GlobalCastMD

In pediatric blunt solid-organ injury, the initial management decision is rarely where things go wrong. At the 2025 Western Pediatric Trauma Conference, experts made a compelling case that the critical failure point is what happens in the 25 days after that initial decision — when anchoring bias keeps care teams committed to a non-operative pathway even as the clinical picture shifts. The willingness to reassess, and the institutional flexibility to change course, may matter more than the index decision. For the most severe hepatic injuries, that reassessment should include an aggressive evaluation of liver transplant as a viable intervention. The argument: children should not die of liver failure following blunt hepatic trauma when transplant may be an option. The underlying principle is worth carrying into every trauma bay: hope is an ineffective strategy in surgery. Structured decision-making flexibility — not optimism — is what protects these patients. The in-person pre-conference starts TODAY — virtual streaming begins TOMORROW, so there's still time to join. Register for the 2026 Western Pediatric Trauma Conference (WPTC): https://lnkd.in/dTUa3WPU More info: https://lnkd.in/dcBiatny Follow for more pediatric surgery research and clinical insights. #SoMe4PedSurg #MedEd #PediatricTrauma #PedSurg

The 14th Annual Pediatric Surgery Update Course is one of the most important educational events in pediatric surgery! Join top experts from across the US on August 10th, 8 AM MDT, for a comprehensive day of clinical updates covering the topics reshaping pediatric surgical practice: 3D imaging for surgical planning, fundoplication selection, inguinal hernia repair in adolescents, pediatric burn care, management of the difficult pectus, pediatric pain control, pediatric cervical spine imaging, and more. This is the kind of structured, expert-led update that department leaders, attendings, trainees, and APPs need to stay current — without leaving the hospital. Register here: https://lnkd.in/drTckH_U Follow for more pediatric surgery research and clinical insights. Thanks to our sponsors: KARL STORZ North America, Cincinnati Children's, Akron Children's, Seattle Children's, , Ann & Robert H. Lurie Children's Hospital of Chicago, Children's Mercy, Intermountain Children's Health, Cleveland Clinic, Phoenix Children's Dr. David Notrica, Dr. Laurie Baumann, Dr. Keri Page, Dr. Rebeccah Brown #SoMe4PedSurg #MedEd #PedSurg #PediatricSurgery

Congenital diaphragmatic hernia is one of the most consequential fetal diagnoses a family can receive — and FETO (fetoscopic endoluminal tracheal occlusion) is one of the most technically precise interventions available to improve outcomes before birth. This carousel from the Cincinnati Children's Fetal Care Center maps the full procedural anatomy of FETO: one trocar through the maternal abdomen, one scope advanced into the fetal airway, and two rules that govern every clinical decision. Rule 1 addresses lung growth and procedural safety. Tracheal balloon occlusion traps amniotic fluid, driving fetal lung expansion and preventing pulmonary hypoplasia — one of the primary determinants of CDH outcome. The technical caution: avoid over-torquing the scope when the fetal head is not ideally positioned. Every degree of rotation travels through both the abdominal wall and the uterine wall. Pulsing the fluid channel to advance is safer and more controlled than scope rotation. Rule 2 addresses confirmation. The team at Cincinnati Children's is clear: always advance to the carina before balloon deployment. The carina confirms tracheal position and rules out inadvertent esophageal placement. It is not a landmark — it is proof. The carousel delivers the complete road map: anatomical landmarks from nasal tip to carina, balloon volumes, and the final pre-completion checklist. Watch the full video: https://lnkd.in/dXiwfqmC More info on the Fetal Care Center at CCHMC: https://lnkd.in/dUwXsfZS Follow for more fetal surgery research and clinical insights. Made possible by Cincinnati Children's #FetalSurgery #CDH #MedEd #PedSurg #SoMe4PedSurg

#Techniquetuesday This week we are highlighting ‘Laparoscopic Jejunal Atresia Repair' by Dr. Steve Rothenberg. Don’t forget to check out our video library of surgical technique videos in the @StayCurrentMD app! Full video: https://lnkd.in/dNm2H2zG #SoMe4PedSurg Made possible by Cincinnati Children's

Pulmonary hypoplasia is one of the most consequential drivers of poor outcomes in congenital diaphragmatic hernia — and FETO addresses it before the baby is born. Fetoscopic Endoluminal Tracheal Occlusion (FETO) is a percutaneous fetal intervention in which a balloon is placed to occlude the fetal trachea via fetoscope. By preventing fluid from escaping the developing lungs, the procedure stimulates lung growth in utero and reduces the severity of pulmonary hypoplasia at delivery. This intervention represents a meaningful advance in the prenatal management of CDH — shifting the treatment window earlier and improving the physiologic foundation these neonates bring to postnatal repair. Watch the full video: https://lnkd.in/dvD_H-Ba More info on the Fetal Care Center at CCHMC: https://lnkd.in/dfPGnSMk Follow for more fetal surgery and pediatric surgery research and clinical insights. Made possible by Cincinnati Children's

