فهرست مطالب
Foreword
Preface
Acknowledgments
Contents
Contributors
Part I: Perioperative Care
1: Preoperative Assessment and Preparation
Risks of Anesthesia
Airway
Respiratory System
Cardiovascular System
Gastroesophageal Reflux Disease
Obesity
Diabetes
Thyroid Disease
Corticosteroids
Anemia
Sickle Cell Disease
Coagulation Disorders
Malignancy
Anterior Mediastinal Mass
Cerebral Palsy
Developmental Disorders
Prematurity
Malignant Hyperthermia
Hypotonia
Trisomy 21
Allergies
Prior to Admission Medications
NSAIDs and Aspirin
Herbal Medications
Illicit/Recreational Medications
Preoperative Fasting
Laboratory Testing and Diagnostic Studies
Editor’s Comments
Further Reading
2: Prenatal Diagnosis and Genetic Counseling
Maternal and Family History
Carrier Screening
Screening and Testing Options
Screening Throughout the Pregnancy
First Trimester
Serum Screening
Ultrasound
Second Trimester
Maternal Serum Quadruple Screen
Combined First- and Second-Trimester Serum Screening
Ultrasound
Diagnostic Testing
Chorionic Villus Sampling
Second Trimester
Genetic Diagnostic Testing
Fluorescent in Situ Hybridization
Chromosome Analysis
Chromosomal Microarray Analysis
Molecular Testing
Whole Exome Sequencing
Summary
Editor’s Comments
Further Reading
3: Neuraxial and Regional Anesthesia
Neuraxial Analgesia and Anesthesia
Epidural and Caudal Analgesia
Spinal Anesthesia
Truncal Anesthesia
Quadratus Lumborum
Erector Spinae
Peripheral Regional Anesthesia
Upper Extremity Regional Anesthesia
Lower Extremity Regional Anesthesia
Duration of Regional Anesthesia
Special Considerations in the Pediatric Patient
Commonly Used Local Anesthetics
Local Anesthetic Toxicity
Conclusion
Editor’s Comments
Further Reading
4: Positioning and Incisions
Positioning
Supine
Dorsal Lithotomy
Lateral Decubitus
Prone
Abdominal Incisions
Midline Abdominal Incision
Transverse Abdominal Incision
Low Transverse Incision
Subcostal Incision
Miscellaneous Abdominal Incisions
Thoracic Incisions
Sternotomy
Thoraco-Abdominal Incision
Other Incisions
Further Reading
5: Enteral Nutrition and Access
Nutritional Requirements
Nutrition for Premature Infants
Short Bowel Syndrome
The Critically Ill Child
Enteral Access
Summary
Editor’s Comments
Further Reading
6: Parenteral Nutrition
Nutrition Assessment
Calories
Carbohydrates
Protein
Protein Recommendations
Lipids
Intralipids
SMOF
Omegaven
Carnitine
Electrolytes
Sodium
Potassium
Calcium
Phosphorus
Magnesium
Trace Elements
Zinc
Copper
Selenium
Iron
Vitamins
Special Considerations
Other Additives/Considerations
Insulin
Refeeding Syndrome
Complications of PN
CLABSI
PN-Associated Liver Disease (PNALD)
Metabolic Bone Disease (MBD)
Venous Access Devices
Neonatal and Preterm Infant PN
Discharge Home with PN
Summary
Editor’s Comments
Further Reading
7: Enhanced Recovery After Surgery Protocols (ERAS): The Next Generation of Perioperative Quality Improvement, Safety, and Innovation
So, What Did You Notice?
Why ERAS? Complications. Complications. Complications
Components and Principles of ERP Care
Pre-operative Phase
Patient Counseling and Optimization
Limited Fasting
Carbohydrate Loading
IV Prophylactic Antibiotics
Bowel Preparation
VTE Prophylaxis
Intraoperative Phase
Euvolemia
Normothermia
Post-operative Phase
Multimodal Analgesia
Local/Regional Analgesia
Oral Medication
Early Mobility
Early Oral Intake
Clear Discharge Goals
Pediatric Outcomes
Crossing Quality Chasm: ERAS Implementation
Audit and Quality Improvement
Multidisciplinary Care
ERAS Coordinator
ERAS Advocacy
Future Directions
Conclusion
Editor’s Comments
Further Reading
8: Quality Improvement in Pediatric Surgery
Methodology
Lean
Six Sigma
Lean Six Sigma
IHI Model
Implementation
Measuring QI Data
Presenting Data
Maintenance Phase
Summary
Editor’s Comments
Further Reading
Part II: Critical Care
9: Fetal Intervention
Medical Therapy
Ultrasound-Guided Procedures
Fetoscopy
Open Maternal-Fetal Surgery
Ex-Utero Intrapartum Treatment
Indications for EXIT
Maternal Considerations
Complicated Monochorionic Twins
Congenital Diaphragmatic Hernia
Lower Urinary Tract Obstruction
Lung Lesions
Sacrococcygeal Teratoma
Myelomeningocele/Myeloschisis
Summary
Editor’s Comments
Further Reading
10: Shock
Recognition of Shock
Pathophysiology of Shock
Hypovolemic Shock
Cardiogenic Shock
Obstructive Shock
Distributive Shock
Histotoxic Shock
Emergency Management
Fluid Resuscitation
Point-of-Care Ultrasound
Vasoactive Agents
Antibiotics
Escalation of Care
Summary
Editor’s Comments
Further Reading
11: Electrolyte Abnormalities
Sodium
Potassium
Calcium
Phosphorus
Acid-Base Abnormalities
Summary
Editor’s Comments
Further Reading
12: Coagulation and Transfusion Medicine
Hemostasis and Fibrinolysis
Coagulopathy
Trauma-Induced Coagulopathy
Disseminated Intravascular Coagulopathy
Hematologic Assessment and Monitoring
Viscoelastic Monitoring
Transfusion Complications
Febrile Non-hemolytic Transfusion Reaction
Allergic Transfusion Reactions
Hemolytic Reactions
Transfusion-Related Acute Lung Injury
Transfusion-Associated Circulatory Overload
Infections
Transfusion Products
Red Blood Cells
Fresh Frozen Plasma
Platelets
Hemostatic Resuscitation
Conventional Coagulation Tests Vs. Viscoelastic Monitoring
Massive Transfusion Protocols
Whole Blood
Pharmacologic Adjuncts
Prothrombin Complex Concentrates and Recombinant Factor VII
Tranexamic Acid
Summary
Editor’s Comments
Further Reading
13: Vascular Access
Short-Term Access
Long-Term Access
Cutdown Techniques
Complications
Summary
Further Reading
14: Acute Kidney Injury
Definition
Etiology and Pathophysiology
Evaluation
Management
Renal Replacement Therapy
Intermittent HD and CRRT
Peritoneal Dialysis
Drug Levels
Prevention
Nutritional Support
Specific Scenarios
Contrast-Induced Nephropathy
Drug-Induced Nephrotoxicity
Acute Interstitial Nephritis
Hemolytic Uremic Syndrome/Thrombotic Thrombocytopenic Purpura
Rhabdomyolysis
Hepatorenal Syndrome
Malignancy
Abdominal Compartment Syndrome
Surgical Considerations
Cardiac Surgery
Summary
Editor’s Comments
Further Reading
15: Mechanical Ventilation
Acute Respiratory Failure
Principles of Mechanical Ventilation
Conventional Mechanical Ventilation
Adjuncts for Refractory Hypoxemia
Alternative Ventilator Modes
Future Considerations
Editor’s Comments
Further Reading
16: Extracorporeal Life Support (ECMO)
The Circuit
ECMO Modalities
Indications
Contraindications
Operative Considerations in the Neonate
Preoperative Preparation
Methods of Cannulation
Cannula and Site Choice
Direct Cervical Cannulation
Bicaval Dual-Lumen Cannula
Management on ECMO
Surgery on ECMO
Weaning from ECMO
Complications
Editor’s Comments
Further Reading
Part III: Trauma
17: Trauma Resuscitation
Pre-arrival
Primary Survey
Airway
Breathing
Circulation
Disability
Exposure/Environmental Support
Secondary Survey
Catheters
Laboratory Testing
Imaging
Patient in Extremis
Resuscitative Thoracotomy
Editor’s Comments
Further Reading
18: Pediatric Head Injury
Medical Management in Severe TBI
Initial Management
Prevention of Secondary Neurologic Injury
Non-operative Management of Intracranial Pressure
Decompressive Craniectomy
Traumatic Injuries
Skull Fractures
Epidural Hematoma
Subdural Hematomas
Intraparenchymal Hematoma
Abusive Head Trauma
Conclusion
Editor’s Comments
Further Reading
Untitled
19: Concussion
Pathophysiology
Diagnosis
Initial Management
Recovery
Follow-Up
Referral for Expert Guidance
Editor’s Comments
Further Reading
20: Neck Injuries
Principle 1: It Begins and Ends with the Airway—the Primacy of Airway Management
Principle 2: Look for Problems Early, Before You Find them by Mistake
Principle 3: Image for a Reason and You Will Image Reasonably
Management Challenges
Blunt Cerebrovascular Injury (BCVI)
Seatbelt Sign
Hanging
Subcutaneous Emphysema
Dog Bites
Expectant Management of Penetrating Injuries
Principle 4: Operate “ABCDE” for Success in Neck Trauma (Table 20.2)
A—Airway, Angiography, Ask
B—Bleeding
C—Central Compartment, Contralateral Side
D—Defend Suture Lines, Drain
E—Endoscopy
Editor’s Comments
Further Reading
21: Spinal Column and Spinal Cord Injuries
Epidemiology
Anatomy
Classification of Injury
Vertebral Column Injury
Occipitoatlantoaxial Injuries
Subaxial Injuries
Thoracolumbar Injuries
Differentiating the Mimickers
Spinal Cord Injury
Classic Neurological Examinations
Penetrating Spine Trauma
Acute Management
Prehospitalization
Trauma Bay
Imaging
Associated Injuries
ICU
Clearing the C-Spine
Long-Term Management
Spinal Bracing
Return to Play (RTP)
Editor’s Comments
Further Reading
22: Burns
Initial Evaluation
Airway Management and Inhalational Injury
Burn Resuscitation and Assessment
Burn Wound Infection
Hypermetabolism
Temperature Regulation
Nutrition
Pharmacologic Regulation of the Hypermetabolic Response
Wound Management
Surgical Treatment
Autografts
Dermal Replacement
Burn Reconstruction
Pain Management
Burn Prevention
Editor’s Comments
Further Reading
23: Abdominal Trauma
Epidemiology
Anatomic and Physiologic Vulnerabilities
Blunt Abdominal Trauma
Seatbelt Sign
Waddell’s Triad
Handlebar Injuries
Diagnostic Evaluation
Focused Abdominal Sonography for Trauma (FAST)
Contrast-Enhanced Ultrasound
Liver and Spleen Injuries
Operative Intervention
Angioembolization
Specifics of Nonoperative Management
Post-Discharge Care
Re-Imaging
Blunt Pancreatic Injury
Injury Grading
Approach to Management
Details of Nonoperative Management
Hollow Viscus Injury
Duodenal Injury
Child Physical Abuse
Penetrating Abdominal Trauma
Damage Control Surgery
Editor’s Comments
Further Reading
24: Thoracic Trauma
Blunt Asphyxia
Rib Fractures
Sucking Chest Wound
Pneumothorax
Hemothorax
Pulmonary Contusion
Pulmonary Laceration
Bronchial Injury
Mediastinum
Tracheal Injury
Blunt Cardiac Injury
Great Vessel Injury
Esophageal Injury
Thoracic Duct Injury
Diaphragm Injury
Editor’s Comment
Further Reading
25: Vascular Injuries
Injury Classification
Iatrogenic Injuries
Diagnosis
Treatment
Outcomes
Long-Term Complications
Special Considerations
Blunt Cerebrovascular Injuries (BCVI)
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)
Tourniquets
Conclusion
Editor’s Comments
Further Reading
26: Pediatric Hand Injuries
Patient Evaluation
Specific Conditions
Burns
Infection
Amputation
Compartment Syndrome
