Table of Contents
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PREFACE
List of Contributors
Physiology of the Newborn
Abstract
PHYSIOLOGY OF NEWBORN
Hypoglycaemia
Hyperglycemias
Calcium
Magnesium
Blood volume
Haemoglobin
Polycythemia
Anemia
Haemolytic Anemia
Hemorrhagic Anemia
Anemia of Prematurity
Jaundice
Retinopathy of Prematurity
Fluids and Electrolytes
Shock
Hypovolemic Shock
Cardiogenic Shock
Distributive Shock
Septic Shock
Anesthetic Considerations for Paediatric Surgical Conditions
Preoperative Anesthesia Evaluation
General Principles
Patient History
Miscellaneous Conditions
Malignant Hyperthermia Susceptibility
Treatment of Malignant Hyperthermia Crisis
Trisomy 21
Preoperative Fasting Guideline
Laboratory Tests
Post Anaesthetic Apnea
Anterior Meditational Mass
Endocarditic Prophylaxis
Special Issues in Patients with Congenital Heart Disease
Pulmonary Hypertension
Cyanosis and Polycythemia
The Difficult Pediatric Airway
Post Anesthesia Care
Common Postanestheia Problems
Postoperative Nausea and Vomiting
Respiratory Complications
Intraoperative Awareness
Pain Management
Opioid
Nonsteroidal Anti-Inflammatory Drugs
Discharge Criteria
Vascular Access
Peripheral Venous Access
Umbilical Vein and Artery Access
Peripherally Introduced Central Catheter
Central Venous Catheters
Totally Implanted Central Venous Catheter
Intraosseous Access
Venous Cutdown
Arterial Catheter
Hemodialysis Catheters
Pathogenesis of Infection
Virulence
Inoculum
Nutrients
Host Defence
Defence Against Infection
Anatomic Barrier
Immune Response
Humoral and Cell-Mediated Immunity
Immunodeficiencies
Antibiotics
Prevention of Infections
Patient Characteristic
Surgical Preparation
Wound Classification
Antibiotic Prophylaxis
Bowel Preparation
Types of Infection
Postoperative Surgical Site Infection
Nosocomial Infection
Catheter Infections
Other Infections Requiring Surgical Care and Treatment
Necrotizing Soft Tissue Infection
Sepsis
Peritonitis
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
References
Physiology of new born & Anesthetic Considerations for Paediatric Surgical Conditions
Vascular Access
Surgical Infection
Head and Neck Surgery
Abstract
THYROGLOSSAL DUCT CYST
Cystic Hygroma
Lymphadenopathy
Cat-Scratch Disease
Branchial Cleft Anomalies
Neonatal or Infantile Primary Hyperparathyroidism
Torticollis
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
References
Thoracic Surgery
Abstract
CHEST WALL DEFORMITIES
Pectus Excavatum
CLINICAL FEATURES
Evaluation and Indications for Operation
Treatment
OPERATIVE APPROACHES
Open Technique
COMPLICATIONS
LONG-TERM FOLLOW-UP
POLAND SYNDROME
STERNAL DEFECTS
Thoracic Insufficiency Syndrome Associated with Diffuse Skeletal Disorders
Congenital Diaphragmatic Hernia
Associated Anomalies
Diaphragm Development and CDH Pathogenesis
Prenatal Diagnosis
Clinical Presentation
Treatment
Operative Repair
Outcomes
Risk Stratification in CDH
Bronchopulmonary Sequestration
Differential Diagnosis
Congenital Lobar Emphysema
Esophageal Atresia and Tracheo-esophageal Fistula
Anomalies Associated with EA
Gross Type A: Pure Esophageal Atresia without TEF
Gross Type B: Esophageal Atresia with Proximal Fistula
Gross Type C: Esophageal Atresia with Distal Fistula
Gross Type D: Esophageal Atresia with Proximal and Distal Fistulas
Gross Type E: H-type Fistula without Esophageal Atresia
Diagnosis
Clinical Presentation of Infants with Esophageal Atresia and Tracheoesophageal Fistula
PREOPERATIVE MANAGEMENT
Operative Repair
Complications from Operative Repair
Anastomotic leaks
Strictures
Recurrent TEF
Gastro Esophageal Reflux
Corrosive Ingestion
