Common paediatric surgical diseases

Common Pediatric Surgical

Diseases

Dr. Ali M AhmadMBBCh, MS, MD, MRCS-Ed, EBPS

Associate Pediatric Surgery; KAAUH_ PNU

Newly deliver FT Baby with excessive salivation

Case Nu 01

THINK VACTERL!

• What is your diagnosis?• What maneuver could be used to establish the Diagnosis?

•Echocardiography•Renal US

• If a distal fistula is present {why there is urgency?}

• If isolated atresia {what is the your plan?}

What are the different

surgical approach ?

Case Nu 02

Full term, 3-week old boy Non bilious projectile vomiting Hungry to feed after vomiting Few wet nappies lost weight

Visible peristaltic

Case Nu 02

What Is Your Differential Diagnosis?

A. Medical causes: GERD, GE, increased intracranial pressure, and metabolic disorders.

B. Surgical causes: HPS, Antral web, Foregut duplication cyst, Gastric tumors, or a Tumor causing extrinsic gastric compression

Case Nu 02

>15mm

> 3 mm

Abd US

What investigation could be used to establish the Diagnosis?

What is the metabolic disturbances ? hypochloraemic, hyponatraemic, hypokalaemic

metabolic alkalosis

What your approach for management? Correction of electrolyte abnormality followed by

Ramstedt Pyloromyotomy

Neonatal intestinal obstruction

1.Abdominal distension2.bile-stained vomiting3.Not pass Meconium

Volvulus neonatorumDuodenal obstruction

Small bowel atresiaNeonatal necrotizing EnterocolitisMeconium ileus

Hirschsprung's disease Duplications of the alimentary tract

Bile-stained vomiting in a normal baby

Is Surgical

until prove otherwise

Midgut Malrotation / Volvulus

Must be excluded

Case Nu 03

Newborn @ bile-stained vomiting

{Polyhydramnios}

Down syndrome in about 30% of cases

Duodeno - duodenostomy

What is your diagnosis

Good intestine + Bad Baby

Bad intestine+ Good Baby

Omphalocele. Gastroschisis

What is thissilo

A newborn baby develops

Abdominal distensionbile-stained vomitingNot pass Meconium

Small bowel atresia

What is your diagnosis

18

What you know about other management ?

What is your diagnosis

What is your diagnosis

What is common site of anal fissure – what you think?

What is your diagnosis

Extensive NEC

Small left colon syndrome.

What is your diagnosis

2 weeks-old female

diabetic mother

Meckle's diverticulum

What is this study

26

Simple wedge resection of the Meckel’s diverticulum.

If bleeding has been a problem it is important to resect the adjacent distal ileum to ensure that the bleeding point/ulcer is included in the resection.

What other presentation ?

What is this study

What is your diagnosis

What is the name of this procedure

Unilateral Frog-Leg Maneuver

Remember to remove diaper

Remember to remove diaper

MCQs

A- Metabolic acidosis with compensatory respiratory alkalosis.

B- Is commoner in females than males.

C- Produces bilious vomiting in premature babies.

D- Can usually be diagnosed on clinical examination alone.

E- Can be demonstrated by ultrasound abdomen.

Congenital hypertrophic pyloric stenosis

D& E

A - A preliminary gastrostomy can be fashioned prior to thoracotomy and reconstitution of esophageal continuity.

B- A concomitant duodenal atresia can be seen as a double bubble on abdominal X-ray.

C - Maternal polyhydramnios may prompt early neonatal investigation.

D - Gastrografin swallow is required for confirmatory diagnosis.

E - Concomitant cardiac anomalies should be considered.

Esophageal Atresia Without TEF

A, C &E

A - commonest reason for emergency abdominal surgery.

B - Requires serological investigation in all cases prior to operation.

C- Should be managed with pre-operative analgesia.

D- Requires only one dose of pre-op antibiotic for prophylaxis against wound infection.

E- Is often distinguished from non-surgical causes of abdominal pain by repeated clinical examination alone.

Childhood appendicitis

All except B

Common Pediatric Surgical

Diseases

Dr. Ali M AhmadMBBCh, MS, MD, MRCS-Ed, EBPS

Associate Pediatric Surgery; KAAUH_ PNU

THANK YOU