Vascular Injury
Nerve Injury
Flexor Tendon Injury
Fractures
Scaphoid Fractures
Seymour Fractures
Phalangeal Fractures
Buckle and Greenstick Fractures
Casts
Editor’s Comments
Further Reading
27: Child Physical Abuse
General Principles
Clinical Presentation
Cutaneous Injuries
Fractures
Head Trauma
Abdominal Injuries
Evaluation
Bias
Conclusion
Editor’s Comments
Further Reading
Part IV: Head and Neck
28: The Critical Airway
Differential Diagnosis
Airway Sounds
Clinical Assessment
Management of the Acute Airway
Medical Management
Oxygen
Epinephrine
Corticosteroids
Heliox
Nasal Airway
Noninvasive Positive Pressure Ventilation
Oral Intubation
Bronchoscopy
Transtracheal Ventilation
Cricothyrotomy
Tracheostomy
Extracorporeal Membrane Oxygenation
Special Considerations
Nasal Obstruction
Micrognathia
Congenital Neck Masses
Our Approach
Editor’s Comments
Further Reading
29: Bronchoscopy and Airway Disorders
Types of Bronchoscopy
Rigid Bronchoscopy
Flexible Bronchoscopy
Complications
Anesthetic Considerations
Equipment
Technique
Airway Anatomy
Airway Dynamics
Laryngomalacia
Pharyngomalacia
Tracheomalacia and Bronchomalacia
Laryngotracheal Stenosis
Glottic Stenosis
Subglottic Stenosis
Tracheal Stenosis
Airway Tumors
Benign Tumors
Malignant Tumors
Infections Causing Central Airway Obstruction
Management
Foreign Bodies
TEF and Laryngeal Cleft
Laryngotracheoesophageal Cleft
TEF
Mucosal Surface Irregularities
Insufflation to Expose Occult TEF
Persistent Air Leak
Transbronchial Lung Biopsy
Limitations
Risks
Transbronchial Lymph Node Sampling
Editor’s Comments
30: Benign Neck Masses
Thyroglossal Duct Cyst
Surgical Management
Outcomes
Plunging Ranula
Dermoid Cysts
Teratoma
Branchial Cleft Anomalies
First Branchial Cleft Anomalies
Second Branchial Cleft Anomalies
Third/Fourth Branchial Cleft Anomalies
Lymphadenitis
Acute Viral Lymphadenitis
Acute Bacterial Lymphadenitis
Subacute/Chronic Bacterial Lymphadenitis
Vascular Anomalies
Treatment
Sclerotherapy
Summary
Editor’s Comments
Further Reading
31: Thyroid and Parathyroid
Anatomy
Histology and Endocrine Function
Thyroid Imaging
Ultrasound (US)
Nuclear Medicine Scan
Computed Tomography (CT)
Congenital Thyroid Abnormalities
Ectopic Thyroid Tissue
Thyroglossal Duct Cysts
Congenital Central Hypothyroidism
Fourth Branchial Cleft Anomaly
Thyroid Disorders
Graves Disease
Hashimoto Disease (Chronic Lymphocytic Thyroiditis)
Subacute (de Quervain) Thyroiditis
Thyroid Nodules
Autonomous Nodules
Thyroid Cyst
Goiter
Thyroid Carcinoma
Papillary Thyroid Carcinoma
Follicular Thyroid Carcinoma
Medullary Thyroid Carcinoma
Surgical Management
Parathyroid Disease
Primary Hyperparathyroidism
Secondary/Tertiary Hyperparathyroidism
Neonatal Severe Hyperparathyroidism
Surgical Management
Multiple Endocrine Neoplasia (MEN)
MEN I
MEN IIA/IIB
Centers of Excellence
Summary
Editor’s Comments
Further Reading
Part V: Skin and Soft Tissues
32: Benign Skin Lesions
Cutaneous Lesions
Verrucae
Calcinosis Cutis
Keloids
Pyogenic Granuloma
Dermatofibroma
Neurofibroma
Juvenile Xanthogranuloma
Subcutaneous Lesions
Lipoma
Granuloma Annulare
Infantile Myofibroma
Cysts
Epidermoid Cyst
Dermoid Cyst
Pilomatricoma
Foreign Bodies
Lymph Nodes
Non-Melanocytic Nevi
Epidermal Nevi
Nevus Sebaceus of Jadassohn
Smooth Muscle Hamartoma
Connective Tissue Nevus
Postoperative Care
Editor’s Comments
Further Reading
33: Hemangiomas and Vascular Malformations
Hemangiomas
Vascular Malformations
Diagnosis
Treatment of Hemangiomas
Treatment of Vascular Malformations
Complications
Editor’s Comments
Further Reading
34: Disorders of the Breast
Congenital Anomalies and Disorders of Development
Thelarche
Virginal/Juvenile Hypertrophy
Trauma
Nipple Discharge
Bloody Discharge
Galactorrhea
Infections
Fibrocystic Disease
Masses
Neonatal Lesions
Pubertal Masses
Retro-areolar Cysts (Montgomery Cysts)
Fibroadenoma
Juvenile Fibroadenoma
Juvenile Papillomatosis
Pseudoangiomatous Stromal Hyperplasia (PASH)
Phyllodes Tumors
Breast Carcinoma
Gynecomastia
Editor’s Comments
Further Reading
35: Necrotizing Soft Tissue Infections
Diagnosis
Preoperative Preparation
Surgery
Postoperative Care
Reconstruction and Rehabilitation
Editor‘s Comments
Further Reading
36: Pilonidal Disease
Conservative Management
Surgical Management
Primary Excision
Trephination
Endoscopic Pilonidal Sinus Treatment
Cleft-Lift Operation
Summary
Further Reading
37: Lymphatic Flow Disorders
Anatomy
Disorders of the Lymphatic System
Imaging
Percutaneous Procedures
Surgical Procedures
Conclusions
Editor’s Comments
Further Reading
38: Palmar Hyperhidrosis
Physiology
Etiology
Diagnosis
Multidisciplinary Approach
Medical Management
Surgical Management
Outcomes
Editor’s Comments
Further Reading
Part VI: Thorax and Mediastinum
39: Complex Wound Management
General Principles
Assessing the Wound
Cleaning the Wound
Debriding the Wound
Dressing the wound
Definitive Coverage of the Wound
Specific Types of Wounds
Pressure Injury
The Open Abdomen
Cavitary Wounds
Vascular Device-Related Wounds
Alternative Therapies
Developmental Approach
Scar Management
Summary
Further Reading
40: Lung Biopsy and Resection
Indications
Diagnosis
Preoperative Considerations
Anesthesia/Airway Management
Positioning
Operative Technique
Lung Biopsy or Wedge Resection
Thoracoscopic Lobectomy
Extralobar Bronchopulmonary Sequestration
Lower Lobectomy
Right Upper Lobectomy
Left Upper Lobectomy
Right Middle Lobectomy
Postoperative Care
Editor’s Comments
Further Reading
41: Diseases of the Pleura
Pneumothorax
Treatment
Complications
Outcomes
Cystic Fibrosis
Empyema
Diagnosis
Treatment
Surgical Treatment
Outcomes
Chylothorax
Diagnosis
Treatment
Thoracic Duct Embolization
Surgical Treatment
Hemothorax
Editor’s Comments
Further Reading
Pneumothorax
Empyema
Chylothorax
Hemothorax
42: Congenital Lung Lesions
Prenatal Management
Corticosteroids
Fetal Intervention
Ex Utero Intrapartum Treatment and Section-to-Resection
Postnatal Management
Congenital Lobar Emphysema
Complications
Summary
Editor’s Comment
Further Reading
43: Vascular Compression Syndromes
Diagnosis
Treatment
Right-Sided Arch with Aberrant Left Subclavian Artery
Double Aortic Arch
Complications
Editor’s Comments
Further Reading
44: Pectus Deformities
Pectus Deformities
Pectus Excavatum
Clinical Presentation
Preoperative Evaluation
Treatment Options
Nuss Procedure
Pain Control
Postoperative Care
Bar Removal
Open Technique
Complications
Pectus Carinatum
Treatment
Editor’s Comments
Further Reading
45: Mediastinal Masses
Introduction
Anterior Mediastinum
Middle Mediastinum
Posterior Mediastinum
Diagnostic Strategy
Anesthetic Evaluation
Biopsy of Suspected Lymphoma
Surgical Approach to Other Mediastinal Masses
Thymic Lesions
Teratoma
Cysts
Vascular Anomalies
Neurogenic Tumors
Summary
Editor’s Comments
Further Reading
46: Esophageal Atresia
Antenatal Diagnosis
Preoperative Workup
Special Considerations
Surgical Technique
Postoperative Care
Complications
Follow-Up
Thoracoscopy for Long-Gap EA
Editor’s Comments
Further Reading
47: Long-Gap Esophageal Atresia
Diagnosis
Initial Management
Timing of Repair
Preoperative Assessment
Surgical Repair
Delayed Primary Repair
Esophageal Myotomy
Esophageal Lengthening or Traction
Jejunal Interposition
Gastric Transposition
Colon Interposition
Esophageal Magnamosis
Tissue Engineering of the Esophagus
Conclusions
Editor’s Comments
Further Reading
Esophageal Atresia
Tracheal Anomalies
Surgical Techniques/Myotomy
Foker Process
Interposition
Magnamosis
Tissue Engineering
48: Lesions, Injuries, and Replacement of the Esophagus
Diverticula
Benign Tumors
Perforations/Injuries
Surgical Repair
Esophageal Replacement
Gastric Transposition
Gastric Tube Reconstruction
Colonic Interposition
Jejunal Interposition
Summary
Editor’s Comments
Further Reading
Part VII: Stomach and Small Intestines
49: Foregut Duplications
Thoracic Duplications
Abdominal Duplications
Antenatal Diagnosis
Concerns and Complications
Editor’s Comments
Further Reading
50: Achalasia
Diagnosis
Non-surgical Treatment
Preoperative Preparation
Surgical Techniques
Open Heller Myotomy
Laparoscopic Heller Myotomy
Postoperative Care
Complications
Per Oral Endoscopic Myotomy
Surgical Technique
Postoperative Care
Complications
Robotic Heller Myotomy
Thoracoscopic Heller Myotomy
Editor’s Comments
Further Reading
51: Gastroesophageal Reflux Disease and Hiatal Hernia
Presentation
Diagnosis
Medical Management
Surgical Approach
Pearls
Pitfalls
Complications
Outcomes
Editor’s Comments
Further Reading
52: The Stomach
Mucosal Lesions
Polyps and Tumors
Duplication Cysts
Gastric Volvulus
Para-Esophageal Hiatal Hernia
Trauma
Bezoar
Gastric Resection and Anastomoses
Pyloroplasty
Summary
Further Reading
53: Hypertrophic Pyloric Stenosis
Diagnosis
Preoperative Preparation
Surgical Technique
Postoperative Care
Editor’s Comments
Further Reading
54: Congenital Duodenal Obstruction
Diagnosis
Prenatal
Postnatal
Preoperative Preparation
Operative Management
Open Repair
Laparoscopic Repair
Postoperative Management
Editor’s Comments
Further Reading
55: Intestinal Atresia
Prenatal Diagnosis
Diagnosis
Preoperative Management
Operative Management
Laparotomy
Laparoscopy
Colonic Atresia
Postoperative Management and Complications
Summary
Editor’s Comments
Further Reading
56: Abdominal Cysts and Duplications
Enteric Cysts
Adnexal
Genitourinary
Renal
Lymphatic
Hepatobiliary
Pancreatic
Splenic
Tumors
Trauma/Pseudocysts
Diagnosis
Treatment
Postoperative Care
Editor’s Comments
Further Reading
Enteric
Genitourinary
Renal
Lymphatic
Hepatobiliary
Pancreatic
Splenic
Trauma/Pseudocyst
Tumors
57: Intestinal Rotational Anomalies
Embryology and Pathophysiology
Classification
Diagnosis
Treatment
Outcomes
Special Cases
Editor’s Comments
Further Reading
58: Necrotizing Enterocolitis
Stages of NEC
The Perfect Pentad: Five Presentations of NEC and Their Surgical Indications
Scenario 1: “Textbook” NEC—Pneumatosis and Free Air in a Previously Healthy Premature Infant
Scenario 2: Failure to Clinically Improve in the Presence of Pneumatosis but the Absence of Free Air
Scenario 3: The Presence of Portal Venous Air: Don’t Let the Child’s Cries Fall on Deaf Ears
Scenario 4: Staccato NEC—From Good to Bad to Worse in No Time at All
Scenario 5: “NEC totalis”—Peek, Shriek, and then Save!
