Pediatric Surgery

Abdominal Masses In Neonatal Period
Abdominal Masses in the Neonatal Period : The discovery of an abdominal mass on physical examination in the newborn period cause

Achalasia In Children Babies Kids
achalasia in children babies kids : Achalasia in children is an uncommon esophageal motor disorder distinguished by clinical, ra

Acute Abdominal Pain In Children
Acute abdominal pain in children presents a diagnostic dilemma. Although many cases of acute abdominal pain are benign, some req

Acute Pancreatitis
Acute pancreatitis (AP) is unusual in the pediatric patient, can affect all age groups and should be considered in children presen

Adrenal Hemorrhage
Adrenal Hemorrhage : Retroperitoneal adrenal Hemorrhage usually occurs at birth or during the first postnatal days the result of

Annular Pancreas Divisum
Annular Pancreas / Pancreas Divisum : The pancreas develops from an anterior and posterior anlage of the foregut early during gest

Anorectal Malformations Baby Health
Anorectal malformations are birth defects (problems that happen as a fetus is developing during pregnancy). With this defect, the

Appendicitis Appendectomy
Appendicitis Included in this group because is caused by obstruction of the appendiceal lumen, most commonly by fecaliths. When ob

Appendicitis Appendix Surgery Treatment
Appendicitis is an irritation, inflammation, and infection of the appendix (a narrow, hollow tube that branches off the large inte

Asplenia Absence Of The Spleen
The absence of the spleen (asplenia) occurs after surgical removal, following chronic conditions or congenital. Trauma is the most

Biliary Atresia Kasai Portoenterostomy
Biliary Atresia : Persistent conjugated hyperbilirubinemia (greater than 20% of total or 1.5 mg%) should be urgently evaluated. In

Biliary Hypoplasia In Children
Biliary hypoplasia is a rare cause of persistent neonatal conjugated hyperbilirubinemia. Pathologically, affected children have ab

Bladder Exstrophy
Exstrophy Bladder exstrophy results from defective development of the anterior bladder and lower abdominal walls, leaving the p

Branchial Cleft Fistulas
Branchial Cleft Fistulas : Branchial cleft fistulas (BCF) originate from the 1st to 3rd branchial apparatus during embryogenesis

Breast Disorders In Children
Most breast disorders in children of either sex are benign. Congenital lesions are: absent or multiple breast. Transplacental hor

Bronchogenic Cysts
Bronchogenic cysts (BC), first described in 1911, are benign congenital lesions of the respiratory tract that have the potential t

Burkitts Lymphoma
Burkitt's lymphoma (BL) is a highly malignant tumor first described during the late 50's in African children (jaw), endemic in nat

Burns In Children
Burns make a significant contribution to paediatric hospital admissions; in 1 year, around 50,000 such patients attended accident

Cat Scratch Disease
Cat Scratch Disease : Cat Scratch Disease (CSD) is a self-limited condition transmitted by a Bartonella species (Rochalimaea hen

Cervical Lymphadenopathy
Cervical Lymphadenopathy : An enlarged lymph node is the most common neck mass in children. Most are anterior to the sternocleidom

Child Constipation Abdominal Radiograph
Abdominal Radiograph and Transit Time An abdominal radiograph is not indicated to establish the presence of a fecal impaction

Choledochal Cyst
Choledochal cyst is a rare dilatation of the common bile duct, prevalent in oriental patients (Japan), where >60% of patients a

Cholelithiasis Cholecystitis
With the increase use of sonography in the work-up of abdominal pain, cholelithiasis is diagnosed more frequent in children. Galls

Chylothorax Effusion Of Lymph
Chylothorax : Effusion of lymph (chyle) into the pleural cavity is known as chylothorax. Chyle is clear-milky fluid with an elevat

Congenital Adrenal Hyperplasia
Congenital adrenal hyperplasia (CAH) involves a functional defect in any of the five enzymatic steps required for cortisol synthes

Congenital Diaphragmatic Hernia Bochdalek
Congenital Diaphragmatic Hernia (Bochdalek) : The most common congenital diaphragmatic hernia (CDH) is that which occurs through t