Liquefactive Necrosis, Reparative Phase, and Scar Retraction
Management
Complications
Esophageal stricture
Barret’s Esophagus
Foreign Body
Clinical Presentation
Diagnosis
Management
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
References
Abdomen
Abstract
HYPERTROPHIC PYLORIC STENOSIS
Etiology
Clinical Presentation
Physical Examination
Imaging
Treatment
Preparation for Surgery
Types of Surgery
Postoperative Care
Complications
Intestinal Obstruction
Duodenal and Intestinal Atresia and Stenosis
Etiology
Classification System
Clinical Presentation
Diagnosis
Treatment
Types of Surgery
Postoperative Care
Intraoperative Complications
Postoperative Complications
Jejunoileal Atresia and Stenosis
Clinical Presentation
Prenatal US Findings
Radiographic Findings
Differential Diagnosis
Management
Surgical Considerations
Postoperative Care
Colonic Atresia
Meconium Ileus
Clinical Presentation
Diagnosis
Treatment
Operative Management
Postoperative Care
Necrotizing Enterocolitis
Clinical Diagnosis
Medical Management
Surgical Management
Clinical Manifestation
Laboratory Investigations
Radiological Imaging
Differential Diagnosis
Management
Preoperative Preparation
Postoperative Care
Hirschsprung Disease
Etiology
Clinical Manifestation
Investigations
Management
Postoperative Care
Intussusception
Etiology
Pathophysiology
Clinical Manifestation
Diagnosis
Management
Non Operative Approach
Drawback of Air Enema
Recurrent Intussusception
Postoperative Intussusception
Malrotation
Pathophysiology
Clinical Manifestation
Diagnosis
Management
Imperforate Anus
Classification
Male
1-Rectourethral Fistulas
2-Rectoperineal Fistulas
3-Rectobladderneck Fistulas
4-Rectal Atresia/Rectal Stenosis
Female
1-Rectovestibular Fistulas
2-Rectoperineal Fistulas
3-Persistent Cloaca
Diagnosis
Management
Advantages of Early Operation
Postoperative Care
Biliary Atresia
Etiology
Classification
Clinical Features
Differential Diagnosis
Laboratory Studies
Imaging
Duodenal Aspiration
Hepatobiliary Scintigraphy
Laparoscopy-assisted Cholangiography
Intraoperative Cholangiogram
Complications
Pre-operative Management
Postoperative Manegement
Postoperative Complications
Prognosis
Choledocal Cyst
Etiology
Classification
Todani’s classification
Clinical Features
Differential Diagnosis
Laboratory Tests
Imaging
Treatment of Choledochal Cyst
Types I and IV Choledochal Cyst
Type II Choledochal Cyst
Type III Choledochal Cyst
Type V Choledochal Cyst (Caroli Disease)
Postoperative Care
Postoperative Complications
Inspissated Bile Syndrome
Investigation
Treatment
Pancreas Conditions
EMBREOLOGY
ANATOMY
ACUTE PANCREATITIS
Etiology
Diagnosis
Management
CHRONIC PANCREATITIS
Causes
Clinical Picture
Surgical Treatment
PANCREATIC PSEUDOCYST
CONGENITAL HYPERINSULINISM
Medical Management
Surgical Management
PANCREATIC TUMOR
ADENOCARCINOMA AND PANCREATOBLASTOMA
SPLENIC CONDITION
Embryology
Anatomy
Physiology
Anatomic Abnormalities
Asplenia and Polysplenia
Accessory Spleens
Splenic Gonadal Fusion
Splenic Cysts
Indications for Splenectomy
Hereditary Spherocytosis
Immune Thrombocytopenic Purpura
Sickle Cell Disease
Thalassemia
Gaucher Disease
Splenectomy
Open Splenectomy
Laparoscopic Splenectomy
Operation
Single-incision Laparoscopic Surgery and Single-incision Laparoendoscopic Surgery Splenectomy
Partial Splenectomy
Complications and Controversies Associated with Laparoscopic Splenectomy
Accessory Spleen Detection
Conversion to Open Splenectomy
Operative Time
Complications
Postsplenectomy Sepsis
Abdominal Wall Defects
Gastroschisis
PRESENTATION AND DIAGNOSIS
PRENATAL MANAGEMENT AND DELIVERY
Postnatal Management