Indications for Operating on a Child with NEC
Peritoneal Drainage for NEC.
Conduct the Operation for the Child with NEC
Complications of NEC Surgery and How to Avoid Them
Expected Outcomes
Summary and Conclusions
Editor’s Comments
References
59: Intestinal Failure and Rehabilitation
Intestinal Length
Parenteral Nutrition
Enteral Nutrition
Medical Therapy
Surgical Intervention
LILT (Bianchi Procedure)
STEP Procedure
Intestinal Transplantation
Summary
Editor’s Comments
Further Reading
60: Meconium Ileus
Pathophysiology
Epidemiology
Prenatal Diagnosis
Postnatal Diagnosis
Nonoperative Treatment
Operative Treatment
Postoperative Care
Long-Term Complications
Editor’s Comments
Further Reading
61: Intussusception
Types
Epidemiology
Clinical Findings
Diagnosis
Treatment
Editor’s Comments
Further Reading
62: Meckel’s Diverticulum
Clinical Presentation
Gastrointestinal Hemorrhage
Small Bowel Obstruction
Inflammation
Surgical Considerations
Incidental Meckel’s Diverticulum
Summary
Editor’s Comments
Further Reading
63: Bariatric Surgery
Patient Selection
Pre-operative Evaluation/Preparation
Procedure Selection
Perioperative Considerations
Outcomes
Summary
Editor’s Comments
Further Reading
64: Chronic Abdominal Pain
Workup
Surgical Management
Gallbladder
Appendix
Rotational Anomalies of the Intestines
Meckel’s Diverticulum
Intussusception
Crohn’s Disease
Intestinal Angina
Adhesions
Ovarian Cysts
Pelvic Inflammatory Disease
Endometriosis
Rare Causes of Chronic Abdominal Pain
Medical Treatment
Summary
Further Reading
65: Crohn’s Disease
Ileal Disease
Imaging
Surgery
Colitis
Surgery
Perianal Disease
Fissures and Skin Tags
Fistulas and Abscesses
Strictures
Atypical Patterns of Disease
Outcomes
Further Reading
66: Ileostomy and Colostomy
Ileostomy
End Ileostomy
Loop Ileostomy
Special Circumstances
Colostomy
Ostomy Closure
Complications
Skin Issues
Retraction and Prolapse
Hernia
Obstruction
Infection
Special Considerations
Further Reading
67: Small Bowel Obstruction
Clinical Presentation
Imaging
Non-operative Management
Failure of Nonoperative Management
Operative Emergency
Postoperative Management
Summary
Editor’s Comments
Further Reading
68: The Small Intestine
Duodenum
Jejunum
Ileum
Summary
Further Reading
69: Gastrointestinal Bleeding
Diagnostic Workup
Surgical Intervention
Aorta-Esophageal Fistula
Esophageal Varices
Foregut Lesions
Intussusception
Meckel Diverticulum
Polyps
Vascular Malformation
Solitary Rectal Ulcer Syndrome
Summary
Further Reading
70: Enterocutaneous Fistula
Surgical Complication
Initial Management
Surgical Planning
Surgical Treatment
Outcomes
Editor’s Comments
Further Reading
Part VIII: Colon, Rectum and Anus
71: Constipation and Fecal Incontinence
Hirschsprung Disease
Mechanism of Continence
Evaluation
Newborns/Infants
Toddlers
School-Age Children
Encopresis (Pseudoincontinence)
True Fecal Incontinence
Radiographic Evaluation
Contrast Enema
Sitz Marker
Manometric Evaluation
Anorectal Manometry
Colonic Manometry
Treatment
Bowel Management
Stimulant Laxatives
Enemas
Diet
Follow-Up
Surgical Treatment
Appendicostomy
Neoappendicostomy
Cecostomy
Rectosigmoid/Left Colon Resection or Colonic Diversion
Outcomes
Surgical Complications
Future Considerations
Sacral Nerve Stimulation
Editor’s Comments
Further Reading
72: Hirschsprung Disease
Epidemiology and Genetics
Clinical Presentation
Diagnosis
Preoperative Management
Operative Management
Leveling Techniques
Stoma Creation
Pull Through
Long-Segment Disease
Postoperative Management
The Struggling Patient
Incontinence
Obstruction
Conclusion
Editor’s Comments
Further Reading
73: Perianal Disease
Rectal Prolapse
Perianal Abscess and Fistula-in-Ano
Anal Fissure
Internal Sphincter Achalasia (IASA)
Hemorrhoids
Sexual Abuse
Summary
Editor’s Comments
Further Reading
74: Appendicitis
Pathophysiology
Presentation
Diagnosis and Initial Management
Nonoperative Management
Surgical Approach
Postoperative Care
Complications
Pearls
Pitfalls
Editor’s Comments
Further Reading
75: Ulcerative Colitis and Familial Polyposis
Ulcerative Colitis
Diagnosis
Medical Management
Indications for Surgical Management
Preoperative Assessment and Preparation
Surgical Management
Complications and Postoperative Management
Psychosocial Considerations
Familial Polyposis
Diagnosis
Surgical Management
Editor’s Comments
Further Reading
76: Anorectal Malformations
Prenatal Imaging
Diagnosis
Males
Females
Associated Anomalies
Initial Surgical Management
Anoplasty
Distal Colostogram
Definitive Operative Repair
Males
Laparoscopically Assisted Anorectoplasty
Females
Posterior Sagittal Anorectovaginourethroplasty (PSARVUP) for the Repair of Cloaca
Postoperative Care
Bowel Management
Outcomes
Complications
Future Considerations
Editor’s Comments
Further Reading
Part IX: Abdominal Wall, Peritoneum and Diaphragm
77: Gastroschisis
Antenatal Management
Newborn Resuscitation
Surgical Care
Primary Vs. Delayed Reduction
Sutured Vs. Sutureless Closure
Nutrition/Feeding Considerations
Complex Gastroschisis
Special Considerations
Long-Term Outcomes
Editor’s Comments
Further Reading
78: Omphalocele
Prenatal Diagnosis
Initial Management
Surgical Management
Immediate Closure
Staged Closure
Delayed Closure (Paint-and-Wait)
Ruptured Omphalocele
Outcomes
Editor’s Comments
Further Reading
79: Eventration of Diaphragm
Physiology
Etiology
Diagnosis
Surgical Treatment
Trans-Thoracic Vs. Trans-Abdominal
Conclusion
Editor’s Comments
Further Reading
80: Congenital Diaphragmatic Hernia
Pathogenesis
Prenatal Evaluation
US and MRI
Lung Size and Liver Position
Echocardiography
Genetic Testing
Fetal Intervention and Antenatal Management
Perinatal Management
Delivery Room Resuscitation
Ventilation
Cardiac Function
ECMO
Surgical Repair
Long-Term Follow-Up
Summary
Editor’s Comments
Further Reading
81: Inguinal Hernia
Embryology
Presentation
Laparoscopic Repair
Open Repair
Incarcerated Hernia
Postoperative Care
Summary
Editor’s Comments
Further Reading
82: Uncommon Hernias
Unusual Inguinal Hernias
Amyand’s Hernia
Littre’s Hernia
Richter’s Hernia
Femoral Hernia
Spigelian Hernia
Lumbar Hernia
Epigastric Hernia
Incisional Hernia
Trocar Site Hernia
Parastomal Hernia
Traumatic Abdominal Wall Hernia
Summary
Further Reading
83: Umbilical Disorders
Umbilical Mass
Umbilical Hernia
Umbilical Granuloma
Umbilical Polyp
Umbilical Drainage
Omphalomesenteric Duct Remnant
Urachal Remnant
Umbilical Infection
Infected Urachal Cyst
Infected Omphalomesenteric Cyst
Omphalitis
Editor’s Comments
Further Reading
84: Peritoneal Dialysis
Catheters
Procedure
Catheter Removal
Complications
Further Reading
85: Ventricular Shunts for Hydrocephalus
Diagnosis
Treatment
CSF Shunts
Postoperative Care
Shunt Malfunction
Shunt Infection
Future Directions
Editor’s Comments
Further Reading
86: Disorders of the Abdominal Aorta and Major Branches
Preoperative Preparation
Surgical Technique
Outcomes
Editor’s Comments
Further Reading
Part X: Liver, Biliary Tree, Pancreas and Spleen
87: Neonatal Hyperbilirubinemia
Diagnosis
Treatment
Editor’s Comments
Further Reading
88: Biliary Atresia
Diagnostic Workup
Preoperative Preparation
Treatment
Postoperative Care
Transplantation
Future Directions
Editor’s Comments
Further Reading
89: Congenital Intrahepatic Cholestasis
Etiology and Presentation
Workup and Perioperative Management
Surgical Approach
Postoperative Management
Outcomes
Editor’s Comments
Further Reading
90: Cholecystitis and Gallstone Disease
Diagnosis
Treatment
Laparoscopic Cholecystectomy
Difficult Dissections
Postoperative Care
Editor’s Comments
Further Reading
91: Choledochal Cysts
Diagnosis
Surgical Therapy
Postoperative Care
Editor’s Comment
Further Reading
92: Benign Liver Masses
Infantile Hepatic Hemangioma
Presentation
Clinical Findings
Imaging
Echocardiography
Laboratory Tests
Management
Pathology
Congenital Hepatic Hemangioma
Rapidly Involuting Congenital Hemangioma (RICH)
Partially Involuting Congenital Hemangioma (PICH)
Non-Involuting Congenital Hemangioma (NICH)
Mesenchymal Hamartoma
Diagnostic Imaging
Pathology
Therapeutic Options
Focal Nodular Hyperplasia
Hepatic Adenoma
Inflammatory Myofibroblastic Tumor
Nested Stromal Epithelial Tumor
Angiolipoma of the Liver
Editor’s Comments
Further Reading
93: Hepatic Resection
Diagnosis
Perioperative Planning
Surgical Technique
Postoperative Care
Editor’s Comments
Further Reading
94: Portal Hypertension
Causes
Presentation
Workup
Preoperative Planning
Surgical Decision Making
Surgical Approach
Common Operative Themes
Meso-Rex Bypass
Distal Splenorenal Shunt
Proximal Splenorenal Shunt
Mesocaval Shunt
Sugiura Devascularization Procedure
Transjugular Intrahepatic Portosystemic Shunt
Postoperative Management
Complications
Early Complications
Late Complications
Shunt Stenosis/Thrombosis
Systemic Syndromes
Hepatic Masses
Conclusion
Editor’s Comments
Further Reading
95: Total Pancreatectomy with Islet Autotransplantation
Presentation
Evaluation and Imaging
Indications and Preoperative Considerations
Operative Procedure
Islet Isolation and Autotransplantation
Postoperative Considerations
Outcomes
Editor’s Comments
Further Reading
96: Congenital Hyperinsulinism
Histology
Genetics and Pathophysiology
Diagnosis
Medical Management
Preoperative Imaging
Surgical Management
Postoperative Management
Outcomes
Editor’s Comments
Further Reading
97: Pancreatitis
Acute Pancreatitis
Diagnosis
Clinical Classification
Medical Management
Complications
Chronic Pancreatitis
CP with Ductal Dilatation
CP Without Ductal Dilatation
Editor’s Comments
Further Reading
98: The Pancreas
Congenital Anomalies
Annular Pancreas
Pancreas Divisum
Ectopic Pancreatic Rests
Pancreatic Cysts
