Abdominal Masses In Neonatal PeriodAbdominal Masses in the Neonatal Period : The discovery of an abdominal mass on
physical examination in the newborn period cause
Achalasia In Children Babies Kidsachalasia in children babies kids : Achalasia in children is an uncommon
esophageal motor disorder distinguished by clinical, ra
Acute Abdominal Pain In ChildrenAcute abdominal pain in children presents a diagnostic dilemma. Although many
cases of acute abdominal pain are benign, some req
Acute PancreatitisAcute pancreatitis (AP) is unusual in the pediatric patient, can affect all age groups and should be considered in children presen
Adrenal HemorrhageAdrenal Hemorrhage : Retroperitoneal adrenal Hemorrhage usually occurs at birth or during the first postnatal days the result
of
Annular Pancreas DivisumAnnular Pancreas / Pancreas Divisum : The pancreas develops from an anterior and posterior anlage of the foregut early during gest
Anorectal Malformations Baby HealthAnorectal malformations are birth defects (problems that happen as a fetus is developing during pregnancy). With this defect, the
Appendicitis AppendectomyAppendicitis Included in this group because is caused by obstruction of the appendiceal lumen, most commonly by fecaliths. When ob
Appendicitis Appendix Surgery TreatmentAppendicitis is an irritation, inflammation, and infection of the appendix (a narrow, hollow tube that branches off the large inte
Asplenia Absence Of The SpleenThe absence of the spleen (asplenia) occurs after surgical removal, following chronic conditions or congenital. Trauma is the most
Biliary Atresia Kasai PortoenterostomyBiliary Atresia : Persistent conjugated hyperbilirubinemia (greater than 20% of total or 1.5 mg%) should be urgently evaluated. In
Biliary Hypoplasia In ChildrenBiliary hypoplasia is a rare cause of persistent neonatal conjugated hyperbilirubinemia. Pathologically, affected children have ab
Bladder ExstrophyExstrophy Bladder exstrophy results from defective development of the anterior bladder and lower abdominal walls, leaving the p
Branchial Cleft FistulasBranchial Cleft Fistulas : Branchial cleft fistulas (BCF) originate from the 1st
to 3rd branchial apparatus during embryogenesis
Breast Disorders In ChildrenMost breast disorders in children of either sex are benign. Congenital lesions are: absent or multiple
breast. Transplacental hor
Bronchogenic CystsBronchogenic cysts (BC), first described in 1911, are benign congenital lesions of the respiratory tract that have the potential t
Burkitts LymphomaBurkitt's lymphoma (BL) is a highly malignant tumor first described during the late 50's in African children (jaw), endemic in nat
Burns In ChildrenBurns make a significant contribution to paediatric hospital admissions; in 1 year, around 50,000 such patients attended accident
Cat Scratch DiseaseCat Scratch Disease : Cat Scratch Disease (CSD) is a self-limited condition
transmitted by a Bartonella species (Rochalimaea hen
Cervical LymphadenopathyCervical Lymphadenopathy : An enlarged lymph node is the most common neck mass in children. Most are anterior to the sternocleidom
Child Constipation Abdominal RadiographAbdominal Radiograph and Transit Time An abdominal radiograph is not
indicated to establish the presence of a fecal impaction
Choledochal CystCholedochal cyst is a rare dilatation of the common bile duct, prevalent in oriental patients (Japan), where >60% of patients a
Cholelithiasis CholecystitisWith the increase use of sonography in the work-up of abdominal pain, cholelithiasis is diagnosed more frequent in children. Galls
Chylothorax Effusion Of LymphChylothorax : Effusion of lymph (chyle) into the pleural cavity is known as chylothorax. Chyle is clear-milky fluid with an elevat
Congenital Adrenal HyperplasiaCongenital adrenal hyperplasia (CAH) involves a functional defect in any of the five enzymatic steps required for cortisol synthes
Congenital Diaphragmatic Hernia BochdalekCongenital Diaphragmatic Hernia (Bochdalek) : The most common congenital diaphragmatic hernia (CDH) is that which occurs through t
Congenital Diaphragmatic Hernia Repaircongenital diaphragmatic hernia repair -
surgery - surgical care: • Postnatal repair o Until recently, specialists be
Congenital Epigastric DefectsCongenital epigastric defects occur anywhere in the linea alba from the navel to the xiphoid process. They represent almost 5% of
Congenital TorticollisCongenital Torticollis : Congenital muscular torticollis is a disorder
characterize by shortening of the cervical muscles, most
Cystic Adenomatoid MalformationCongenital cystic adenomatoid malformation is a lung bud lesion characterize by dysplasia of respiratory epithelium caused by over
Cystic HygromaCystic Hygroma : Cystic hygroma (CH) is an uncommon congenital lesion of the lymphatic system appearing as a multilocular fluid fi
