Pediatric Surgery Digest (eBook)

Preface 5
Synopsis 7
Contents 8
Contributors 19
PART I INTRODUCTION 27
Introduction 28
1.1 What is Pediatric Surgery? 28
1.2 Timing of Operations in Pediatric Surgical Patients 30
1.3 Preoperative Management 31
1.4 The Newborn as a Pediatric Surgical Patient 33
PART II GENERAL CONSIDERATIONS 37
Enteral/ Parenteral Nutrition in Infants and Children 38
2.1 Nutrition of the Newborn 38
2.2 Vascular Access in Infants and Children 44
2.3 Parenteral Nutrition 52
2.4 Dehydration/ Rehydration 60
2.5 Antibiotics 67
3.1 Systemic Infections in Newborns 75
Emergencies/ Resuscitation 75
3.2 Shock 76
3.3 Hypoglycemia 82
3.4 Acid– Base Balance 83
3.5 Resuscitation 86
3.6 Ventilation 97
3.7 Circulatory Resuscitation 103
3.8 Defibrillation 106
4.1 Blood Transfusion 108
Blood/ Blood Products Transfusion 108
4.2 Platelet Transfusion 111
4.3 Fresh Frozen Plasma Transfusion 111
5.1 WHO Grades for Analgesia 112
Pain Management 112
6.1 General Considerations 114
Wounds/ Surgical Techniques 114
6.2 Wound Healing 115
6.3 Common Types of Surgical Incisions 117
6.4 Skin Flaps 120
6.5 Skin Grafts 122
6.6 Surgical Sutures 123
7.1 General Considerations 138
Minimal Invasive Surgery Principles 138
7.2 Instrumentation 140
7.3 Indications 141
7.4 Ergonomics 143
8.1 General Considerations 145
Imaging in Pediatric Surgery 145
8.2 Common Radiographic Images 146
8.3 Nomograms for Organ Size 155
8.4 Conventional X- rays 159
8.5 Ultrasonography 161
9.1 General Considerations 167
Expert Opinion 167
9.2 Examination of the Musculoskeletal Apparatus 168
9.3 Anthropometric Measures 170
10.1 The Polytraumatized Child 185
Special Situations 185
10.2 Child Abuse 191
11.1 Skull 198
Birth Trauma 198
11.2 Extremities 199
12.1 Congenital Osteocutaneous Defect 201
12.2 Encephalocele 201
Skull 201
12.3 Hydrocephalus 203
12.4 Craniosynostosis 207
12.5 Brain Injuries 209
12.6 Skull Fractures 213
13.1 Spina Bifida/ Meningocele/ Myelomeningocele 215
Spinal Column 215
14.1 Oral Cavity 220
Face 220
14.2 Face 222
15.1 Median and Lateral Neck Masses 231
Neck 231
15.2 Congenital Malformations 232
15.3 Infections 237
16.1 General Considerations 243
Thorax 243
16.2 Chest Wall 257
16.3 Pleura and Pleural Cavity 275
16.4 Laryngotracheal Lesions 284
16.5 Lung 291
16.6 Mediastinum 317
17.1 Diaphragmatic Hernia 320
Diaphragm 320
17.2 Fetoscopic Approach ( FETENDO) 325
17.3 Extracorporeal Membrane Oxygenation 326
17.4 Diaphragmatic Eventration 327
17.5 Gastroesophageal Reflux/ Paraesophageal Hernia 329
17.6 Traumatic Diaphragm Rupture 336
18.1 Esophageal Stenosis 338
Esophagus 338
18.2 Corrosive Esophagitis 342

18.3 Achalasia 345
18.4 Esophageal Atresia 348
18.5 Esophagotracheal H- Fistulas 362
18.6 Esophageal Dilatation 364
18.7 Esophageal Varices 364
19.1 Umbilical Hernia 367
Abdominal Wall 367
19.2 Supraumbilical Hernia 369
19.3 Omphaloenteric Duct 371
19.4 Urachal Cysts/ Urachal Fistulas 373
19.5 Inguinal Hernia 375
19.6 Femoral Hernia 379
19.7 Other Types of Hernias 381
19.8 Hydrocele 381
19.9 Omphalocele ( Exomphalos) 383
19.10 Laparoschisis (Gastroschisis) 388
20.1 Principles of Abdominal Surgery 393
20.2 Organ Anatomy 393
Abdomen 393
20.3 Anatomical Abdominal Particularities in Children 398
20.4 Abdominal Incisions 398
20.5 Common Bowel Surgical Techniques 400
21.1 Infantile Hypertrophic Pyloric Stenosis 403
Stomach and Duodenum 403
21.2 Gastrostomy 407
21.3 Duodenal Atresia and Stenosis 412
22.1 Jejunoileal/ Colonic Atresia 418
Intestinal Congenital Malformations 418
22.2 Malrotation/ Ladd’s Bands 424
22.3 Intestinal Volvulus 429
22.4 Duplications of the Gastrointestinal Tract 430
22.5 Stoma Complications 435
22.6 Short Bowel Syndrome 436
PART III SPECIFIC DISEASES 442
Intestinal Diseases 443
23.1 Meconium Ileus 443
23.2 Necrotizing Enterocolitis 449
23.3 Meckel’s Diverticulum 451
23.4 Intussusception 453
23.5 Appendicitis 457