Neonatal Resuscitation
RISK STRATIFICATION
SURGICAL MANAGEMENT
CLOSING GASTROSCHISIS
POSTOPERATIVE COURSE
LONG-TERM OUTCOMES
Omphalocele
Incidence, Embryology and Etiology
Prenatal Diagnosis and Management
Neonatal Resuscitation and Management
Surgical Management
Postoperative Course
Long-term Outcomes
Umbilical Hernia
Anatomy
Treatment
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
References
Undescended Testis (Cryptorchidism)
Abstract
Genitalia
DIAGNOSIS
FERTILITY
RISK OF MALIGNANCY
Treatment
Indications for Operation
Hormonal Treatment
Possible Complications
PRESENTATION AND DIAGNOSIS
CARCINOMA in situ
GERM CELL TUMORS
Yolk Sac Tumors
Teratoma
Mixed Germ Cell Tumor
Seminomas
Leydig Cell Tumors
The Granulose Cell Tumor
The Sertoli Cell Tumor
Ovarian Cysts and Tumour
OVARIAN CYSTS IN THE NEONATE
Management
OVARIAN CYSTS IN CHILDREN
OVARIAN CYSTS IN ADOLESCENTS
Evaluation
Ambiguous Genitalia
Embryology
Female Pseudohermaphroditism
Management
Treatment
Evaluation of the Newborn with Ambiguous Genitalia
Conclusion
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
References
Pediatric Malignancy
Abstract
RENAL TUMORS
Wilms Tumor
Metastasis of Nephroblastoma
Causes of Nephroblastoma
Associated with Multiple Genetic Syndromes (10% of all WT Cases)
Clinical Presentation of Wilms’ Tumor
Diagnosis of Wilms’ Tumor
Staging of Wilms Tumor According to the National Wilms Tumor Study Group (NWT) [11]
Treatment
Preoperative Chemotherapy
Follow-Up
Neonatal Wilms Tumor
Extrarenal Wilms Tumor
Renal Cell Carcinoma
Neuroblastoma
Anatomical Site
Incidence
Presentation
Signs
Histopathological Classification
Laboratory finding
Radiology Findings
Risk Determination
Stage (I: localized, IV: disseminated)
Histology
Favorable Prognosis
Treatment
High-risk Patients
Low-risk Patients
Stage 4S Neuroblastoma
Rhabdomyosarcoma
Treatment
Site Specific Surgical Guidelines
In Head/Neck Tumors
TUMOR OF THE Extremities
Genitourinary Tumors
Bladder/Prostate Tumors
Paratesticular Tumors
Other Sites
Prognosis
Malignant Hepatic Tumors
Epidemiology
Biology and Cytogenetics
Histology
Clinical Features and Laboratory Data
Imaging
Staging and Risk Stratification
Treatment
Outcome
PROGNOSIS AND FOLLOW-UP
CONCLUSION
Sacrococcygeal Teratoma
Classification
Deferential Diagnosis
Prenatal Diagnosis
Operative Approach
Adjuvant Therapy
Prognosis
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
Refrences
Neurosurgery
Abstract
HYDROCEPHALUS
Skull Masses
Neural Tube Defects
Craniosynostosis
Vascular Malformations of the Brain
Tethered Spinal Cord
Pilocytic Astrocytoma
Medulloblastoma
EPENDYMOMA
Choroid Plexus Tumours
Germ Cell Neoplasms
DIFFUSE INTRINSIC PONTINE GLIOMA
Intracranial Infections
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
Refrences
Breast Surgery
Abstract
DEVELOPMENT, ANATOMY, AND PHYSIOLOGY
Pathophysiology
Disorder of Development and Growth Neonatal Hypertrophy
Polythelia
Hypoplasia and Aplasia
Gynecomastia
Inflammatory Lesions
Breast Trauma and Fat Necrosis
MASTITIS AND ABSCESS
Breast Masses
Evaluation of Breast Masses
Benign Breast Diseases
SIMPLE CYSTS
FIBROEPITHELIAL TUMORS
Fibroadenomas
Phyllodes Tumors
Breast Cancer
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
Refrences
Abbreviations
Essentials of Pediatric Surgery
Edited by
Sultan M. Ghanem
Faculty of Medicine
University of Kufa
Iraq
Najah R. Hadi
Faculty of Medicine
University of Kufa
Iraq
&
Nada R. AlHaris
Faculty of Medicine
University of Kufa
Iraq
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PREFACE