Pancreatic Tumors
Solid Pseudopapillary Neoplasm
Pancreatoblastoma
Acinar Cell Neoplasms
Invasive Ductal Adenocarcinoma
Other Epithelial Neoplasms
Endocrine Neoplasms
Lymphoma
Mesenchymal Neoplasms
Secondary Neoplasms
Editor’s Comments
Further Reading
99: Surgical Disorders of the Spleen
Indications for Splenectomy
Congenital Hemolytic Anemias
Primary Immune Thrombocytopenia
Traumatic Injury
Splenic Cysts
Infections
Neoplasms
Preoperative Care
Surgical Technique
Total Splenectomy
Partial Splenectomy
Special Considerations
Postoperative Care
Risks of Splenectomy
Clinical Outcomes
Adverse Events
Hematologic Outcomes
Future Considerations
Editor’s Comments
Further Reading
Part XI: Genitourinary
100: Vesicoureteral Reflux
Embryology
Imaging
Natural History
Diagnosis
Medical Management
Surgery
Endoscopic Surgery
Associated Anomalies
Editor’s Comments
Further Reading
101: Neurogenic Bladder and Bladder Augmentation
Basics and Theory
Definition and Pathophysiology
Diagnostics
Management
Clean Intermittent Catheterization (CIC)
Pharmacological Treatment
Intravesical Injection of Botulinum Toxin
Surgical Treatment
Bladder-Outlet Surgery
Important Clinical Principles
Summary
Editor’s Comments
Further Reading
102: Penile Anomalies and Circumcision
Embryology and Anatomy
Foreskin Abnormalities
Phimosis
Paraphimosis
Penile Shaft Anomalies
Penile Torsion
Penile Chordee
Micropenis
Inconspicuous Penis
Penile Masses
Hypospadias
Epispadias
Urethral Duplication
Other Penile Anomalies
Circumcision
Circumcision Complications
Anesthesia Complications
Intra-operative Complications
Postoperative Complications
Editor’s Comments
Further Reading
103: Undescended Testes
Testicular Descent
Intervention
Evaluation
Adjunct Investigations
Management
Medical Therapies
Surgical Therapy
Inguinal Orchidopexy
Trans-scrotal (Bianchi) Orchidopexy
Diagnostic Laparoscopy
Laparoscopic Orchidopexy
Postoperative Care and Complications
Editor’s Comments
Further Reading
104: The Acute Scrotum
History
Physical Examination
Ancillary Studies
Management
Prognosis
Editor’s Comments
Further Reading
105: Bladder and Cloacal Exstrophy
Anatomy
Cloacal Exstrophy
Prenatal Diagnosis
Postnatal Evaluation
Goals of Surgery
Osteotomies
Closure of BE
Closure of CE
Postoperative Management
Complications
Summary
Editor’s Comments
Further Reading
106: Differences in Sex Development
Laboratory Evaluation
Imaging
46,XX DSD
Gonadal Dysgenesis
46,XY DSD
Ovotesticular DSD
Sex of Rearing
Psychosocial Considerations
Conclusion
Editor’s Comments
Further Reading
107: Disorders of the Vagina
Physical Examination
Vaginal Anomalies
Cysts
Inflammatory Disease
Tumors
Trauma
Foreign Body
Summary
Further Reading
108: Benign Adnexal Lesions
Ovarian Torsion
Ovarian Cysts
Teratoma
Paratubal Cysts
Tubo-ovarian Abscess
Endometrioma
Summary
Further Reading
Part XII: Surgical Oncology
109: Pediatric Surgical Oncology
Cooperative Study Groups
The Multidisciplinary Team
Diagnosis
Fine Needle Aspiration
Core Needle Biopsy
Open or Minimally Invasive Biopsy
Tumors of the Extremity and Trunk
Tumors in the Thoracic Cavity
Quality of Care
Additional Procedures
Central Venous Access
Nutritional Access
Fertility Preservation
Summary
Editor’s Comments
Further Reading
110: Neuroblastoma
Work Up
Staging and Risk Stratification
Treatment
Operative Management
Pre-operative Management
Extra-abdominal Neuroblastic Tumors
Abdominal Neuroblastoma
Postoperative Management
Recurrent Disease
Editor’s Comments
Further Reading
111: Adrenal Tumors and Pheochromocytoma
Adrenocortical Tumors
Treatment
Neonatal Adrenal Mass
Pheochromocytoma and Paraganglioma
Biochemistry
Genetics
Presentation
Biochemical Testing
Imaging
Preoperative Preparation
Intraoperative Care
Surgical Resection
Postoperative Care
Follow-Up
Further Reading
112: Wilms Tumor
Differential Diagnosis
Imaging
Risk Stratification
Age and Tumor Weight
Histology
Stage
Molecular Genetics
Stratification
Medical Management
Surgical Management
Lymph Nodes
Tumor Thrombus
Bilateral Disease
Stage IV Disease
Minimally Invasive Surgery
Unilateral Partial Nephrectomy
Horseshoe Kidney
Nephroblastomatosis (Nephrogenic Rests)
Lung Metastases
Summary
Further Reading
Untitled
113: Liver Tumors
Benign Liver Tumors
Hemangiomas
Mesenchymal Hamartoma
Focal Nodular Hyperplasia
Regenerative Nodules
Hepatocellular Adenoma
Hepatic Teratoma
Malignant Liver Tumors
Diagnosis
Imaging
PRETEXT and Segmental Anatomy
Biopsy
Treatment
Liver Tumor Resection
Hepatoblastoma
Hepatocellular Carcinoma
Hepatic Sarcomas
Biliary Rhabdomyosarcoma
Angiosarcoma
Undifferentiated Embryonal Sarcoma of the Liver
Rhabdoid Tumor
Metastatic Liver Tumors
Editor’s Comments
Further Reading
114: Rhabdomyosarcoma
Histology and Tumor Biology
Diagnosis
Workup
Staging
Clinical Group
Risk Stratification
Treatment
Biopsy
Surgical Resection
Nodal Sampling
Pretreatment Re-excision
Delayed Primary Excision
Site-Specific Considerations
Extremity
Bladder/Prostate
Female Genital Tract
Paratesticular
Radiotherapy
Systemic Therapy
Outcomes
Editor’s Comments
Further Reading
115: Non-Rhabdomyosarcoma Soft-Tissue Sarcoma
Pathophysiology
Staging
Presentation
Workup
Biopsy
Infantile Fibrosarcoma
Synovial Sarcoma
Malignant Peripheral Nerve Sheath Tumor
Desmoplastic Small Round Cell Tumor
Treatment
Chemotherapy
Radiation Therapy
Biologic Therapy
Surgical Therapy
Outcomes
Editor’s Comments
Further Reading
116: Chest Wall Tumors
Tumor Types
Clinical Presentation/Workup
Surgical Resection
Reconstruction
Outcomes
Further Reading
117: Sacrococcygeal Teratoma
Classification
Diagnosis
Management
Postnatal Resection
Rescue Maneuvers
Fetal Interventions
Prognostic Factors
Postoperative Follow-Up
Future Directions
Editor’s Comments
Further Reading
118: Ovarian Tumors
Diagnosis
Germ Cell Tumors
Sex Cord-Stromal Tumors
Epithelial Tumors
Staging
Surgery
Medical Therapy
Ovarian Torsion and Malignancy
Editor’s Comments
Further Reading
119: Testicular Tumors
Risk Factors
Etiology
Germ Cell Tumors (GCT)
Diagnosis
Workup
Serum Markers
Staging
Surgical Considerations
Prepubertal Masses
Partial Orchiectomy
Other Considerations
Outcomes
Editor’s Comments
Further Reading
120: Melanoma and Atypical Nevi
Neonates and Infants
Children
Adolescents
Congenital Melanocytic Nevi
Melanocytic Tumors of Uncertain Malignant Potential (MelTUMP)
Cutaneous Melanoma
Biopsy and Wide Local Excision
Regional Lymph Nodes
Completion Lymph Node Dissection
Adjuvant Therapy
Locoregional Disease
In Transit Disease
Metastatic Disease
Anti-CTLA4
BRAF Inhibitors
MEK Inhibitors
PD-1 Inhibitors
c-KIT Inhibitor
Second-Line Systemic Therapies
Outcomes
Summary
Further Reading
121: Bone Tumors
Diagnosis
Benign Bone Tumors
Benign Latent
Benign Active
Benign Aggressive
Malignant Bone Tumors
Surgical Considerations
Postoperative Care and Follow-Up
Summary
Editor’s Comments
Further Reading
122: Uncommon Malignancies
Lung Tumors
Pleuropulmonary Blastoma
Workup
Treatment
Outcomes
Surveillance
Peritoneal and Abdominal Tumors
Desmoplastic Round Cell Tumor
Presentation
Workup
Treatment
Outcomes
Pancreatic Tumors
Pancreatoblastoma
Workup
Treatment
Outcomes
Solid Pseudopapillary Neoplasm
Workup
Treatment
Outcomes
Gastrointestinal Tumors
Gastrointestinal Stromal Tumors
Workup
Treatment
Colorectal Carcinoma
Workup
Treatment
Outcomes
Carcinoid Tumors
Workup
Management and Controversy
Adrenal Tumors
Adrenocortical Carcinoma
Workup
Treatment
Outcomes
Controversies
Editor’s Comments
References
Further Reading
123: Inflammatory Myofibroblastic Tumors and Pseudotumors
Epidemiology
Presentation
Diagnosis
Imaging
Histopathology
Genetics
Management
Adjuvant Therapy
Outcomes and Surveillance
Other Inflammatory Pseudotumors
IgG4-Related Sclerosing Disease
Inflammatory Pseudotumor-Like Follicular Dendritic Cell Sarcoma
Pseudosarcomatous Myofibroblastic Proliferations
Pseudotumor of Hemophilia
Editor’s Comments
Further Reading
IMT
IPT
124: Pediatric Fertility Preservation
The Fertility Preservation Team
Risk Assessment and FP Options
Female Patients
Ovarian Hormone Stimulation and Egg Retrieval
Ovarian Tissue Cryopreservation
Male Patients
Sperm Banking
Testicular Tissue Cryopreservation
Testicular Sperm Extraction
Patients with Differences of Sex Development
Gonadal Tissue Cryopreservation
Outcomes/State of the Science
Ovarian Tissue and Eggs
Testicular Tissue and Sperm
Dysgenetic Gonads
Ethical Considerations
Conclusion
Editor’s Comments
Further Reading
Index
Preface
Acknowledgments
Contents
Contributors
Part I: Perioperative Care
1: Preoperative Assessment and Preparation
Risks of Anesthesia
Airway
Respiratory System
Cardiovascular System
Gastroesophageal Reflux Disease
Obesity
Diabetes
Thyroid Disease
Corticosteroids
Anemia
Sickle Cell Disease
Coagulation Disorders
Malignancy
Anterior Mediastinal Mass
Cerebral Palsy
Developmental Disorders
Prematurity
Malignant Hyperthermia
Hypotonia
Trisomy 21
Allergies
Prior to Admission Medications
NSAIDs and Aspirin
Herbal Medications
Illicit/Recreational Medications
Preoperative Fasting
Laboratory Testing and Diagnostic Studies
Editor’s Comments
Further Reading
2: Prenatal Diagnosis and Genetic Counseling
Maternal and Family History
Carrier Screening
Screening and Testing Options
Screening Throughout the Pregnancy
First Trimester
Serum Screening
Ultrasound
Second Trimester
Maternal Serum Quadruple Screen
Combined First- and Second-Trimester Serum Screening
Ultrasound
Diagnostic Testing
Chorionic Villus Sampling
Second Trimester
Genetic Diagnostic Testing
Fluorescent in Situ Hybridization
Chromosome Analysis
Chromosomal Microarray Analysis
Molecular Testing
Whole Exome Sequencing
Summary
Editor’s Comments