24.1 Bowel Washout 463
Anorectal Diseases 463
24.2 Chronic Constipation 464
24.3 Anorectal Manometry 469
24.4 Rectal/ Colonic Biopsy 470
24.5 Hirschsprung’s Disease 472
24.6 Allied Hirschsprung’s Disease 484
24.7 Anorectal Malformations 486
24.8 Anal Fissures 506
24.9 Anal Fistulas 508
24.10 Rectal Prolapse 510
24.11 Colonoscopy 511
24.12 Large Bowel Polyps 513
25.1 Ulcerative Colitis 515
Inflammatory Bowel Diseases 515
25.2 Crohn’s Disease 520
Blunt Abdominal Trauma 523
27.1 Nesidioblastosis/ Congenital Hyperinsulinism 527
Liver and Pancreas 527
27.2 Congenital Biliary Atresia 531
27.3 Choledochal Cyst 537
27.4 Cholelithiasis 541
27.5 Parasitic Liver Cysts 545
27.6 Nonparasitic Liver Cysts 547
27.7 Benign Liver Tumors 548
27.8 Liver Transplantation 551
28.1 Pediatric Tumor Patients 553
Pediatric Surgical Oncology 553
28.2 Hemangioma/ Vascular Malformations 557
28.3 Lymphangioma/ Cystic Neck Hygroma 560
28.4 Lymphoma 564
28.5 Neuroblastoma 566
28.6 Sacrococcygeal Teratoma 575
28.7 Lung Tumors 578
28.8 Parasitic Lung Tumors 580
28.9 Mediastinal Tumors 582
28.10 Malignant Liver Tumors 584
28.11 Nephroblastoma 591
28.12 Ovarian Tumors 604
28.13 Testicular Tumors 606
28.14 Soft Tissue Sarcomas 608
28.15 Rhabdomyosarcoma 609
28.16 Ewing’s Sarcoma 612
28.17 Osteosarcoma 614
29.1 General Considerations 616
Urogenital Tract 616
29.2 Organ Anatomy 617
29.3 Vascular Anatomy 619
29.4 Development of the Genital Organs in Puberty 621
29.5 Pathophysiology 622
29.6 Principles of Pediatric Urology 623
30.1 Phimosis/ Paraphimosis 625
Penis 625
30.2 Hypospadias 628
31.1 Cryptorchidism 651
Testicles 651
31.2 Testicular Torsion 658
31.3 Testicular Appendages Torsion 661
31.4 Varicocele 662
32.1 Labial Synechiae 667
Vagina and External Female Genitalia 667
32.2 Hymeneal Atresia 668
Ovarian Cysts 669
34.1 Urinary Tract Infection 671
Kidney and Bladder 671
34.2 Vesicoureteral Reflux 672
34.3 Ureterovesical Junction Obstruction/ Megaureter 678
34.4 Ureteric Duplication 680
34.5 Ureteropelvic Junction Obstruction/ Hydronephrosis 684
34.6 Cutaneous Ureterostomy 687
34.7 Posterior Urethral Valves 689
34.8 Bladder Exstrophy 692
34.9 Bladder Augmentation 698
34.10 Mitrofanoff Procedure 699
34.11 Intersex 701
34.12 Renal Malformations 706
34.13 Nephrolithiasis 707
34.14 Urinary Incontinence 709
34.15 Bladder Rupture 712
34.16 Urethral Injuries 714
Kidney Insufficiency 716
36.1 Pigmented Nevi 720
Skin and Soft Tissues 720
36.2 Dermoid Cysts 721
36.3 Lymphadenitis 722
36.4 Burns 723
37.1 Trigger Thumb 729
Osteoarticular System 729
37.2 Polydactyly 730
37.3 Syndactyly 731
37.4 Hand Trauma Treatment 732
37.5 Ganglions/ Baker’s Cyst 735
37.6 Congenital Hip Dislocation 736
37.7 Osteomyelitis 738
38.1 General Considerations 742
Skeletal System 742
38.2 Classification 743
38.3 Skeleton Standard and Special X- rays 754
38.4 Development of Ossification Centers 757
38.5 Plaster Immobilization 760
38.6 Therapy Principles 762
38.7 Spinal Injuries 769
38.8 Sling- Shot Injury of the Cervical Spine 771
38.9 Pectoral Girdle and Clavicle 772
38.10 Humeral Fractures 773
38.11 Elbow Joint Region Fractures 776
38.12 Forearm Fractures 783
38.13 Wrist and Hand Fractures 786
38.14 Pelvic Ring Fractures 788
38.15 Lower Limb Fractures 791
38.16 Distal Femur and Proximal Tibia Fractures 795
38.17 Patella Fractures and Dislocations 798
38.18 Tibial Shaft Fractures 800
38.19 Distal Tibia and Ankle Joint Fractures 801
38.20 Foot Fractures 806
PART IV APPENDICES 808
Embryology 809
39.1 Embryological Organ Development 809
39.2 Fetal Circulation 809
39.3 Newborn Icterus 809
39.4 Segmental Innervation 812
Vaccination 813
40.1 Vaccines 813
40.2 Rabies Vaccination 813
Notifiable Infectious Diseases 816
Fever Types 820
Catheter Size 822
Reference Values 825
Commonly Used Pharmaceuticals 844
Syndromes 859
List of Figure Sources 865
Subject Index 869