Duodenal MalformationsDuodenal Malformations Can be intrinsic (Atresia, Stenosis, Webs) or extrinsic (Annular pancreas, Ladd's bands). Occur distal or p
Ectopic UreterEctopic ureter Definition : The ureteric orifice is situated below the normal anatomical insertion on the trigone of the bla
EpispadiasEpispadias In epispadias, the urethra opens onto the dorsal surface of the penis, anywhere from the glans, penile shaft, or, mo
Esophageal Atresia Tracheoesophageal FistulaEsophageal Atresia a/o Tracheo-esophageal fistula 1. Embryology : The trachea and esophagus initially begin as a ventral divert
Femoral HerniasFemoral 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 DefectFetal Abdominal Wall Defect : Most common abdominal wall defects (AWD) are gastroschisis, omphalocele and hernia of the umbilical
Fetal Intestinal ObstructionFetal Intestinal Obstruction : The fetal gastrointestinal tract (foregut, midgut and hindgut) undergoes ventral folding between 24
Foreign Body IngestionAccidental foreign body (FB) ingestion such as - coins, fish bones, toys plastic
parts, jewels, batteries, safety pin, needle
Functional Constipation ManagementMANAGEMENT OF CHILDRENWITH FUNCTIONAL CONSTIPATION The general approach to
the child with functional constipation includes th
Gastric AnomaliesCongenital gastric outlet obstruction is extremely rare. It occurs either in the pyloric or antral region. Antral membranes (web o
Gastroschisis Omphalocele CausesCauses: • Factors associated with high-risk pregnancies, such as maternal
illness and infection, drug use, smoking, and
Gastroschisis Omphalocele Follow UpFurther Inpatient Care (gastroschisis omphalocele follow up): • Omphalocele o Babies with omphalocele usually have rap
Gastroschisis Omphalocele Medical CareMedical Care: • Intestinal inflammation o Intestinal inflammation may occur with either gastroschisis or ruptured omp
Gastroschisis Omphalocele Wall DefectsGastroschisis and omphalocele (abdominal wall defects, exomphalos, exumbilication) Gastroschisis and omphalocele are among the
Hepatic Cysts Parasitic CongenitalHepatic cysts (HC) can be either parasitic (echinococcal) following infestation
in endemic regions, acquired (after trauma or in
Hepatoblastoma In ChildhoodHepatoblastoma and hepatocellular carcinoma are the most common malignant tumor of liver. These represent about 2% of all malignan
Hepatocellular Carcinoma In ChildhoodHepatocellular carcinoma in childhood is histologically identical to hepatoma seen in the adult and is associated 50% of the time
Hereditary SpherocytosisHereditary spherocytosis is a clinically heterogenous autosomal dominant red blood cell membrane
disorder that causes anemia. The
Hirschsprung Disease Bowel ObstructionHirschsprung disease : Hirschsprung disease is a disorder of the neuroenteric pathways within the distal large bowel that prevents
Hirschsprung Disease DiagnosisHirschsprung Disease Hirschsprung disease is the most common cause of lower intestinal obstruction in neonates and is a rare ca
Hirschsprungs DiseaseHirschsprung's Disease : Hirschsprung's is the congenital absence of
parasympathetic innervation of the distal intestine. The co
HydroceleA hydrocele is a collection of fluid in the space surrounding the testicle between the layers of the tunica vaginalis. Hydroceles
Hydrocelectomy Hydrocele RepairHydrocelectomy, also known as hydrocele repair, is a surgical procedure
performed to correct a hydrocele. A hydrocele is an accu
HydrometrocolposHydrometrocolpos (HMC) is accumulation of secretions in the vagina and uterus
caused by one of two mechanisms: 1- excessive i
Hypospadias Meatus UrethraHypospadias - Definition Hypospadias is a congenital deformity where the opening of the urethra (the meatus) occurs on the unde
Hypospadias Repair AftercareThe
diagnosis of hypospadias in boys is often made at the time of delivery
during the newborn examination. The condition may als
Hypospadias Repair Genital SurgeryHypospadias repair refers to a group of surgical approaches used to correct or reconstruct parts of the external genitalia and uri
Imperforate AnusImperforate Anus : Embryology- Between 4-6 weeks, the cloaca becomes the common depository for the developing urinary, genital and
Inguinal HerniasA hernia is defined as a protrusion of a portion of an organ or tissue through an abnormal opening. For groin (inguinal or femo
Intestinal AtresiasIntestinal atresias are the product of a late intrauterine mesenteric vascular
accident (blood supply was not received by a port
Intraoperative Pain Management NewbornINTRAOPERATIVE PAIN MANAGEMENT To a large extent, management of the surgical stress response in neonates can be accomplished wi