Congenital Diaphragmatic Hernia Repair
congenital diaphragmatic hernia repair - surgery - surgical care: • Postnatal repair o Until recently, specialists be

Congenital Epigastric Defects
Congenital epigastric defects occur anywhere in the linea alba from the navel to the xiphoid process. They represent almost 5% of

Congenital Torticollis
Congenital Torticollis : Congenital muscular torticollis is a disorder characterize by shortening of the cervical muscles, most

Cystic Adenomatoid Malformation
Congenital cystic adenomatoid malformation is a lung bud lesion characterize by dysplasia of respiratory epithelium caused by over

Cystic Hygroma
Cystic Hygroma : Cystic hygroma (CH) is an uncommon congenital lesion of the lymphatic system appearing as a multilocular fluid fi

Duodenal Malformations
Duodenal Malformations Can be intrinsic (Atresia, Stenosis, Webs) or extrinsic (Annular pancreas, Ladd's bands). Occur distal or p

Ectopic Ureter
Ectopic ureter Definition : The ureteric orifice is situated below the normal anatomical insertion on the trigone of the bla

Epispadias
Epispadias In epispadias, the urethra opens onto the dorsal surface of the penis, anywhere from the glans, penile shaft, or, mo

Esophageal Atresia Tracheoesophageal Fistula
Esophageal Atresia a/o Tracheo-esophageal fistula 1. Embryology : The trachea and esophagus initially begin as a ventral divert

Femoral Hernias
Femoral hernias (FH) in the pediatric age are very rare accounting for less than 0.5% of all groin hernias in children. Children p

Fetal Abdominal Wall Defect
Fetal Abdominal Wall Defect : Most common abdominal wall defects (AWD) are gastroschisis, omphalocele and hernia of the umbilical

Fetal Intestinal Obstruction
Fetal Intestinal Obstruction : The fetal gastrointestinal tract (foregut, midgut and hindgut) undergoes ventral folding between 24

Foreign Body Ingestion
Accidental foreign body (FB) ingestion such as - coins, fish bones, toys plastic parts, jewels, batteries, safety pin, needle

Functional Constipation Management
MANAGEMENT OF CHILDRENWITH FUNCTIONAL CONSTIPATION The general approach to the child with functional constipation includes th

Gastric Anomalies
Congenital gastric outlet obstruction is extremely rare. It occurs either in the pyloric or antral region. Antral membranes (web o

Gastroschisis Omphalocele Causes
Causes: • Factors associated with high-risk pregnancies, such as maternal illness and infection, drug use, smoking, and

Gastroschisis Omphalocele Follow Up
Further Inpatient Care (gastroschisis omphalocele follow up): • Omphalocele o Babies with omphalocele usually have rap

Gastroschisis Omphalocele Medical Care
Medical Care: • Intestinal inflammation o Intestinal inflammation may occur with either gastroschisis or ruptured omp

Gastroschisis Omphalocele Wall Defects
Gastroschisis and omphalocele (abdominal wall defects, exomphalos, exumbilication) Gastroschisis and omphalocele are among the

Hepatic Cysts Parasitic Congenital
Hepatic cysts (HC) can be either parasitic (echinococcal) following infestation in endemic regions, acquired (after trauma or in

Hepatoblastoma In Childhood
Hepatoblastoma and hepatocellular carcinoma are the most common malignant tumor of liver. These represent about 2% of all malignan

Hepatocellular Carcinoma In Childhood
Hepatocellular carcinoma in childhood is histologically identical to hepatoma seen in the adult and is associated 50% of the time

Hereditary Spherocytosis
Hereditary spherocytosis is a clinically heterogenous autosomal dominant red blood cell membrane disorder that causes anemia. The

Hirschsprung Disease Bowel Obstruction
Hirschsprung disease : Hirschsprung disease is a disorder of the neuroenteric pathways within the distal large bowel that prevents

