Common Conditions in Pediatric Surgery Inability to retract the preputial skin on the glans. A common condition, which may require surgical correction in children. Need to operate if painful passage of urine or recurrent infection of skin. Treatment: Circumcision or preputioplasty. Conditions Surgery in New Born Baby Surgery in Pediatric Age Group Trauma in Children Hernia/Hydrocele Phimosis/Paraphimosis Constipation Bleeding Per Rectum Painful Defection Hypospadias/ Exstrophy Bladder Hydronephrosis Vascular Malformation Hydrocephalus Hypospadias Urinary opening on undersurface of the penis. Surgical correction preferably completed before 2 yrs age and may be started at 1 or 1½ yrs. UTI (Urinary Tract Infections) Manifests as painful passage of urine/ fever/ excessive crying / non-specific. Responsible for a various complications of kidneys in older ages. Many cases of chronic renal failure have a past history of recurrent UTI. Can lead to kidney damage. 40% of UTIs have surgically correctable cause: Obstruction at the bladder outlet Obstruction of either kidneys Vesico-ureteric reflux (VUR) Inguinal Hernia Occurs in Boys and Girls Swelling in groin, which comes and goes Commonest problem in children Surgery is the cure Undescended Testis When Testis does not come down into the scrotum Operation is a must Why? Possibility of damage to testis and cancer Operation Day care Laparoscopy useful in some cases Cleft Lip & Palate Common Problem Advantages of Surgery Good cosmesis Improved speech Feeding problems avoided When to do surgery? Cleft Lip -when child is 3 to 6 months old Cleft Palate- when child is 9 to 12 months old Hydronephrosis Swelling of Kidney due to extra fluids in the kidney May be detected before or after birth Various causes Consult a pediatric surgeon as some cases need early surgery to avoid long term damage to kidney. Laparoscopic surgery possible Bleeding in Stool Must be evaluated by specialist Causes Fissure in Ano Rectal Polyp Meckel’s Diverticulum Intussusception Severe gastroenteritis Peptic Ulcer Rectal Polyp Common in the age group of 3-6 years Something comes out from the anus Child passes fresh blood in drops at the time of passing stools Polyp maybe felt with finger examination – Usually single Needs to be removed surgically Hydronephrosis Something coming out from the anus May be associated with bleeding Predisposing factors Constipation Loose motions Severe cough Treatment Of the predisposing factors Submucosal injections – usually curative. Surgery is required in very rare cases – may be done laparoscopically Constipation Loose motions Severe cough