IntussusceptionAlthough intussusception can occur at any age, the greatest incidence occurs in infants between 4-10 months of age. Over half o
Intussusception ReductionIntussusception reduction Definition Intussusception is a condition in which one portion of the intestine telescopes into
Labial Adhesions In InfantsLabial Adhesions in Infants : Minor labial adhesions is a common pediatric gynecologic problem occasionally confused with imperfor
Lower Gastrointestinal Bleeding In ChildrenLower gastrointestinal bleeding in children 1- Anal Fissure : Anal fissure is the most common cause of rectal bleeding in the f
Malrotation And VolvulusMalrotation and Volvulus : Embryology: The rotation and normal fixation of the intestinal tract takes place within the first three
Meckels Diverticulectomy Meckels DiverticulumMeckels diverticulectomy Definition Meckel’s diverticulectomy is a surgical procedure that isolates and removes an a
Meconium IleusMeconium ileus is a neonatal intraluminal intestinal obstruction caused by inspissated meconium blocking the distal ileum. Occu
Meconium PeritonitisMeconium peritonitis (MP) is a chemical peritonitis that occurs following bowel perforation during fetal life. It is generally loo
Meconium Plug SyndromeMeconium plug syndrome / Left hypoplastic colon syndrome : Colonic obstruction in the newborn child could be the result of necroti
Mediastinal CystsMediastinal cysts identified in children are classified according to the compartment where they arise as: anterior (extends to the
Mixed Gonadal DysgenesisMixed gonadal dysgenesis (MGD) is an intersexual genetic abnormality caused by a defect in the sex
chromosomes (gonosomes) associ
Morgagni HerniasMorgagni Hernias (MH) are rare congenital diaphragmatic defects close to the anterior midline between the costal and sternal origi
Müllerian Duct SyndromeMüllerian Duct Syndrome (MDS) refers to a genetic disorder of male pseudohermaphroditism (46 XY karyotype) characterized by normal
Necrotizing EnterocolitisNecrotizing enterocolitis (NEC) is the most common gastrointestinal
medical and/or surgical emergency occurring in neonates. With
Necrotizing Enterocolitis Follow UpNecrotizing Enterocolitis FOLLOW-UP Necrotizing Enterocolitis Further
Inpatient Care: • Prolonged parenteral nutriti
Necrotizing Enterocolitis Imaging Studiesnecrotizing enterocolitis imaging studies: • The mainstay of diagnostic
imaging is abdominal radiography. An anteropost
Necrotizing Enterocolitis Lab StudiesLab Studies of necrotizing enterocolitis: • Initial presentation usually
includes subtle signs of feeding intolerance,
Necrotizing Enterocolitis Medical CareMedical Care of necrotizing enterocolitis : • Diagnosis of NEC is based on
clinical suspicion supported by findings on
Necrotizing Enterocolitis MedicationMEDICATION of necrotizing enterocolitis Pharmacologic therapy includes agents
to treat the developing disease and those to pr
Necrotizing Enterocolitis Proceduresnecrotizing enterocolitis procedures: • Upper GI (with or without) small
bowel follow-through o This procedure is a
Necrotizing Enterocolitis Surgical CareSurgical Care of necrotizing enterocolitis : Any patient requiring surgical
intervention and many of those patients not progr
Neonatal Gastrointestinal BleedingA. Upper GI bleeding (Neonate) : Initially do an Apt test to determine if blood comes from fetal origin or maternal origin (blood
Neonatal Intestinal Obstructionneonatal intestinal obstruction : Signs and Symptoms 1. Bilious vomiting is always abnormal. 2. Abdominal distention (scapho
Neuroblastoma Infancy Childhood TumorNeuroblastoma is the most common solid tumor of infancy and childhood. Most
appear during the first five years of life; over hal
Newborn Postoperative Pain ControlPerioperative Pain Management in Newborns - neonatal analgesia, newborn postoperative pain control POSTOPERATIVE PAIN CONTROL:
Nocturnal EnuresisNocturnal enuresis : Nocturnal enuresis is a condition in which a person who has bladder control while awake urinates while asleep
Normal Sexual DifferentiationNormal sexual differentiation Sexual differentiation and gonadal development
is determined by the sex chromosomes (XY male, X
Omphalocele GastroschisisOmphalocele and Gastroschisis : The three most common abdominal wall defect in newborns are umbilical hernia, gastroschisis and om
Omphalocele RepairOmphalocele repair Definition An omphalocele is a congenital defect in which internal organs such as the liver, stomach, a
Orchiopexy Cryptorchidism Testicular TorsionCryptorchidism The
diagnosis of cryptorchidism is usually made when a pediatrician examines the newborn baby, although the con
Orchiopexy Orchidopexy Undescended TesticleOrchiopexy Definition : Orchiopexy is a procedure in which a surgeon fastens an undescended testicle inside the scrotum, usual