The ongoing struggle with coronavirus has resulted in a forced distance between the professor and his students. Moreover, we lost our loved ones and colleagues. The importance of pediatric surgery has been compromised due to the neglect of this delicate specialized field, resulting in the loss of many cases due to the loss of the correct written curriculum. I decided with my students, at the final stage of studying medicine, that we would have a hand that writes and a hand that works to save children with surgical problems that require surgical intervention. It might be simple at first, but we believe it is more than that. For a child with the slightest trace of a birth defect, to live for decades would be a blessing. Therefore, we started to communicate, consult, summarise, disagree, and agree through the closed electronic circuit; accordingly, the result of these efforts is the book titled “Essentials of Pediatric Surgery” that we are now putting in the hands of our students and our dear colleagues to serve as the best guide in the field of pediatric surgery. We have summarized the important chapters of the international references related to pediatric surgery that benefit medical students and trainees to enter the field of specialization in pediatric surgery. All thanks and appreciation to those who contributed, participated, and gave their time. We are full of happiness and joy because we did not succumb to the coronavirus epidemic and its repercussions, and we hope that the earth will be free of coronavirus. We stand a minute of silence in respect of those who have passed. It is necessary to note the great effort made by Dr. Houreleen H. Salman in following up the book step by step and all those who contributed and participated in it. I do not forget the continuous support of the Dean of the College of Medicine, Professor Raed Reda Omran; I give them all my love and respect.
Sultan M. Ghanim
Faculty of Medicine
University of Kufa
Iraq
List of Contributors
Asalah T. Gumer6th Grade Medical College, University of Kufa, IraqFatima H. Naeima6th Grade Medical College, University of Kufa, IraqHiba A. Mirza6th Grade Medical College, University of Kufa, IraqHoureleen H. Salman6th Grade Medical College, University of Kufa, IraqHayder D. Abbas5th Grade Jabir Ibn Hayyan Medical University, University of Kufa, IraqKarrar K. Abdulsahib6th Grade Medical College, University of Kufa, IraqKarrar Z. Sadoun5th Grade Jabir Ibn Hayyan Medical University, University of Kufa, IraqNada R. AlharisFaculty of Medicine University of Kufa, IraqNajah R. HadiFaculty of Medicine University of Kufa, IraqNoor Al-Huda I. Khalaf6th Grade Medical College, University of Kufa, IraqSultan M. GhanimME Uint, Medical College University of Kufa, IraqSarah N. Ahmed6th Grade Medical College, University of Kufa, IraqZainab H. Ibrahim6th Grade Medical College, University of Kufa, Iraq
Physiology of the Newborn
Sultan M. Ghanim1,*,Najah R. Hadi2
1 ME Unit, Medical College, University of Kufa, Iraq
2 Faculty of Medicine, University of Kufa, Iraq
Abstract
The survival of the neonates is dependent on the physiological charac-teristics that enable them to adapt themselves initially to the placenta and then to the extra uterine environment. Of all the pediatric patients, neonates exhibit the most distinguishing physiological features that ensure their rapid development. This chapter focuses on the physiological characteristics exhibited by the neonates in the intrauterine as well as the extra uterine environment.
Keywords: Growth, Neonate, Physiology.
*Corresponding author Sultan M. Ghanim: ME Unit, Medical College, University of Kufa, Iraq;
Tel: +9647816669997; E-mail:
[email protected]