Hirschsprung Disease Diagnosis
Hirschsprung Disease Hirschsprung disease is the most common cause of lower intestinal obstruction in neonates and is a rare ca

Hirschsprungs Disease
Hirschsprung's Disease : Hirschsprung's is the congenital absence of parasympathetic innervation of the distal intestine. The co

Hydrocele
A hydrocele is a collection of fluid in the space surrounding the testicle between the layers of the tunica vaginalis. Hydroceles

Hydrocelectomy Hydrocele Repair
Hydrocelectomy, also known as hydrocele repair, is a surgical procedure performed to correct a hydrocele. A hydrocele is an accu

Hydrometrocolpos
Hydrometrocolpos (HMC) is accumulation of secretions in the vagina and uterus caused by one of two mechanisms: 1- excessive i

Hypospadias Meatus Urethra
Hypospadias - Definition Hypospadias is a congenital deformity where the opening of the urethra (the meatus) occurs on the unde

Hypospadias Repair Aftercare
The diagnosis of hypospadias in boys is often made at the time of delivery during the newborn examination. The condition may als

Hypospadias Repair Genital Surgery
Hypospadias repair refers to a group of surgical approaches used to correct or reconstruct parts of the external genitalia and uri

Imperforate Anus
Imperforate Anus : Embryology- Between 4-6 weeks, the cloaca becomes the common depository for the developing urinary, genital and

Inguinal Hernias
A hernia is defined as a protrusion of a portion of an organ or tissue through an abnormal opening. For groin (inguinal or femo

Intestinal Atresias
Intestinal atresias are the product of a late intrauterine mesenteric vascular accident (blood supply was not received by a port

Intraoperative Pain Management Newborn
INTRAOPERATIVE PAIN MANAGEMENT To a large extent, management of the surgical stress response in neonates can be accomplished wi

Intussusception
Although intussusception can occur at any age, the greatest incidence occurs in infants between 4-10 months of age. Over half o

Intussusception Reduction
Intussusception reduction Definition Intussusception is a condition in which one portion of the intestine telescopes into

Labial Adhesions In Infants
Labial Adhesions in Infants : Minor labial adhesions is a common pediatric gynecologic problem occasionally confused with imperfor

Lower Gastrointestinal Bleeding In Children
Lower gastrointestinal bleeding in children 1- Anal Fissure : Anal fissure is the most common cause of rectal bleeding in the f

Malrotation And Volvulus
Malrotation and Volvulus : Embryology: The rotation and normal fixation of the intestinal tract takes place within the first three

Meckels Diverticulectomy Meckels Diverticulum
Meckels diverticulectomy Definition Meckel’s diverticulectomy is a surgical procedure that isolates and removes an a

Meconium Ileus
Meconium ileus is a neonatal intraluminal intestinal obstruction caused by inspissated meconium blocking the distal ileum. Occu

Meconium Peritonitis
Meconium peritonitis (MP) is a chemical peritonitis that occurs following bowel perforation during fetal life. It is generally loo

Meconium Plug Syndrome
Meconium plug syndrome / Left hypoplastic colon syndrome : Colonic obstruction in the newborn child could be the result of necroti

Mediastinal Cysts
Mediastinal cysts identified in children are classified according to the compartment where they arise as: anterior (extends to the

Mixed Gonadal Dysgenesis
Mixed gonadal dysgenesis (MGD) is an intersexual genetic abnormality caused by a defect in the sex chromosomes (gonosomes) associ

Morgagni Hernias
Morgagni Hernias (MH) are rare congenital diaphragmatic defects close to the anterior midline between the costal and sternal origi

Müllerian Duct Syndrome
Müllerian Duct Syndrome (MDS) refers to a genetic disorder of male pseudohermaphroditism (46 XY karyotype) characterized by normal

Necrotizing Enterocolitis
Necrotizing enterocolitis (NEC) is the most common gastrointestinal medical and/or surgical emergency occurring in neonates. With

Necrotizing Enterocolitis Follow Up
Necrotizing Enterocolitis FOLLOW-UP Necrotizing Enterocolitis Further Inpatient Care: • Prolonged parenteral nutriti