Further Reading
3: Neuraxial and Regional Anesthesia
Neuraxial Analgesia and Anesthesia
Epidural and Caudal Analgesia
Spinal Anesthesia
Truncal Anesthesia
Quadratus Lumborum
Erector Spinae
Peripheral Regional Anesthesia
Upper Extremity Regional Anesthesia
Lower Extremity Regional Anesthesia
Duration of Regional Anesthesia
Special Considerations in the Pediatric Patient
Commonly Used Local Anesthetics
Local Anesthetic Toxicity
Conclusion
Editor’s Comments
Further Reading
4: Positioning and Incisions
Positioning
Supine
Dorsal Lithotomy
Lateral Decubitus
Prone
Abdominal Incisions
Midline Abdominal Incision
Transverse Abdominal Incision
Low Transverse Incision
Subcostal Incision
Miscellaneous Abdominal Incisions
Thoracic Incisions
Sternotomy
Thoraco-Abdominal Incision
Other Incisions
Further Reading
5: Enteral Nutrition and Access
Nutritional Requirements
Nutrition for Premature Infants
Short Bowel Syndrome
The Critically Ill Child
Enteral Access
Summary
Editor’s Comments
Further Reading
6: Parenteral Nutrition
Nutrition Assessment
Calories
Carbohydrates
Protein
Protein Recommendations
Lipids
Intralipids
SMOF
Omegaven
Carnitine
Electrolytes
Sodium
Potassium
Calcium
Phosphorus
Magnesium
Trace Elements
Zinc
Copper
Selenium
Iron
Vitamins
Special Considerations
Other Additives/Considerations
Insulin
Refeeding Syndrome
Complications of PN
CLABSI
PN-Associated Liver Disease (PNALD)
Metabolic Bone Disease (MBD)
Venous Access Devices
Neonatal and Preterm Infant PN
Discharge Home with PN
Summary
Editor’s Comments
Further Reading
7: Enhanced Recovery After Surgery Protocols (ERAS): The Next Generation of Perioperative Quality Improvement, Safety, and Innovation
So, What Did You Notice?
Why ERAS? Complications. Complications. Complications
Components and Principles of ERP Care
Pre-operative Phase
Patient Counseling and Optimization
Limited Fasting
Carbohydrate Loading
IV Prophylactic Antibiotics
Bowel Preparation
VTE Prophylaxis
Intraoperative Phase
Euvolemia
Normothermia
Post-operative Phase
Multimodal Analgesia
Local/Regional Analgesia
Oral Medication
Early Mobility
Early Oral Intake
Clear Discharge Goals
Pediatric Outcomes
Crossing Quality Chasm: ERAS Implementation
Audit and Quality Improvement
Multidisciplinary Care
ERAS Coordinator
ERAS Advocacy
Future Directions
Conclusion
Editor’s Comments
Further Reading
8: Quality Improvement in Pediatric Surgery
Methodology
Lean
Six Sigma
Lean Six Sigma
IHI Model
Implementation
Measuring QI Data
Presenting Data
Maintenance Phase
Summary
Editor’s Comments
Further Reading
Part II: Critical Care
9: Fetal Intervention
Medical Therapy
Ultrasound-Guided Procedures
Fetoscopy
Open Maternal-Fetal Surgery
Ex-Utero Intrapartum Treatment
Indications for EXIT
Maternal Considerations
Complicated Monochorionic Twins
Congenital Diaphragmatic Hernia
Lower Urinary Tract Obstruction
Lung Lesions
Sacrococcygeal Teratoma
Myelomeningocele/Myeloschisis
Summary
Editor’s Comments
Further Reading
10: Shock
Recognition of Shock
Pathophysiology of Shock
Hypovolemic Shock
Cardiogenic Shock
Obstructive Shock
Distributive Shock
Histotoxic Shock
Emergency Management
Fluid Resuscitation
Point-of-Care Ultrasound
Vasoactive Agents
Antibiotics
Escalation of Care
Summary
Editor’s Comments
Further Reading
11: Electrolyte Abnormalities
Sodium
Potassium
Calcium
Phosphorus
Acid-Base Abnormalities
Summary
Editor’s Comments
Further Reading
12: Coagulation and Transfusion Medicine
Hemostasis and Fibrinolysis
Coagulopathy
Trauma-Induced Coagulopathy
Disseminated Intravascular Coagulopathy
Hematologic Assessment and Monitoring
Viscoelastic Monitoring
Transfusion Complications
Febrile Non-hemolytic Transfusion Reaction
Allergic Transfusion Reactions
Hemolytic Reactions
Transfusion-Related Acute Lung Injury
Transfusion-Associated Circulatory Overload
Infections
Transfusion Products
Red Blood Cells
Fresh Frozen Plasma
Platelets
Hemostatic Resuscitation
Conventional Coagulation Tests Vs. Viscoelastic Monitoring
Massive Transfusion Protocols
Whole Blood
Pharmacologic Adjuncts
Prothrombin Complex Concentrates and Recombinant Factor VII
Tranexamic Acid
Summary
Editor’s Comments
Further Reading
13: Vascular Access
Short-Term Access
Long-Term Access
Cutdown Techniques
Complications
Summary
Further Reading
14: Acute Kidney Injury
Definition
Etiology and Pathophysiology
Evaluation
Management
Renal Replacement Therapy
Intermittent HD and CRRT
Peritoneal Dialysis
Drug Levels
Prevention
Nutritional Support
Specific Scenarios
Contrast-Induced Nephropathy
Drug-Induced Nephrotoxicity
Acute Interstitial Nephritis
Hemolytic Uremic Syndrome/Thrombotic Thrombocytopenic Purpura
Rhabdomyolysis
Hepatorenal Syndrome
Malignancy
Abdominal Compartment Syndrome
Surgical Considerations
Cardiac Surgery
Summary
Editor’s Comments
Further Reading
15: Mechanical Ventilation
Acute Respiratory Failure
Principles of Mechanical Ventilation
Conventional Mechanical Ventilation
Adjuncts for Refractory Hypoxemia
Alternative Ventilator Modes
Future Considerations
Editor’s Comments
Further Reading
16: Extracorporeal Life Support (ECMO)
The Circuit
ECMO Modalities
Indications
Contraindications
Operative Considerations in the Neonate
Preoperative Preparation
Methods of Cannulation
Cannula and Site Choice
Direct Cervical Cannulation
Bicaval Dual-Lumen Cannula
Management on ECMO
Surgery on ECMO
Weaning from ECMO
Complications
Editor’s Comments
Further Reading
Part III: Trauma
17: Trauma Resuscitation
Pre-arrival
Primary Survey
Airway
Breathing
Circulation
Disability
Exposure/Environmental Support
Secondary Survey
Catheters
Laboratory Testing
Imaging
Patient in Extremis
Resuscitative Thoracotomy
Editor’s Comments
Further Reading
18: Pediatric Head Injury
Medical Management in Severe TBI
Initial Management
Prevention of Secondary Neurologic Injury
Non-operative Management of Intracranial Pressure
Decompressive Craniectomy
Traumatic Injuries
Skull Fractures
Epidural Hematoma
Subdural Hematomas
Intraparenchymal Hematoma
Abusive Head Trauma
Conclusion
Editor’s Comments
Further Reading
Untitled
19: Concussion
Pathophysiology
Diagnosis
Initial Management
Recovery
Follow-Up
Referral for Expert Guidance
Editor’s Comments
Further Reading
20: Neck Injuries
Principle 1: It Begins and Ends with the Airway—the Primacy of Airway Management
Principle 2: Look for Problems Early, Before You Find them by Mistake
Principle 3: Image for a Reason and You Will Image Reasonably
Management Challenges
Blunt Cerebrovascular Injury (BCVI)
Seatbelt Sign
Hanging
Subcutaneous Emphysema
Dog Bites
Expectant Management of Penetrating Injuries
Principle 4: Operate “ABCDE” for Success in Neck Trauma (Table 20.2)
A—Airway, Angiography, Ask
B—Bleeding
C—Central Compartment, Contralateral Side
D—Defend Suture Lines, Drain
E—Endoscopy
Editor’s Comments
Further Reading
21: Spinal Column and Spinal Cord Injuries
Epidemiology
Anatomy
Classification of Injury
Vertebral Column Injury
Occipitoatlantoaxial Injuries
Subaxial Injuries
Thoracolumbar Injuries
Differentiating the Mimickers
Spinal Cord Injury
Classic Neurological Examinations
Penetrating Spine Trauma
Acute Management
Prehospitalization
Trauma Bay
Imaging
Associated Injuries
ICU
Clearing the C-Spine
Long-Term Management
Spinal Bracing
Return to Play (RTP)
Editor’s Comments
Further Reading
22: Burns
Initial Evaluation
Airway Management and Inhalational Injury
Burn Resuscitation and Assessment
Burn Wound Infection
Hypermetabolism
Temperature Regulation
Nutrition
Pharmacologic Regulation of the Hypermetabolic Response
Wound Management
Surgical Treatment
Autografts
Dermal Replacement
Burn Reconstruction
Pain Management
Burn Prevention
Editor’s Comments
Further Reading
23: Abdominal Trauma
Epidemiology
Anatomic and Physiologic Vulnerabilities
Blunt Abdominal Trauma
Seatbelt Sign
Waddell’s Triad
Handlebar Injuries
Diagnostic Evaluation
Focused Abdominal Sonography for Trauma (FAST)
Contrast-Enhanced Ultrasound
Liver and Spleen Injuries
Operative Intervention
Angioembolization
Specifics of Nonoperative Management
Post-Discharge Care
Re-Imaging
Blunt Pancreatic Injury
Injury Grading
Approach to Management
Details of Nonoperative Management
Hollow Viscus Injury
Duodenal Injury
Child Physical Abuse
Penetrating Abdominal Trauma
Damage Control Surgery
Editor’s Comments
Further Reading
24: Thoracic Trauma
Blunt Asphyxia
Rib Fractures
Sucking Chest Wound
Pneumothorax
Hemothorax
Pulmonary Contusion
Pulmonary Laceration
Bronchial Injury
Mediastinum
Tracheal Injury
Blunt Cardiac Injury
Great Vessel Injury
Esophageal Injury
Thoracic Duct Injury
Diaphragm Injury
Editor’s Comment
Further Reading
25: Vascular Injuries
Injury Classification
Iatrogenic Injuries
Diagnosis
Treatment
Outcomes
Long-Term Complications
Special Considerations
Blunt Cerebrovascular Injuries (BCVI)
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)
Tourniquets
Conclusion
Editor’s Comments
Further Reading
26: Pediatric Hand Injuries
Patient Evaluation
Specific Conditions
Burns
Infection
Amputation
Compartment Syndrome
Vascular Injury
Nerve Injury
Flexor Tendon Injury
Fractures
Scaphoid Fractures
Seymour Fractures
Phalangeal Fractures
Buckle and Greenstick Fractures
Casts
Editor’s Comments
Further Reading
27: Child Physical Abuse
General Principles
Clinical Presentation
Cutaneous Injuries
Fractures
Head Trauma
Abdominal Injuries
Evaluation
Bias
Conclusion
Editor’s Comments
Further Reading
Part IV: Head and Neck
28: The Critical Airway
Differential Diagnosis
Airway Sounds
Clinical Assessment
Management of the Acute Airway
Medical Management
Oxygen
Epinephrine
Corticosteroids
Heliox
Nasal Airway
Noninvasive Positive Pressure Ventilation