Ovarian Tumors In ChildrenOvarian tumors are uncommon childhood malignancies (1%) characterized by recurrence and resistance to therapy. Aggressive
surgery
Pancreatic CystsPancreatic Cysts : Pancreatic cystic lesions are usually inflammatory pseudocyst
(90%) or neoplastic process (10%). Distinguishi
Patent Urachus RepairPatent 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 SurgeryPediatric concerns in pediatric
surgery : Pediatric concerns refers to those issues that are unique to the care of children when s
Pediatric SurgeryPediatric
surgery is a specialized field of
surgery for the
treatment of conditions that can be surgically corrected in a baby, ch
Pediatric Surgery 2Congenital diaphragmatic hernia (CDH) CDH can be diagnosed by the fourth month of pregnancy via ultrasound studies. Of the inf
Pelviureteric Junction ObstructionPelviureteric junction (PUJ) obstruction Definition A blockage of the ureter at the junction with the renal pelvis resulting
Pneumatocele PneumoniaA pneumatocele is a benign air-containing cyst in the lung most commonly the result of Staphylococcus Aureus pneumonia. Other less
Posterior Urethral Valves PUVsPosterior urethral valves (PUVs) Definition Abnormal congenital mucosal folds in the prostatic (posterior) urethra causing l
Postoperative Pain Assessment NewbornsPOSTOPERATIVE PAIN ASSESSMENT IN NEONATES One factor that has contributed
to inadequate pain management in neonates has been
Postoperative Pain Control OpiatesPOSTOPERATIVE PAIN CONTROL: OPIATES After appropriate pain assessment
practices are established, the most formidable hindranc
Preoperative Pain Management Newbornspreoperative pain management in newborns : The practice of
medicine has become progressively more sophisticated. Physicians can
Pyloric StenosisPyloric Stenosis Is an abnormality of the pyloric musculature (hypertrophy)
causing gastric outlet obstruction in early infancy.
Rectal Motility Studies ConstipationRectal Motility Studies and Constipation : Constipation accounts for 10 to 25% of referrals to pediatric gastroenterologists. Whil
Recurrent Abdominal Pain Of ChildhoodThe generally accepted definition of this condition is three or more bouts of pain severe enough to affect activities (usually sch
RhabdomyosarcomaRhabdomyosarcoma : Most common soft tissue sarcoma in infants and children and represents about 5-15% of all solid malignant lesio
Splenic Cysts In ChildrenSplenic cysts in children are either considered true epidermal (congenital), pseudocysts (post-traumatic), or infectious (echinoco
Splenic TraumaSplenic Trauma : Spleen is the most common injured organ in blunt abdominal trauma. Hematologic and immunologic
importance of the
Splenoptosis Wandering SpleenSplenoptosis (Wandering spleen) is a rare congenital fusion anomaly of the dorsal mesogastrium of
the spleen that results in fail
Spontaneous PneumothoraxSpontaneous Pneumothorax : Most pneumothorax in children are the result of blunt/open chest trauma, mechanical ventilation (barotr
Surgical Response Of NewbornsSurgical Response of Newborns : The endocrine and metabolic response to surgical
stress in newborns (Newborns) is characterized
TeratomasTeratomas contains tissues derived from the three embryonic layers (endoderm, mesoderm, and ectoderm), found in a locus that does
Testicular Feminization SyndromeTesticular feminization syndrome (TFS) is a genetic form of male pseudohermaphroditism (patient who is genetically 46 XY but has d
Thoracic EmpyemaThoracic Empyema (TE) is an infection (pus) of the pleural cavity. TE develops after complications of bacterial pneumonia (most co
Thyroglossal Duct CystsThyroglossal Duct Cysts : Thyroglossal duct cyst (TDC) is the most common
congenital anterior midline neck mass usually (2/3 of
Thyroid Cancer In ChildrenThyroid Cancer : In spite of presenting with advanced, multicentric and larger tumors children have a better survival than adults.
Umbilical HerniasUmbilical Hernias : Between the sixth and tenth gestational week, the developing gastrointestinal tract is partially extruded into
Undescended TestesUndescended testes : The testes descend into the scrotum in the 3rd trimester (passing through the inguinal canal at 24 - 28 we
Undescended TestisThe 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 ChildrenIn the initial evaluation a history should be obtained for bleeding disorders, skin lesions, and aspirin or steroid ingestion. The
UreteroceleUreterocele Definition A ureterocele is a cystic dilatation of the distal ureter as it drains into the bladder. Incid
Urinary Tract InfectionUrinary 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 TumorWilms Tumor : This is the most common solid intra-abdominal tumor (malignant) in
children. It affects 450-500 children annually