Necrotizing Enterocolitis Imaging Studies
necrotizing enterocolitis imaging studies: • The mainstay of diagnostic imaging is abdominal radiography. An anteropost

Necrotizing Enterocolitis Lab Studies
Lab Studies of necrotizing enterocolitis: • Initial presentation usually includes subtle signs of feeding intolerance,

Necrotizing Enterocolitis Medical Care
Medical Care of necrotizing enterocolitis : • Diagnosis of NEC is based on clinical suspicion supported by findings on

Necrotizing Enterocolitis Medication
MEDICATION of necrotizing enterocolitis Pharmacologic therapy includes agents to treat the developing disease and those to pr

Necrotizing Enterocolitis Procedures
necrotizing enterocolitis procedures: • Upper GI (with or without) small bowel follow-through o This procedure is a

Necrotizing Enterocolitis Surgical Care
Surgical Care of necrotizing enterocolitis : Any patient requiring surgical intervention and many of those patients not progr

Neonatal Gastrointestinal Bleeding
A. Upper GI bleeding (Neonate) : Initially do an Apt test to determine if blood comes from fetal origin or maternal origin (blood

Neonatal Intestinal Obstruction
neonatal intestinal obstruction : Signs and Symptoms 1. Bilious vomiting is always abnormal. 2. Abdominal distention (scapho

Neuroblastoma Infancy Childhood Tumor
Neuroblastoma is the most common solid tumor of infancy and childhood. Most appear during the first five years of life; over hal

Newborn Postoperative Pain Control
Perioperative Pain Management in Newborns - neonatal analgesia, newborn postoperative pain control POSTOPERATIVE PAIN CONTROL:

Nocturnal Enuresis
Nocturnal enuresis : Nocturnal enuresis is a condition in which a person who has bladder control while awake urinates while asleep

Normal Sexual Differentiation
Normal sexual differentiation Sexual differentiation and gonadal development is determined by the sex chromosomes (XY male, X

Omphalocele Gastroschisis
Omphalocele and Gastroschisis : The three most common abdominal wall defect in newborns are umbilical hernia, gastroschisis and om

Omphalocele Repair
Omphalocele repair Definition An omphalocele is a congenital defect in which internal organs such as the liver, stomach, a

Orchiopexy Cryptorchidism Testicular Torsion
Cryptorchidism The diagnosis of cryptorchidism is usually made when a pediatrician examines the newborn baby, although the con

Orchiopexy Orchidopexy Undescended Testicle
Orchiopexy Definition : Orchiopexy is a procedure in which a surgeon fastens an undescended testicle inside the scrotum, usual

Ovarian Tumors In Children
Ovarian tumors are uncommon childhood malignancies (1%) characterized by recurrence and resistance to therapy. Aggressive surgery

Pancreatic Cysts
Pancreatic Cysts : Pancreatic cystic lesions are usually inflammatory pseudocyst (90%) or neoplastic process (10%). Distinguishi

Patent Urachus Repair
Patent urachus repair : Patent urachus repair is surgery to correct a urachus (a tube that connects the fetal bladder to the umbil

Pediatric Abdominal Emergencies
• Two principles apply to all visceral pain - Neurological mechanisms involved in visceral pain are different than t

Pediatric Concerns In Pediatric Surgery
Pediatric concerns in pediatric surgery : Pediatric concerns refers to those issues that are unique to the care of children when s

Pediatric Surgery
Pediatric surgery is a specialized field of surgery for the treatment of conditions that can be surgically corrected in a baby, ch

Pediatric Surgery 2
Congenital diaphragmatic hernia (CDH) CDH can be diagnosed by the fourth month of pregnancy via ultrasound studies. Of the inf

Pelviureteric Junction Obstruction
Pelviureteric junction (PUJ) obstruction Definition A blockage of the ureter at the junction with the renal pelvis resulting

Pneumatocele Pneumonia
A pneumatocele is a benign air-containing cyst in the lung most commonly the result of Staphylococcus Aureus pneumonia. Other less