Bacterial vaginosis recurs in the majority of patients under standard care — a new randomized trial suggests the reason may be that we have only been treating one partner. New article review by Dr. Katherine Byrket in collaboration with North American Society of Pediatric and Adolescent Gynecology (NASPAG) "Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis" from Vodstrcil LA et al. This trial randomized couples in which the female partner had bacterial vaginosis and was in a monogamous relationship with a male partner. One arm received standard female treatment only. The other arm added oral metronidazole and topical penile clindamycin cream for the male partner over seven days. The trial was stopped early based on the magnitude of effect: recurrence rates fell from 63% to 35%. The implication is mechanistically important. Bacterial vaginosis-associated bacteria are exchanged between sexual partners. Treating only one person leaves the reservoir intact and the cycle unbroken. This is not a minor modification to existing protocol — it is a reconceptualization of bacterial vaginosis as a condition requiring dyadic management. For clinicians managing adolescent and adult patients with recurrent bacterial vaginosis, this evidence warrants serious attention to partner treatment as part of the standard conversation. Full text: https://lnkd.in/dxBbrdGe More on the Pediatric and Adolescent Gynecology team at Cincinnati Children's: https://lnkd.in/d9NcNDbi Follow for more gynecology research and clinical insights Made possible by Cincinnati Children's

Four specialists, one discussion — what does the conversation sound like when they're all at the table? Join Drs. Dasgupta, Pressey, Meyers, and Pater NEXT WEEK at the Clinical & Research Update on Sarcoma on July 22, 2026 (9:30–11:00 AM EST) — a case-based discussion. The program covers metastatic Ewing's sarcoma management, high-grade ovarian pathology, radical surgical interventions, and clinical success stories drawn from one of the leading pediatric oncology programs in the country. This is the kind of case-based learning that sharpens clinical judgment and reinforces what's possible when the right team is in the room. Register here: https://lnkd.in/dd2fnyPV Learn more about Cincinnati Children's Cancer & Blood Diseases Institute: https://lnkd.in/dQMHNkcV Follow for more pediatric oncology research and clinical insights. Made possible by Cincinnati Children's

Pelvic floor physical therapy is effective for Hirschsprung disease — but most referred patients never receive it. A 2025 study quantifies the access gap and demands a structural response. Sponsored by Nationwide Children's New article you should know by Megan Read, MD "Evaluating Access and Efficacy of Pelvic Floor Physical Therapy in Pediatric Hirschsprung Disease" Srinivas S et. al. This retrospective analysis of 83 pediatric patients with Hirschsprung disease who were referred to pelvic floor physical therapy (PFPT). Only 45% attended at least one session. Only 20% completed a full treatment course. Scheduling was the primary documented barrier, with financial stressors and inadequate support systems as compounding factors. Among patients who did attend, fecal incontinence rates fell from 81% to 40% — a result that confirms the clinical value of PFPT in this population. The study raises a structural question that pediatric colorectal programs should be asking: are we designing care delivery in a way that gives our highest-need patients a realistic path to completing treatment? Integrating PFPT directly into colorectal clinic workflows may be one evidence-based step toward closing that gap. Full text: https://lnkd.in/dtcmUz4g More info: https://lnkd.in/dTewYr62 Follow for more pediatric colorectal surgery research and clinical insights. #SoMe4PedSurg #MedEd #PedSurg #Hirschsprung #PelvicFloorPT

In favorable histology Wilms tumor with pulmonary-only metastases, does the number or size of lung nodules predict how a child will do — or is something deeper driving outcomes? New infographic by Lizzy Lee, PA-C "Impact of Pulmonary Tumor Burden in Favorable Histology Wilms Tumor Outcomes: A Report From the Children's Oncology Group Study AREN0533" Dix DB et al. This 2025 Children's Oncology Group analysis of 251 children with stage IV, pulmonary-only metastatic favorable histology Wilms tumor (FHWT) compared outcomes across two response groups. Among rapid complete responders managed with chemotherapy alone, nodule count showed no association with survival — and while nodule size did associate with event-free survival, the effect was modest. Among slow incomplete responders receiving chemotherapy plus whole lung radiation, neither metric influenced survival outcomes. The factor that consistently outweighed pulmonary tumor burden: chromosome 1q gain — significantly associated with worse event-free and overall survival in this cohort. The takeaway has real implications for how we counsel families and risk-stratify patients. Radiographic burden matters less than tumor biology. Molecular profiling — specifically 1q status — should be central to prognosis conversations in this population. Full text: https://lnkd.in/dZvvzjNN Made possible by Cincinnati Children's Journal of Pediatric Surgery #SoMe4PedSurg #PedSurg #MedEd

The 14th Annual Pediatric Surgery Update Course is one of the most important educational events in pediatric surgery! Join top experts from across the US on August 10th, 8 AM MDT, for a comprehensive day of clinical updates covering the topics reshaping pediatric surgical practice: 3D imaging for surgical planning, fundoplication selection, inguinal hernia repair in adolescents, pediatric burn care, management of the difficult pectus, pediatric pain control, pediatric cervical spine imaging, and more. This is the kind of structured, expert-led update that department leaders, attendings, trainees, and APPs need to stay current — without leaving the hospital. Register here: https://lnkd.in/dNQxvnpJ Follow for more pediatric surgery research and clinical insights. Thanks to our sponsors: KARL STORZ North America, Cincinnati Children's, Akron Children's, Seattle Children's, , Ann & Robert H. Lurie Children's Hospital of Chicago, Children's Mercy, Intermountain Children's Health, Cleveland Clinic, Phoenix Children's, Golisano Children’s Hospital Dr. David Notrica, Dr. Laurie Baumann, Dr. Keri Page, Dr. Rebeccah Brown #SoMe4PedSurg #MedEd #PedSurg #PediatricSurgery