Contributors
RONALD F. MARTIN, MD, FACS (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - October 1, 2022 Category: Surgery Source Type: research
Contents
Ronald F. Martin (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - October 1, 2022 Category: Surgery Source Type: research
Forthcoming Issues
Management of Benign Breast Disease (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - October 1, 2022 Category: Surgery Source Type: research
Management of Abdominal Wall Defects
Congenital abdominal wall defects vary from abdominal wall hernias to severe congenital structural anomalies that include gastroschisis, omphalocele, and prune belly syndrome. The conditions often carry various associated anomalies and require multidisciplinary treatment approaches. Complex surgical reconstructive techniques are frequently required and prenatal, perioperative, and long-term follow-up is critical to ensuring the best possible outcomes. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - September 12, 2022 Category: Surgery Authors: Victoriya Staab Source Type: research
Small Bowel Congenital Anomalies
The small intestine is a complex organ system that is vital to the life of the individual. There are several congenital anomalies that occur and present most commonly in infancy; however, some may not present until adulthood. Most congenital anomalies of the small intestine will present with obstructive symptoms, whereas some may present with vomiting, abdominal pain, and/or gastrointestinal bleeding. Various radiologic procedures can aid in the diagnosis of these lesions that vary depending on the particular anomaly. The congenital anomalies of the small intestine discussed include Meckel diverticulum, duodenal web, duode...
Source: Surgical Clinics of North America - September 12, 2022 Category: Surgery Authors: Grant Morris, Alfred Kennedy Source Type: research
Medical and Surgical Aspects of Intestinal Failure in the Child
Medical and surgical care for children with intestinal failure has evolved so that long-term life expectancy is common even in the setting of the shortest bowel lengths. The long-term administration of parenteral nutrition has become safe with alterations in lipid formulation, and the risk of liver injury has been dramatically reduced. Well-established techniques for bowel lengthening and tapering exist to increase the absorptive capacity of the remnant bowel. These advances allow for ongoing intestinal rehabilitation in the child with the ultimate goal of enteral autonomy while the use of intestinal transplantation in thi...
Source: Surgical Clinics of North America - September 12, 2022 Category: Surgery Authors: Danielle Wendel, Patrick J. Javid Source Type: research
Chest Wall Deformities and Congenital Lung Lesions
Pectus excavatum, carinatum, and arcuatum are 3 developmental chest wall deformities that may evolve during childhood and cause cardiac and/or pulmonary compression. Evaluation may include nonsurgical subspecialty consultations and imaging studies. Treatment may be nonoperative or surgical. Long-term follow-up studies have identified rare complications of traditional open repair. Routine in utero ultrasonography has led to increasing identification of congenital lung anomalies, including congenital cystic adenomatoid malformations, pulmonary sequestrations, and bronchogenic cysts. Short-term follow-up studies have suggeste...
Source: Surgical Clinics of North America - September 12, 2022 Category: Surgery Authors: J. Duncan Phillips, John David Hoover Source Type: research
Pediatric Inflammatory Bowel Disease for General Surgeons
Key differences exist in pediatric and adult inflammatory bowel disease (IBD), and a multidisciplinary approach focused on meeting these needs should be implemented. In an emergency situation, surgical management of pediatric IBD should focus on patient stabilization with an eye toward future intestinal function. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - September 12, 2022 Category: Surgery Authors: Michael R. Phillips, Erica Brenner, Laura N. Purcell, Ajay S. Gulati Source Type: research
Pediatric Surgery
Right patient, right clinical team, right facility, and right time: the Holy Grail of medical care and particularly true of surgery. I might throw in “right diagnosis” as well, as that should not always be considered a given. This basic premise of having patients cared for in the most optimal environment would be the backbone as well as the measuring stick of any worthwhile health care system that anyone might want to construct in an ideal wo rld. Yet, it is not how we function here in the United States, and we are not alone in this dilemma. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - September 12, 2022 Category: Surgery Authors: Ronald F. Martin Tags: Foreword Source Type: research
Management of Anorectal Malformations and Hirschsprung Disease
Anorectal malformations (ARM) and Hirschsprung disease (HD) are managed with placement of normal intestine within the anal sphincter complex. Long-term complications specific to ARM include fistula remnants, recurrence, urinary reflux with associated chronic renal insufficiency, sexual dysfunction, and fertility difficulties. Complications specific to HD include enterocolitis, persistent or acquired aganglionosis, and internal sphincter achalasia. ARM and HD patients are both at risk of stricture, bowel dysfunction and incontinence, which can have a severe impact on quality of life. Bowel management strategies should be ta...