Posterior Urethral Valves PUVs
Posterior urethral valves (PUVs) Definition Abnormal congenital mucosal folds in the prostatic (posterior) urethra causing l

Postoperative Pain Assessment Newborns
POSTOPERATIVE PAIN ASSESSMENT IN NEONATES One factor that has contributed to inadequate pain management in neonates has been

Postoperative Pain Control Opiates
POSTOPERATIVE PAIN CONTROL: OPIATES After appropriate pain assessment practices are established, the most formidable hindranc

Preoperative Pain Management Newborns
preoperative pain management in newborns : The practice of medicine has become progressively more sophisticated. Physicians can

Pyloric Stenosis
Pyloric Stenosis Is an abnormality of the pyloric musculature (hypertrophy) causing gastric outlet obstruction in early infancy.

Rectal Motility Studies Constipation
Rectal Motility Studies and Constipation : Constipation accounts for 10 to 25% of referrals to pediatric gastroenterologists. Whil

Recurrent Abdominal Pain Of Childhood
The generally accepted definition of this condition is three or more bouts of pain severe enough to affect activities (usually sch

Rhabdomyosarcoma
Rhabdomyosarcoma : Most common soft tissue sarcoma in infants and children and represents about 5-15% of all solid malignant lesio

Splenic Cysts In Children
Splenic cysts in children are either considered true epidermal (congenital), pseudocysts (post-traumatic), or infectious (echinoco

Splenic Trauma
Splenic Trauma : Spleen is the most common injured organ in blunt abdominal trauma. Hematologic and immunologic importance of the

Splenoptosis Wandering Spleen
Splenoptosis (Wandering spleen) is a rare congenital fusion anomaly of the dorsal mesogastrium of the spleen that results in fail

Spontaneous Pneumothorax
Spontaneous Pneumothorax : Most pneumothorax in children are the result of blunt/open chest trauma, mechanical ventilation (barotr

Surgical Response Of Newborns
Surgical Response of Newborns : The endocrine and metabolic response to surgical stress in newborns (Newborns) is characterized

Teratomas
Teratomas contains tissues derived from the three embryonic layers (endoderm, mesoderm, and ectoderm), found in a locus that does

Testicular Feminization Syndrome
Testicular feminization syndrome (TFS) is a genetic form of male pseudohermaphroditism (patient who is genetically 46 XY but has d

Thoracic Empyema
Thoracic Empyema (TE) is an infection (pus) of the pleural cavity. TE develops after complications of bacterial pneumonia (most co

Thyroglossal Duct Cysts
Thyroglossal Duct Cysts : Thyroglossal duct cyst (TDC) is the most common congenital anterior midline neck mass usually (2/3 of

Thyroid Cancer In Children
Thyroid Cancer : In spite of presenting with advanced, multicentric and larger tumors children have a better survival than adults.

Umbilical Hernias
Umbilical Hernias : Between the sixth and tenth gestational week, the developing gastrointestinal tract is partially extruded into

Undescended Testes
Undescended testes : The testes descend into the scrotum in the 3rd trimester (passing through the inguinal canal at 24 - 28 we

Undescended Testis
The undescended testis is a term we use to describe all instances in which the testis cannot be manually manipulated into the scro

Upper Gastrointestinal Bleeding In Children
In the initial evaluation a history should be obtained for bleeding disorders, skin lesions, and aspirin or steroid ingestion. The

Ureterocele
Ureterocele Definition A ureterocele is a cystic dilatation of the distal ureter as it drains into the bladder. Incid

Urinary Tract Infection
Urinary tract infection (UTI) Definitions : UTI is a bacterial infection of the urine (>105 colony-forming units/ml of

Vesicoureteric Reflux VUR
Vesicoureteric reflux (VUR) Definition : VUR results from abnormal retrograde flow of urine from the bladder into the upper

Wilms Tumor
Wilms Tumor : This is the most common solid intra-abdominal tumor (malignant) in children. It affects 450-500 children annually