Paediatric surgery

2021 ◽  
pp. 521-552
Keyword(s):  
Abdominal Wall ◽  
Necrotizing Enterocolitis ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Undescended Testis ◽  
Oesophageal Atresia ◽  
Solid Tumours ◽  
Abdominal Wall Defects ◽  
Paediatric Surgery

This chapter outlines the principles of managing paediatric surgical cases. It provides an overview of the assessment of a child with abdominal wall defects, inguinal or scrotal swellings and neck swellings. Conditions such as oesophageal atresia, phyloric stenosis, malrotation and volvulus, intussusception, hirschsprung’s disease, necrotizing enterocolitis, childhood hernias, undescended testis and solid tumours of childhood.

Paediatric surgery

2019 ◽  
pp. 725-732
Keyword(s):  
Abdominal Pain ◽  
Medical School ◽  
Surgical Management ◽  
Necrotizing Enterocolitis ◽  
Pyloric Stenosis ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Paediatric Surgery ◽  
Wide Range ◽  
Gastrointestinal Illnesses

This chapter on paediatric surgery covers procedures performed from fetus to 16 years of age. The wide range is succinctly covered with appropriate detail for both those looking to apply for medicine, and those in medical school. The chapter reviews oncological conditions, most importantly, leukaemia. It also studies common conditions such as abdominal pain, hernia, undescended testicles, and appendicitis. Surgical management of gastrointestinal illnesses such as pyloric stenosis, intussusception, and Hirschsprung’s disease is covered along with urological conditions such as hypospadias. It also discusses important neonatal presentations of necrotizing enterocolitis and gastrointestinal atresia, to name a few.

Modified Duhamel Retrorectal Pull-Through for Hirschsprung’s Disease

2021 ◽  
Vol 15 (10) ◽  
pp. 2886-2889
Author(s):  
Shafiq ur Rehman ◽  
Muhammad Anwar ◽  
Zarlish Fazal
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Operation Time ◽  
Clinical Score ◽  
Toilet Training ◽  
Paediatric Surgery ◽  
Short Term ◽  
Female Ratio ◽  
Bowel Habits ◽  
Pull Through

Objectives: To evaluate the post-operative complications and short-term outcomes of modified Duhamel retrorectal pull-through procedure for Hirschsprung’s disease. Design: Prospective descriptive study Place and Duration of Study: Department of Paediatric Surgery Sahiwal Teaching Hospital Sahiwal from 1stJanuary 2018 to 31st December 2020. Methodology: Thirty seven histologically confirmed cases of Hirschsprung’sdisease having previous decompressing colostomy/stoma age between 1 to 12 years of agewere included. Children under one year of age, with sever comorbidities like Down syndrome and cardiac abnormalities, and those who require re-do pull through procedure were excluded. Modified Duhamel retrorectal pull-through procedure was performed in all cases. The demographic information included age, sex, proximal level of aganglinosis, complications of definite procedure, length of hospitalization andmortality. Other information recorded included long term complications like obstructive symptoms, enterocolitis, incontinence and soiling at follow up. Krickenbeck classification was used to evaluate faecal incontinence and constipation. Kelly’s clinical score was used to assess the anal sphincter. Bowel habits were assessed only in children above three years of age. Results: Twenty six (70.27%) were males and 11 (29.72%) females with male to female ratio 2.3:1 and mean age at operation was 2.89±1-9 years. Twenty nine (78.37%) children were ≤3 years of age and 8 (21.62%) were >3 years. Mean weight was 12.91 kgs, operation time was 126.81 time, fasting time was 6.67 days and hospital stay was 11.91 days. Length of aganglionic segment was short segment 27 (72.97%), long segment 9 (24.32%) and total colonic 1 (2.7%). Hirschsprung associated enterocolitis 7 (18.91%) and wound infection 6(16.21%) were most common reported complications. Constipation in 5(13.51) and soiling with retentive constipation was present in 3 (8.10%) patients. Out of total 31 patients who reached toilet training age, 28 (90.32%) developed satisfactory voluntary bowel habits. Conclusion: Modified Duhamel pull-through procedure was found to be safe, applicable and with lower associated complications and satisfactory short term functional outcomes in our settings. Key words: Hirschsprung’s disease, Modified Duhamel pull-through procedure, Complications, Outcomes

scholarly journals Oesophageal atresia with tracheo-oesophageal fistula, ileal atresia and Hirschsprung’s disease: outcome of a rare phenotype

