PAEDIATRIC SURGERYAn Overview

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• General Considerations:

• * Most problems encountered are in the form of congenital

anomalies, however, the pediatric age group are also liable for the common surgical diseases and trauma.

• *Delicate ,careful and professional interactions with their parents are

required.

• *Children are not like adults,they have unique fluids, electrolytes and medications needs all based on body weight.

• *Children with surgical conditions can deteriorate very rapidly, careful

attention to their physical findings and vital signs is required.

• *Always listen to the parents.

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Head and neck swellings:

• Please refer to the lecture given earlier, in children we add thymic

cyst to the differential diagnosis of midline swellings and definitely children will not have carotid body tumors.

• Again, remember that the commonist swelling in this age group is

also an enlarged L.N

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• Congenital diaphragmatic hernia:

• Bochdalic hernia

- Posterolateral

- hypoplastic lung

- diagnosed prenatally by USS

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GIT Anomalies:

• Approach to the vomiting infant:

It is important to differentiate between normal and abnormal vomiting.

1. What the vomit looks like?.

2. How sick is the baby. Generally:

• Vomit that looks like feeds and come immediately after feeding is almost always gastroesophageal reflux.

• * vomit that occurs a short while after feed and is projectile is due to pyloric stenosis.

• * Vomit that has any green colour is always worrisome.

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Oesophageal Atresia

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Pyloric Stenosis

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Duodenal Atresia

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Annular Pancreas

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Gastroschesis

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Biliary Atresia

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Intussusception

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• Meckles Diverticulum:

A true diverticulum

Rule of two's:

2% of population

2 feet ( 60 Cms)from the iliocecal valve

2 inches ( 5 Cms ) long

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• Complications of Meckles diverticulum:

1.Inflamation (diverticulitis)

2. Perforation

3. Obstruction

Reminant band

Leading point for intussusception.

4. Lower GI bleeding (heterogeneous gastric mucosa).

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Imperforated Anus

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Invertogram

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Undescended Testes

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Torsion Undescended Testes

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Torsion Testes

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Hernia

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Milroy's Disease

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Cystic Hygroma

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Wilms Tumour

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