatric retrieval services appear to take significantly longer to transfer patients than nonpediatric ambulance transfers even after allowing for patient age and injury severity. Although this did not result in mortality or morbidity, there appears to be considerable scope for a reduction in transfer times through better coordination of these services.
%Z FOR Codes: 111403 110305