2019 ◽  
Vol 12 (2) ◽  
pp. e226675 ◽  
Author(s):  
Liliana Pimenta Santos ◽  
Diana Coimbra ◽  
Catarina Cunha ◽  
Maria Francelina Lopes
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Neonatal Period ◽  
Ganglion Cells ◽  
Oesophageal Atresia ◽  
Intestinal Atresia ◽  
Successful Outcome ◽  
Ileal Atresia ◽  
Prolonged Hospitalisation ◽  
Rare Phenotype

Oesophageal atresia with or without tracheo-oesophageal fistula, ileal atresia and Hirschsprung’s disease are surgical malformations of the gastrointestinal tract typically diagnosed early in the neonatal period and varying in severity and prognosis. This report describes a full-term male newborn presenting simultaneous oesophageal atresia with distal tracheo-oesophageal fistula, ileal atresia and Hirschsprung’s disease. In addition to the complex types of gastrointestinal malformations involved, the combination of ileal atresia and Hirschsprung’s disease, as well as ganglion cells distal to intestinal atresia, resulted in a challenging diagnosis. Despite a successful outcome, the patient presented increased morbidity and prolonged hospitalisation. We highlight some important findings that may aid the early diagnosis of Hirschsprung’s disease in this clinical setting. To our knowledge, the association of oesophageal atresia/tracheo-oesophageal fistula, ileal atresia and Hirschsprung’s disease has not been previously reported.

scholarly journals Congenital abdominal wall defects and cryptorchidism: a population-based study

2021 ◽  
Author(s):  
Arimatias Raitio ◽  
Johanna Syvänen ◽  
Asta Tauriainen ◽  
Anna Hyvärinen ◽  
Ulla Sankilampi ◽  
...  
Keyword(s):  
General Population ◽  
Abdominal Wall ◽  
Undescended Testis ◽  
Population Based ◽  
Abdominal Wall Defects ◽  
Population Based Study ◽  
True Prevalence ◽  
High Prevalence ◽  
Congenital Abdominal Wall Defects

Abstract Purpose Several studies have reported high prevalence of undescended testis (UDT) among boys with congenital abdominal wall defects (AWD). Due to rarity of AWDs, however, true prevalence of testicular maldescent among these boys is not known. We conducted a national register study to determine the prevalence of UDT among Finnish males with an AWD. Methods All male infants with either gastroschisis or omphalocele born between Jan 1, 1998 and Dec 31, 2015 were identified in the Register of Congenital Malformations. The data on all performed operations were acquired from the Care Register for Health Care. The register data were examined for relevant UDT diagnosis and operation codes. Results We identified 99 males with gastroschisis and 89 with omphalocele. UDT was diagnosed in 10 (10.1%) infants with gastroschisis and 22 (24.7%) with omphalocele. Majority of these required an operation; 8/99 (8.1%) gastroschisis and 19/89 (21.3%) omphalocele patients. UDT is more common among AWD patients than general population with the highest prevalence in omphalocele. Conclusions Cryptorchidism is more common among boys with an AWD than general population. Furthermore, omphalocele carries significantly higher risk of UDT and need for orchidopexy than gastroschisis. Due to high prevalence testicular maldescent, careful follow-up for UDT is recommended.

Gastrointestinal problems

2017 ◽  
Author(s):  
Grenville Fox ◽  
Nicholas Hoque ◽  
Timothy Watts
Keyword(s):  
Surgical Management ◽  
Necrotizing Enterocolitis ◽  
Hirschsprung's Disease ◽  
Oesophageal Atresia ◽  
Intestinal Atresia ◽  
Meconium Ileus ◽  
Differential Diagnoses ◽  
Anorectal Anomalies ◽  
Gastrointestinal Problems ◽  
Bloody Stools

This chapter describes the presentation, investigation, and management of congenital and acquired gastrointestinal problems. It begins with a symptom-based approach giving differential diagnoses for vomiting, haematemesis, bloody stools, and diarrhoea. All common congenital problems are covered including oesophageal atresia, tracheo-oesophageal fistula, intestinal atresia, exomphalos, gastroschisis, malrotation, volvulus, meconium ileus, Hirschsprung’s disease, and anorectal anomalies. There are several pages devoted to necrotizing enterocolitis. Throughout there is a description of the surgical management of relevant conditions.