Oral Intubation
Bronchoscopy
Transtracheal Ventilation
Cricothyrotomy
Tracheostomy
Extracorporeal Membrane Oxygenation
Special Considerations
Nasal Obstruction
Micrognathia
Congenital Neck Masses
Our Approach
Editor’s Comments
Further Reading
29: Bronchoscopy and Airway Disorders
Types of Bronchoscopy
Rigid Bronchoscopy
Flexible Bronchoscopy
Complications
Anesthetic Considerations
Equipment
Technique
Airway Anatomy
Airway Dynamics
Laryngomalacia
Pharyngomalacia
Tracheomalacia and Bronchomalacia
Laryngotracheal Stenosis
Glottic Stenosis
Subglottic Stenosis
Tracheal Stenosis
Airway Tumors
Benign Tumors
Malignant Tumors
Infections Causing Central Airway Obstruction
Management
Foreign Bodies
TEF and Laryngeal Cleft
Laryngotracheoesophageal Cleft
TEF
Mucosal Surface Irregularities
Insufflation to Expose Occult TEF
Persistent Air Leak
Transbronchial Lung Biopsy
Limitations
Risks
Transbronchial Lymph Node Sampling
Editor’s Comments
30: Benign Neck Masses
Thyroglossal Duct Cyst
Surgical Management
Outcomes
Plunging Ranula
Dermoid Cysts
Teratoma
Branchial Cleft Anomalies
First Branchial Cleft Anomalies
Second Branchial Cleft Anomalies
Third/Fourth Branchial Cleft Anomalies
Lymphadenitis
Acute Viral Lymphadenitis
Acute Bacterial Lymphadenitis
Subacute/Chronic Bacterial Lymphadenitis
Vascular Anomalies
Treatment
Sclerotherapy
Summary
Editor’s Comments
Further Reading
31: Thyroid and Parathyroid
Anatomy
Histology and Endocrine Function
Thyroid Imaging
Ultrasound (US)
Nuclear Medicine Scan
Computed Tomography (CT)
Congenital Thyroid Abnormalities
Ectopic Thyroid Tissue
Thyroglossal Duct Cysts
Congenital Central Hypothyroidism
Fourth Branchial Cleft Anomaly
Thyroid Disorders
Graves Disease
Hashimoto Disease (Chronic Lymphocytic Thyroiditis)
Subacute (de Quervain) Thyroiditis
Thyroid Nodules
Autonomous Nodules
Thyroid Cyst
Goiter
Thyroid Carcinoma
Papillary Thyroid Carcinoma
Follicular Thyroid Carcinoma
Medullary Thyroid Carcinoma
Surgical Management
Parathyroid Disease
Primary Hyperparathyroidism
Secondary/Tertiary Hyperparathyroidism
Neonatal Severe Hyperparathyroidism
Surgical Management
Multiple Endocrine Neoplasia (MEN)
MEN I
MEN IIA/IIB
Centers of Excellence
Summary
Editor’s Comments
Further Reading
Part V: Skin and Soft Tissues
32: Benign Skin Lesions
Cutaneous Lesions
Verrucae
Calcinosis Cutis
Keloids
Pyogenic Granuloma
Dermatofibroma
Neurofibroma
Juvenile Xanthogranuloma
Subcutaneous Lesions
Lipoma
Granuloma Annulare
Infantile Myofibroma
Cysts
Epidermoid Cyst
Dermoid Cyst
Pilomatricoma
Foreign Bodies
Lymph Nodes
Non-Melanocytic Nevi
Epidermal Nevi
Nevus Sebaceus of Jadassohn
Smooth Muscle Hamartoma
Connective Tissue Nevus
Postoperative Care
Editor’s Comments
Further Reading
33: Hemangiomas and Vascular Malformations
Hemangiomas
Vascular Malformations
Diagnosis
Treatment of Hemangiomas
Treatment of Vascular Malformations
Complications
Editor’s Comments
Further Reading
34: Disorders of the Breast
Congenital Anomalies and Disorders of Development
Thelarche
Virginal/Juvenile Hypertrophy
Trauma
Nipple Discharge
Bloody Discharge
Galactorrhea
Infections
Fibrocystic Disease
Masses
Neonatal Lesions
Pubertal Masses
Retro-areolar Cysts (Montgomery Cysts)
Fibroadenoma
Juvenile Fibroadenoma
Juvenile Papillomatosis
Pseudoangiomatous Stromal Hyperplasia (PASH)
Phyllodes Tumors
Breast Carcinoma
Gynecomastia
Editor’s Comments
Further Reading
35: Necrotizing Soft Tissue Infections
Diagnosis
Preoperative Preparation
Surgery
Postoperative Care
Reconstruction and Rehabilitation
Editor‘s Comments
Further Reading
36: Pilonidal Disease
Conservative Management
Surgical Management
Primary Excision
Trephination
Endoscopic Pilonidal Sinus Treatment
Cleft-Lift Operation
Summary
Further Reading
37: Lymphatic Flow Disorders
Anatomy
Disorders of the Lymphatic System
Imaging
Percutaneous Procedures
Surgical Procedures
Conclusions
Editor’s Comments
Further Reading
38: Palmar Hyperhidrosis
Physiology
Etiology
Diagnosis
Multidisciplinary Approach
Medical Management
Surgical Management
Outcomes
Editor’s Comments
Further Reading
Part VI: Thorax and Mediastinum
39: Complex Wound Management
General Principles
Assessing the Wound
Cleaning the Wound
Debriding the Wound
Dressing the wound
Definitive Coverage of the Wound
Specific Types of Wounds
Pressure Injury
The Open Abdomen
Cavitary Wounds
Vascular Device-Related Wounds
Alternative Therapies
Developmental Approach
Scar Management
Summary
Further Reading
40: Lung Biopsy and Resection
Indications
Diagnosis
Preoperative Considerations
Anesthesia/Airway Management
Positioning
Operative Technique
Lung Biopsy or Wedge Resection
Thoracoscopic Lobectomy
Extralobar Bronchopulmonary Sequestration
Lower Lobectomy
Right Upper Lobectomy
Left Upper Lobectomy
Right Middle Lobectomy
Postoperative Care
Editor’s Comments
Further Reading
41: Diseases of the Pleura
Pneumothorax
Treatment
Complications
Outcomes
Cystic Fibrosis
Empyema
Diagnosis
Treatment
Surgical Treatment
Outcomes
Chylothorax
Diagnosis
Treatment
Thoracic Duct Embolization
Surgical Treatment
Hemothorax
Editor’s Comments
Further Reading
Pneumothorax
Empyema
Chylothorax
Hemothorax
42: Congenital Lung Lesions
Prenatal Management
Corticosteroids
Fetal Intervention
Ex Utero Intrapartum Treatment and Section-to-Resection
Postnatal Management
Congenital Lobar Emphysema
Complications
Summary
Editor’s Comment
Further Reading
43: Vascular Compression Syndromes
Diagnosis
Treatment
Right-Sided Arch with Aberrant Left Subclavian Artery
Double Aortic Arch
Complications
Editor’s Comments
Further Reading
44: Pectus Deformities
Pectus Deformities
Pectus Excavatum
Clinical Presentation
Preoperative Evaluation
Treatment Options
Nuss Procedure
Pain Control
Postoperative Care
Bar Removal
Open Technique
Complications
Pectus Carinatum
Treatment
Editor’s Comments
Further Reading
45: Mediastinal Masses
Introduction
Anterior Mediastinum
Middle Mediastinum
Posterior Mediastinum
Diagnostic Strategy
Anesthetic Evaluation
Biopsy of Suspected Lymphoma
Surgical Approach to Other Mediastinal Masses
Thymic Lesions
Teratoma
Cysts
Vascular Anomalies
Neurogenic Tumors
Summary
Editor’s Comments
Further Reading
46: Esophageal Atresia
Antenatal Diagnosis
Preoperative Workup
Special Considerations
Surgical Technique
Postoperative Care
Complications
Follow-Up
Thoracoscopy for Long-Gap EA
Editor’s Comments
Further Reading
47: Long-Gap Esophageal Atresia
Diagnosis
Initial Management
Timing of Repair
Preoperative Assessment
Surgical Repair
Delayed Primary Repair
Esophageal Myotomy
Esophageal Lengthening or Traction
Jejunal Interposition
Gastric Transposition
Colon Interposition
Esophageal Magnamosis
Tissue Engineering of the Esophagus
Conclusions
Editor’s Comments
Further Reading
Esophageal Atresia
Tracheal Anomalies
Surgical Techniques/Myotomy
Foker Process
Interposition
Magnamosis
Tissue Engineering
48: Lesions, Injuries, and Replacement of the Esophagus
Diverticula
Benign Tumors
Perforations/Injuries
Surgical Repair
Esophageal Replacement
Gastric Transposition
Gastric Tube Reconstruction
Colonic Interposition
Jejunal Interposition
Summary
Editor’s Comments
Further Reading
Part VII: Stomach and Small Intestines
49: Foregut Duplications
Thoracic Duplications
Abdominal Duplications
Antenatal Diagnosis
Concerns and Complications
Editor’s Comments
Further Reading
50: Achalasia
Diagnosis
Non-surgical Treatment
Preoperative Preparation
Surgical Techniques
Open Heller Myotomy
Laparoscopic Heller Myotomy
Postoperative Care
Complications
Per Oral Endoscopic Myotomy
Surgical Technique
Postoperative Care
Complications
Robotic Heller Myotomy
Thoracoscopic Heller Myotomy
Editor’s Comments
Further Reading
51: Gastroesophageal Reflux Disease and Hiatal Hernia
Presentation
Diagnosis
Medical Management
Surgical Approach
Pearls
Pitfalls
Complications
Outcomes
Editor’s Comments
Further Reading
52: The Stomach
Mucosal Lesions
Polyps and Tumors
Duplication Cysts
Gastric Volvulus
Para-Esophageal Hiatal Hernia
Trauma
Bezoar
Gastric Resection and Anastomoses
Pyloroplasty
Summary
Further Reading
53: Hypertrophic Pyloric Stenosis
Diagnosis
Preoperative Preparation
Surgical Technique
Postoperative Care
Editor’s Comments
Further Reading
54: Congenital Duodenal Obstruction
Diagnosis
Prenatal
Postnatal
Preoperative Preparation
Operative Management
Open Repair
Laparoscopic Repair
Postoperative Management
Editor’s Comments
Further Reading
55: Intestinal Atresia
Prenatal Diagnosis
Diagnosis
Preoperative Management
Operative Management
Laparotomy
Laparoscopy
Colonic Atresia
Postoperative Management and Complications
Summary
Editor’s Comments
Further Reading
56: Abdominal Cysts and Duplications
Enteric Cysts
Adnexal
Genitourinary
Renal
Lymphatic
Hepatobiliary
Pancreatic
Splenic
Tumors
Trauma/Pseudocysts
Diagnosis
Treatment
Postoperative Care
Editor’s Comments
Further Reading
Enteric
Genitourinary
Renal
Lymphatic
Hepatobiliary
Pancreatic
Splenic
Trauma/Pseudocyst
Tumors
57: Intestinal Rotational Anomalies
Embryology and Pathophysiology
Classification
Diagnosis
Treatment
Outcomes
Special Cases
Editor’s Comments
Further Reading
58: Necrotizing Enterocolitis
Stages of NEC
The Perfect Pentad: Five Presentations of NEC and Their Surgical Indications
Scenario 1: “Textbook” NEC—Pneumatosis and Free Air in a Previously Healthy Premature Infant
Scenario 2: Failure to Clinically Improve in the Presence of Pneumatosis but the Absence of Free Air
Scenario 3: The Presence of Portal Venous Air: Don’t Let the Child’s Cries Fall on Deaf Ears
Scenario 4: Staccato NEC—From Good to Bad to Worse in No Time at All
Scenario 5: “NEC totalis”—Peek, Shriek, and then Save!
