MAGNET AND BUTTON BATTERY INGESTION IN CHILDREN: MULTICENTRE OBSERVATIONAL STUDY OF MANAGEMENT AND OUTCOMES
Collaborative work published in BJS Open 2022
Magnets and button batteries are dangerous ingested foreign bodies in children. The scale and consequences of this public health issue in the UK are unknown. This study aimed to report the current management strategies and outcomes associated with paediatric magnet and button battery ingestion in 13 UK centres. In one year, 263 patients were identified, comprising 146 magnet, 112 button battery, and 5 mixed ingestions. Of the 108 children who swallowed multiple magnets, 51 required endoscopic or surgical intervention, predominantly for failure of magnets to progress on serial imaging. Younger age and ingestion of greater numbers of multiple magnets were independently associated with surgery. Button battery ingestion caused morbidity in 14 children and life-threatening injuries in 2.
ORCHESTRA STUDY: DOES EARLIER ORCHIDOPEXY AFFECT TESTICULAR ATROPHY
Presented at the British Association of Paediatric Surgeons Annual Congress July 2017
In September 2011 the British Association of Paediatric Urologists wrote a consensus statement recommending that orchidopexy should be performed from as early as 3 months of age although between 6 and 12 months is acceptable. It is not known whether operating at earlier age may affect the rate of post-operative testicular atrophy following orchidopexy. The ORCHESTRA study aimed to establish current practice with regards to the age at orchidopexy in a multicentre, international audit and determine the testicular atrophy rate post surgery at > 6 months follow-up. We have not shown an increased risk of post-operative testicular atrophy for early surgery although there is a higher rate of wound infection. Only 1 in 8 boys receive orchidopexy before 1 yrs. Further study is required to demonstrate that early orchidopexy is not inferior to orchidopexy at > 1yrs
RIGHT ILIAC FOSSA PAIN TREATMENT (RIFT) STUDY
Collaborative work published in British Journal of Surgery and the Lancet Child and Adolescent Health
Acute appendicitis is the most common surgical emergency in children. Differentiation of acute appendicitis from conditions that do not require operative management can be challenging in children. This study aimed to identify the optimum risk prediction model to stratify acute appendicitis risk in children.
THE IMPACT OF COVID 19 PANDEMIC LOCKDOWN ON INFANTS WITH PYLORIC STENOSIS
Accepted for publication in Archives of Disease in Childhood November 2020
The COVID 19 pandemic posed challenges to the delivery of healthcare to infants due to the disruption in health checks and health visitor services. Of particular concern is delayed presentation to hospital. There was at the time no objective measure of the extent of potential delays. Infantile hypertrophic pyloric stenosis is a common non infective condition with a predictable clinical course, making it a good indicator to assess for delays to presentation. We conducted a multicentre case control study comparing babies with pyloric stenosis presenting during the lockdown of March- May 2020 with a historic cohort that presented in March - May 2019 (87 total patients- 40 controls, 47 cases). No statistical difference in median age at presentation, weight loss, biochemistry, or need for intensive care was observed. We concluded that infants with pyloric stenosis did not have a significantly delayed presentation due to COVID 19, likely due to prompt and proactive changes made by the NHS, and guidelines released for parents by several key organisations.