Surgical Conditions

2021 ◽  
pp. 195-226
Keyword(s):  
Abdominal Wall ◽  
Acute Abdomen ◽  
Necrotizing Enterocolitis ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Abdominal Distension ◽  
Abdominal Radiograph ◽  
Abdominal Wall Defects ◽  
Tube Insertion ◽  
Surgical Conditions

The surgical considerations chapter focuses on conditions that require surgery soon after birth but first require stabilization. Such conditions include anterior abdominal wall defects, neural tube defects, and gastrointestinal obstructions. Gastroschisis and omphalocele are comparatively rare, but protecting such lesions at birth (e.g., by applying a bowel bag) is essential for stabilization. Neural tube defects occur on a spectrum and are more common, but taking immediate steps to prevent injury and infection is necessary. Gastrointestinal obstructions are signalled and/or differentially diagnosed by vomiting, the inability to swallow or handle secretions, delayed meconium, or abdominal distension. Causes of acute abdomen, such as necrotizing enterocolitis, volvulus, or gastrointestinal perforation are considered. Skills such as gastric or Replogle tube insertion, suctioning, and chest and abdominal radiograph interpretation are discussed in detail. Stabilization pathways and protocols are applied in two case scenarios.

Neonatal Emergencies II: Necrotizing Enterocolitis and Abdominal Wall Defects

2019 ◽  
Author(s):  
Iva Vassileva Vesselinova
Keyword(s):  
Abdominal Wall ◽  
Necrotizing Enterocolitis ◽  
Perinatal Care ◽  
Disease Process ◽  
Abdominal Wall Defects ◽  
Anesthetic Care ◽  
Vulnerable Patients ◽  
Key Words Anesthesia ◽  
Critically Ill Neonates ◽  
Neonatal Physiology

Recent advances in perinatal care have dramatically improved the survival of the youngest and smallest infants, including critically ill neonates and those born with congenital malformations. This has increased the neonatal population at risk for intraabdominal diseases due to prematurity that require surgical intervention. Thus, the pediatric anesthesiologist is increasingly confronted with the challenging task of providing anesthetic care for these vulnerable patients. Despite our better understanding of the immature transitional physiology and developmental pharmacology, pathology of the diseases of prematurity and impact of surgery and anesthesia on their fragile homeostasis, the risk for adverse perioperative events is still the highest in neonatal patients. Therefore, thoughtful preparation, anticipation of potential complications, and efficient collaboration within the multidisciplinary team are essential to ensure safety and quality of the delivered anesthetic care. This review focuses on the perioperative management of necrotizing enterocolitis and abdominal wall defects, with emphasis on preoperative stabilization and tailoring of anesthetic intraoperative plan to the unique neonatal physiology and disease process. This review contains 4 tables, and 50 references. Key Words: anesthesia, necrotizing enterocolitis, gastroschisis, omphalocele, neonatal, prematurity, resuscitation, morbidity, mortality.

scholarly journals Etiology and Treatment Outcome of Neona tal Intestinal Obstruction in a Tertiary Hospital

2009 ◽  
Vol 22 (2) ◽  
pp. 198-203
Author(s):  
SS Islam ◽  
MA Nowshad ◽  
A Jator ◽  
I Faisal ◽  
M Ahmed
Keyword(s):  
Intestinal Obstruction ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Intestinal Atresia ◽  
Paediatric Surgery ◽  
College Hospital ◽  
Female Ratio ◽  
Neonatal Intestinal Obstruction ◽  
Surgery Department

A prospective study was conducted on 54 cases of neonatal intestinal obstruction, admitted in Paediatric surgery department of Rajshahi Medical College Hospital during the period from January 2008 to December 2008, a period of 12 months. The objective of the study was to find out etiological aspect and outcome of admitted patient with neonatal intestinal obstruction. The patient constituted 33.7% of total neonatal admission in Paediatric surgery department during the study period. The male: female ratio was 1.4:1 with age ranging from 1 to 28 days. Birth weight of most of the patients was above 2 kg. Most of the patients came from poor and average family. Patients from poor family are slightly ahead. Plain x-ray abdomen was done in all cases in our study. Contrast radiography performed in selected cases. Ultrasound scan done to in selective case to rule out IHPS. No rectal biopsy was taken in case of suspected Hirschsprung's disease. The causes of neonatal intestinal obstruction were in order of frequency-Hirschsprung's disease (45.2%), Intestinal atresia (24.5%), malrotation (9.4%), bands & adhesion (5.6%), meconium ileus (5.6%), volvulus neonatarum (5.6%), meconium plug syndrome (1.8%), unknown (3.7%). 50 patients were treated operatively. 28.3% cases developed complications. Most of the complications were related to colostomy and sepsis. Overall mortality was 20.8%. Mortality was maximum in intestinal atresia. Every patient was advised to come for follow up at the time of discharge but most of the people did not report. In the study only 17 (32.1%) patient came for follow up as per advice.TAJ 2009; 22(1): 198-203

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