Indications for Operating on a Child with NEC
Peritoneal Drainage for NEC.
Conduct the Operation for the Child with NEC
Complications of NEC Surgery and How to Avoid Them
Expected Outcomes
Summary and Conclusions
Editor’s Comments
References
59: Intestinal Failure and Rehabilitation
Intestinal Length
Parenteral Nutrition
Enteral Nutrition
Medical Therapy
Surgical Intervention
LILT (Bianchi Procedure)
STEP Procedure
Intestinal Transplantation
Summary
Editor’s Comments
Further Reading
60: Meconium Ileus
Pathophysiology
Epidemiology
Prenatal Diagnosis
Postnatal Diagnosis
Nonoperative Treatment
Operative Treatment
Postoperative Care
Long-Term Complications
Editor’s Comments
Further Reading
61: Intussusception
Types
Epidemiology
Clinical Findings
Diagnosis
Treatment
Editor’s Comments
Further Reading
62: Meckel’s Diverticulum
Clinical Presentation
Gastrointestinal Hemorrhage
Small Bowel Obstruction
Inflammation
Surgical Considerations
Incidental Meckel’s Diverticulum
Summary
Editor’s Comments
Further Reading
63: Bariatric Surgery
Patient Selection
Pre-operative Evaluation/Preparation
Procedure Selection
Perioperative Considerations
Outcomes
Summary
Editor’s Comments
Further Reading
64: Chronic Abdominal Pain
Workup
Surgical Management
Gallbladder
Appendix
Rotational Anomalies of the Intestines
Meckel’s Diverticulum
Intussusception
Crohn’s Disease
Intestinal Angina
Adhesions
Ovarian Cysts
Pelvic Inflammatory Disease
Endometriosis
Rare Causes of Chronic Abdominal Pain
Medical Treatment
Summary
Further Reading
65: Crohn’s Disease
Ileal Disease
Imaging
Surgery
Colitis
Surgery
Perianal Disease
Fissures and Skin Tags
Fistulas and Abscesses
Strictures
Atypical Patterns of Disease
Outcomes
Further Reading
66: Ileostomy and Colostomy
Ileostomy
End Ileostomy
Loop Ileostomy
Special Circumstances
Colostomy
Ostomy Closure
Complications
Skin Issues
Retraction and Prolapse
Hernia
Obstruction
Infection
Special Considerations
Further Reading
67: Small Bowel Obstruction
Clinical Presentation
Imaging
Non-operative Management
Failure of Nonoperative Management
Operative Emergency
Postoperative Management
Summary
Editor’s Comments
Further Reading
68: The Small Intestine
Duodenum
Jejunum
Ileum
Summary
Further Reading
69: Gastrointestinal Bleeding
Diagnostic Workup
Surgical Intervention
Aorta-Esophageal Fistula
Esophageal Varices
Foregut Lesions
Intussusception
Meckel Diverticulum
Polyps
Vascular Malformation
Solitary Rectal Ulcer Syndrome
Summary
Further Reading
70: Enterocutaneous Fistula
Surgical Complication
Initial Management
Surgical Planning
Surgical Treatment
Outcomes
Editor’s Comments
Further Reading
Part VIII: Colon, Rectum and Anus
71: Constipation and Fecal Incontinence
Hirschsprung Disease
Mechanism of Continence
Evaluation
Newborns/Infants
Toddlers
School-Age Children
Encopresis (Pseudoincontinence)
True Fecal Incontinence
Radiographic Evaluation
Contrast Enema
Sitz Marker
Manometric Evaluation
Anorectal Manometry
Colonic Manometry
Treatment
Bowel Management
Stimulant Laxatives
Enemas
Diet
Follow-Up
Surgical Treatment
Appendicostomy
Neoappendicostomy
Cecostomy
Rectosigmoid/Left Colon Resection or Colonic Diversion
Outcomes
Surgical Complications
Future Considerations
Sacral Nerve Stimulation
Editor’s Comments
Further Reading
72: Hirschsprung Disease
Epidemiology and Genetics
Clinical Presentation
Diagnosis
Preoperative Management
Operative Management
Leveling Techniques
Stoma Creation
Pull Through
Long-Segment Disease
Postoperative Management
The Struggling Patient
Incontinence
Obstruction
Conclusion
Editor’s Comments
Further Reading
73: Perianal Disease
Rectal Prolapse
Perianal Abscess and Fistula-in-Ano
Anal Fissure
Internal Sphincter Achalasia (IASA)
Hemorrhoids
Sexual Abuse
Summary
Editor’s Comments
Further Reading
74: Appendicitis
Pathophysiology
Presentation
Diagnosis and Initial Management
Nonoperative Management
Surgical Approach
Postoperative Care
Complications
Pearls
Pitfalls
Editor’s Comments
Further Reading
75: Ulcerative Colitis and Familial Polyposis
Ulcerative Colitis
Diagnosis
Medical Management
Indications for Surgical Management
Preoperative Assessment and Preparation
Surgical Management
Complications and Postoperative Management
Psychosocial Considerations
Familial Polyposis
Diagnosis
Surgical Management
Editor’s Comments
Further Reading
76: Anorectal Malformations
Prenatal Imaging
Diagnosis
Males
Females
Associated Anomalies
Initial Surgical Management
Anoplasty
Distal Colostogram
Definitive Operative Repair
Males
Laparoscopically Assisted Anorectoplasty
Females
Posterior Sagittal Anorectovaginourethroplasty (PSARVUP) for the Repair of Cloaca
Postoperative Care
Bowel Management
Outcomes
Complications
Future Considerations
Editor’s Comments
Further Reading
Part IX: Abdominal Wall, Peritoneum and Diaphragm
77: Gastroschisis
Antenatal Management
Newborn Resuscitation
Surgical Care
Primary Vs. Delayed Reduction
Sutured Vs. Sutureless Closure
Nutrition/Feeding Considerations
Complex Gastroschisis
Special Considerations
Long-Term Outcomes
Editor’s Comments
Further Reading
78: Omphalocele
Prenatal Diagnosis
Initial Management
Surgical Management
Immediate Closure
Staged Closure
Delayed Closure (Paint-and-Wait)
Ruptured Omphalocele
Outcomes
Editor’s Comments
Further Reading
79: Eventration of Diaphragm
Physiology
Etiology
Diagnosis
Surgical Treatment
Trans-Thoracic Vs. Trans-Abdominal
Conclusion
Editor’s Comments
Further Reading
80: Congenital Diaphragmatic Hernia
Pathogenesis
Prenatal Evaluation
US and MRI
Lung Size and Liver Position
Echocardiography
Genetic Testing
Fetal Intervention and Antenatal Management
Perinatal Management
Delivery Room Resuscitation
Ventilation
Cardiac Function
ECMO
Surgical Repair
Long-Term Follow-Up
Summary
Editor’s Comments
Further Reading
81: Inguinal Hernia
Embryology
Presentation
Laparoscopic Repair
Open Repair
Incarcerated Hernia
Postoperative Care
Summary
Editor’s Comments
Further Reading
82: Uncommon Hernias
Unusual Inguinal Hernias
Amyand’s Hernia
Littre’s Hernia
Richter’s Hernia
Femoral Hernia
Spigelian Hernia
Lumbar Hernia
Epigastric Hernia
Incisional Hernia
Trocar Site Hernia
Parastomal Hernia
Traumatic Abdominal Wall Hernia
Summary
Further Reading
83: Umbilical Disorders
Umbilical Mass
Umbilical Hernia
Umbilical Granuloma
Umbilical Polyp
Umbilical Drainage
Omphalomesenteric Duct Remnant
Urachal Remnant
Umbilical Infection
Infected Urachal Cyst
Infected Omphalomesenteric Cyst
Omphalitis
Editor’s Comments
Further Reading
84: Peritoneal Dialysis
Catheters
Procedure
Catheter Removal
Complications
Further Reading
85: Ventricular Shunts for Hydrocephalus
Diagnosis
Treatment
CSF Shunts
Postoperative Care
Shunt Malfunction
Shunt Infection
Future Directions
Editor’s Comments
Further Reading
86: Disorders of the Abdominal Aorta and Major Branches
Preoperative Preparation
Surgical Technique
Outcomes
Editor’s Comments
Further Reading
Part X: Liver, Biliary Tree, Pancreas and Spleen
87: Neonatal Hyperbilirubinemia
Diagnosis
Treatment
Editor’s Comments
Further Reading
88: Biliary Atresia
Diagnostic Workup
Preoperative Preparation
Treatment
Postoperative Care
Transplantation
Future Directions
Editor’s Comments
Further Reading
89: Congenital Intrahepatic Cholestasis
Etiology and Presentation
Workup and Perioperative Management
Surgical Approach
Postoperative Management
Outcomes
Editor’s Comments
Further Reading
90: Cholecystitis and Gallstone Disease
Diagnosis
Treatment
Laparoscopic Cholecystectomy
Difficult Dissections
Postoperative Care
Editor’s Comments
Further Reading
91: Choledochal Cysts
Diagnosis
Surgical Therapy
Postoperative Care
Editor’s Comment
Further Reading
92: Benign Liver Masses
Infantile Hepatic Hemangioma
Presentation
Clinical Findings
Imaging
Echocardiography
Laboratory Tests
Management
Pathology
Congenital Hepatic Hemangioma
Rapidly Involuting Congenital Hemangioma (RICH)
Partially Involuting Congenital Hemangioma (PICH)
Non-Involuting Congenital Hemangioma (NICH)
Mesenchymal Hamartoma
Diagnostic Imaging
Pathology
Therapeutic Options
Focal Nodular Hyperplasia
Hepatic Adenoma
Inflammatory Myofibroblastic Tumor
Nested Stromal Epithelial Tumor
Angiolipoma of the Liver
Editor’s Comments
Further Reading
93: Hepatic Resection
Diagnosis
Perioperative Planning
Surgical Technique
Postoperative Care
Editor’s Comments
Further Reading
94: Portal Hypertension
Causes
Presentation
Workup
Preoperative Planning
Surgical Decision Making
Surgical Approach
Common Operative Themes
Meso-Rex Bypass
Distal Splenorenal Shunt
Proximal Splenorenal Shunt
Mesocaval Shunt
Sugiura Devascularization Procedure
Transjugular Intrahepatic Portosystemic Shunt
Postoperative Management
Complications
Early Complications
Late Complications
Shunt Stenosis/Thrombosis
Systemic Syndromes
Hepatic Masses
Conclusion
Editor’s Comments
Further Reading
95: Total Pancreatectomy with Islet Autotransplantation
Presentation
Evaluation and Imaging
Indications and Preoperative Considerations