Source: Surgical Clinics of North America - September 7, 2022 Category: Surgery Authors: Colin D. Gause, Sanjay Krishnaswami Source Type: research
Abdominal Tumors
This article reviews four of the most common solid abdominal tumors in the pediatric population and the long-term sequelae of their respective treatment regimens. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - September 7, 2022 Category: Surgery Authors: Jennifer T. Castle, Brittany E. Levy, David A. Rodeberg Source Type: research
Congenital Diaphragmatic Hernia
The contemporary pillars of congenital diaphragmatic hernia (CDH) management include prenatal diagnosis for multidisciplinary care coordination and counseling, medical optimization after birth, and elective (not emergent) operative repair after stabilization, allowing for improvement in pulmonary hypertension and maturation of lungs. Lung hypoplasia and pulmonary hypertension in infants with CDH represent a medical emergency, not one that necessitates immediate surgery. Many infants surviving CDH repair have significant morbidities that may persist into adulthood. Rare cases of previously occult CDH may present acutely in ...
Source: Surgical Clinics of North America - September 7, 2022 Category: Surgery Authors: Xiao-Yue Han, Leigh Taryn Selesner, Marilyn W. Butler Source Type: research
Esophageal Atresia and Tracheoesophageal Fistula
Esophageal atresia (EA) with tracheoesophageal fistula (TEF) is among the most common congenital anomalies requiring surgical intervention in infancy. General surgeons practicing in rural or austere environments may encounter emergency situations requiring their involvement. Respiratory emergencies can arise in the neonatal period; the recommended approaches are the ligation of the fistula through the chest or occlusion of the distal esophagus through the abdomen. As survivors of the condition reach late adulthood, general surgeons can anticipate encountering these patients. An understanding of risk factors, common symptom...
Source: Surgical Clinics of North America - September 7, 2022 Category: Surgery Authors: Ryan M. Walk Source Type: research
Pediatric Ingestions
Pediatric ingestions encompass a wide range of diseases, including foreign body ingestions, caustic ingestions, and aspiration. Specific topics of interest in the pediatric age group for adult general surgeons are button batteries and magnets, which have significant morbidity and mortality and require a high index of suspicion to provide timely care. Evaluation and management of these cases should be tailored to the offending agent and managed at an appropriate pediatric center. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - September 7, 2022 Category: Surgery Authors: Torbjorg Holtestaul, Jace Franko, Mauricio A. Escobar, Meade Barlow Source Type: research
Common Conditions II
Perforated appendicitis continues to be a significant cause of morbidity for children. In most centers, ultrasound has replaced computed tomography as the initial imaging modality for this condition. Controversies surrounding optimal medical and surgical management of appendicitis are discussed. Management of intussusception begins with clinical assessment and ultrasound, followed by image-guided air or saline reduction enema. When surgery is required, laparoscopy is typically utilized unless bowel resection is required. The differential diagnosis for pediatric gastrointestinal bleeding is broad but often made with age, hi...
Source: Surgical Clinics of North America - September 7, 2022 Category: Surgery Authors: Patrick N. Nguyen, Adam Petchers, Sarah Choksi, Mary J. Edwards Source Type: research
