No abstract

Interventional procedures in the adult chest are well described and practiced. Many of the same procedures, although somewhat less commonly employed, also apply in pediatric settings. In the realm of chest intervention, probably the biggest impact in pediatric disease has been the percutaneous drainage of empyema and parenchymal abscesses. In this article, techniques, with emphasis on special applications in regard to children, and sedations appropriate for various intrathoracic procedures, highlighting percutaneous drainage, are discussed.Objectives: On completion of this article, the reader will be able to (1) list some of the more common regimens used for sedating the child undergoing a procedure involving the thorax and (2) summarize the steps involved in performing drainages and biopsies within the chests of children. Accreditation: Tufts University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. TUSM takes full responsibility for the content, quality, and scientific integrity of this continuing education activity. Credit: Tufts University School of Medicine designates this education activity for a maximum of 1.0 hour credit toward the AMA Physicians Recognition Award in category one. Each physician should claim only those hours that he/she actually spent in the educational activity.with an emphasis on procedure and how they apply to the pediatric population.Downloaded by: University of Michigan. Copyrighted material.

Metastatic malignancy to the umbilicus, also known as Sister Mary Joseph's nodule, is a rare condition, which to our knowledge has not been reported in a child. We present a case of an umbilical metastasis from carcinoma of the colon in a boy who was also receiving chemotherapy for mediastinal lymphoblastic lymphoma.