Operative Procedure
Islet Isolation and Autotransplantation
Postoperative Considerations
Outcomes
Editor’s Comments
Further Reading
96: Congenital Hyperinsulinism
Histology
Genetics and Pathophysiology
Diagnosis
Medical Management
Preoperative Imaging
Surgical Management
Postoperative Management
Outcomes
Editor’s Comments
Further Reading
97: Pancreatitis
Acute Pancreatitis
Diagnosis
Clinical Classification
Medical Management
Complications
Chronic Pancreatitis
CP with Ductal Dilatation
CP Without Ductal Dilatation
Editor’s Comments
Further Reading
98: The Pancreas
Congenital Anomalies
Annular Pancreas
Pancreas Divisum
Ectopic Pancreatic Rests
Pancreatic Cysts
Pancreatic Tumors
Solid Pseudopapillary Neoplasm
Pancreatoblastoma
Acinar Cell Neoplasms
Invasive Ductal Adenocarcinoma
Other Epithelial Neoplasms
Endocrine Neoplasms
Lymphoma
Mesenchymal Neoplasms
Secondary Neoplasms
Editor’s Comments
Further Reading
99: Surgical Disorders of the Spleen
Indications for Splenectomy
Congenital Hemolytic Anemias
Primary Immune Thrombocytopenia
Traumatic Injury
Splenic Cysts
Infections
Neoplasms
Preoperative Care
Surgical Technique
Total Splenectomy
Partial Splenectomy
Special Considerations
Postoperative Care
Risks of Splenectomy
Clinical Outcomes
Adverse Events
Hematologic Outcomes
Future Considerations
Editor’s Comments
Further Reading
Part XI: Genitourinary
100: Vesicoureteral Reflux
Embryology
Imaging
Natural History
Diagnosis
Medical Management
Surgery
Endoscopic Surgery
Associated Anomalies
Editor’s Comments
Further Reading
101: Neurogenic Bladder and Bladder Augmentation
Basics and Theory
Definition and Pathophysiology
Diagnostics
Management
Clean Intermittent Catheterization (CIC)
Pharmacological Treatment
Intravesical Injection of Botulinum Toxin
Surgical Treatment
Bladder-Outlet Surgery
Important Clinical Principles
Summary
Editor’s Comments
Further Reading
102: Penile Anomalies and Circumcision
Embryology and Anatomy
Foreskin Abnormalities
Phimosis
Paraphimosis
Penile Shaft Anomalies
Penile Torsion
Penile Chordee
Micropenis
Inconspicuous Penis
Penile Masses
Hypospadias
Epispadias
Urethral Duplication
Other Penile Anomalies
Circumcision
Circumcision Complications
Anesthesia Complications
Intra-operative Complications
Postoperative Complications
Editor’s Comments
Further Reading
103: Undescended Testes
Testicular Descent
Intervention
Evaluation
Adjunct Investigations
Management
Medical Therapies
Surgical Therapy
Inguinal Orchidopexy
Trans-scrotal (Bianchi) Orchidopexy
Diagnostic Laparoscopy
Laparoscopic Orchidopexy
Postoperative Care and Complications
Editor’s Comments
Further Reading
104: The Acute Scrotum
History
Physical Examination
Ancillary Studies
Management
Prognosis
Editor’s Comments
Further Reading
105: Bladder and Cloacal Exstrophy
Anatomy
Cloacal Exstrophy
Prenatal Diagnosis
Postnatal Evaluation
Goals of Surgery
Osteotomies
Closure of BE
Closure of CE
Postoperative Management
Complications
Summary
Editor’s Comments
Further Reading
106: Differences in Sex Development
Laboratory Evaluation
Imaging
46,XX DSD
Gonadal Dysgenesis
46,XY DSD
Ovotesticular DSD
Sex of Rearing
Psychosocial Considerations
Conclusion
Editor’s Comments
Further Reading
107: Disorders of the Vagina
Physical Examination
Vaginal Anomalies
Cysts
Inflammatory Disease
Tumors
Trauma
Foreign Body
Summary
Further Reading
108: Benign Adnexal Lesions
Ovarian Torsion
Ovarian Cysts
Teratoma
Paratubal Cysts
Tubo-ovarian Abscess
Endometrioma
Summary
Further Reading
Part XII: Surgical Oncology
109: Pediatric Surgical Oncology
Cooperative Study Groups
The Multidisciplinary Team
Diagnosis
Fine Needle Aspiration
Core Needle Biopsy
Open or Minimally Invasive Biopsy
Tumors of the Extremity and Trunk
Tumors in the Thoracic Cavity
Quality of Care
Additional Procedures
Central Venous Access
Nutritional Access
Fertility Preservation
Summary
Editor’s Comments
Further Reading
110: Neuroblastoma
Work Up
Staging and Risk Stratification
Treatment
Operative Management
Pre-operative Management
Extra-abdominal Neuroblastic Tumors
Abdominal Neuroblastoma
Postoperative Management
Recurrent Disease
Editor’s Comments
Further Reading
111: Adrenal Tumors and Pheochromocytoma
Adrenocortical Tumors
Treatment
Neonatal Adrenal Mass
Pheochromocytoma and Paraganglioma
Biochemistry
Genetics
Presentation
Biochemical Testing
Imaging
Preoperative Preparation
Intraoperative Care
Surgical Resection
Postoperative Care
Follow-Up
Further Reading
112: Wilms Tumor
Differential Diagnosis
Imaging
Risk Stratification
Age and Tumor Weight
Histology
Stage
Molecular Genetics
Stratification
Medical Management
Surgical Management
Lymph Nodes
Tumor Thrombus
Bilateral Disease
Stage IV Disease
Minimally Invasive Surgery
Unilateral Partial Nephrectomy
Horseshoe Kidney
Nephroblastomatosis (Nephrogenic Rests)
Lung Metastases
Summary
Further Reading
Untitled
113: Liver Tumors
Benign Liver Tumors
Hemangiomas
Mesenchymal Hamartoma
Focal Nodular Hyperplasia
Regenerative Nodules
Hepatocellular Adenoma
Hepatic Teratoma
Malignant Liver Tumors
Diagnosis
Imaging
PRETEXT and Segmental Anatomy
Biopsy
Treatment
Liver Tumor Resection
Hepatoblastoma
Hepatocellular Carcinoma
Hepatic Sarcomas
Biliary Rhabdomyosarcoma
Angiosarcoma
Undifferentiated Embryonal Sarcoma of the Liver
Rhabdoid Tumor
Metastatic Liver Tumors
Editor’s Comments
Further Reading
114: Rhabdomyosarcoma
Histology and Tumor Biology
Diagnosis
Workup
Staging
Clinical Group
Risk Stratification
Treatment
Biopsy
Surgical Resection
Nodal Sampling
Pretreatment Re-excision
Delayed Primary Excision
Site-Specific Considerations
Extremity
Bladder/Prostate
Female Genital Tract
Paratesticular
Radiotherapy
Systemic Therapy
Outcomes
Editor’s Comments
Further Reading
115: Non-Rhabdomyosarcoma Soft-Tissue Sarcoma
Pathophysiology
Staging
Presentation
Workup
Biopsy
Infantile Fibrosarcoma
Synovial Sarcoma
Malignant Peripheral Nerve Sheath Tumor
Desmoplastic Small Round Cell Tumor
Treatment
Chemotherapy
Radiation Therapy
Biologic Therapy
Surgical Therapy
Outcomes
Editor’s Comments
Further Reading
116: Chest Wall Tumors
Tumor Types
Clinical Presentation/Workup
Surgical Resection
Reconstruction
Outcomes
Further Reading
117: Sacrococcygeal Teratoma
Classification
Diagnosis
Management
Postnatal Resection
Rescue Maneuvers
Fetal Interventions
Prognostic Factors
Postoperative Follow-Up
Future Directions
Editor’s Comments
Further Reading
118: Ovarian Tumors
Diagnosis
Germ Cell Tumors
Sex Cord-Stromal Tumors
Epithelial Tumors
Staging
Surgery
Medical Therapy
Ovarian Torsion and Malignancy
Editor’s Comments
Further Reading
119: Testicular Tumors
Risk Factors
Etiology
Germ Cell Tumors (GCT)
Diagnosis
Workup
Serum Markers
Staging
Surgical Considerations
Prepubertal Masses
Partial Orchiectomy
Other Considerations
Outcomes
Editor’s Comments
Further Reading
120: Melanoma and Atypical Nevi
Neonates and Infants
Children
Adolescents
Congenital Melanocytic Nevi
Melanocytic Tumors of Uncertain Malignant Potential (MelTUMP)
Cutaneous Melanoma
Biopsy and Wide Local Excision
Regional Lymph Nodes
Completion Lymph Node Dissection
Adjuvant Therapy
Locoregional Disease
In Transit Disease
Metastatic Disease
Anti-CTLA4
BRAF Inhibitors
MEK Inhibitors
PD-1 Inhibitors
c-KIT Inhibitor
Second-Line Systemic Therapies
Outcomes
Summary
Further Reading
121: Bone Tumors
Diagnosis
Benign Bone Tumors
Benign Latent
Benign Active
Benign Aggressive
Malignant Bone Tumors
Surgical Considerations
Postoperative Care and Follow-Up
Summary
Editor’s Comments
Further Reading
122: Uncommon Malignancies
Lung Tumors
Pleuropulmonary Blastoma
Workup
Treatment
Outcomes
Surveillance
Peritoneal and Abdominal Tumors
Desmoplastic Round Cell Tumor
Presentation
Workup
Treatment
Outcomes
Pancreatic Tumors
Pancreatoblastoma
Workup
Treatment
Outcomes
Solid Pseudopapillary Neoplasm
Workup
Treatment
Outcomes
Gastrointestinal Tumors
Gastrointestinal Stromal Tumors
Workup
Treatment
Colorectal Carcinoma
Workup
Treatment
Outcomes
Carcinoid Tumors
Workup
Management and Controversy
Adrenal Tumors
Adrenocortical Carcinoma
Workup
Treatment
Outcomes
Controversies
Editor’s Comments
References
Further Reading
123: Inflammatory Myofibroblastic Tumors and Pseudotumors
Epidemiology
Presentation
Diagnosis
Imaging
Histopathology
Genetics
Management
Adjuvant Therapy
Outcomes and Surveillance
Other Inflammatory Pseudotumors
IgG4-Related Sclerosing Disease
Inflammatory Pseudotumor-Like Follicular Dendritic Cell Sarcoma
Pseudosarcomatous Myofibroblastic Proliferations
Pseudotumor of Hemophilia
Editor’s Comments
Further Reading
IMT
IPT
124: Pediatric Fertility Preservation
The Fertility Preservation Team
Risk Assessment and FP Options
Female Patients
Ovarian Hormone Stimulation and Egg Retrieval
Ovarian Tissue Cryopreservation
Male Patients
Sperm Banking
Testicular Tissue Cryopreservation
Testicular Sperm Extraction
Patients with Differences of Sex Development
Gonadal Tissue Cryopreservation
Outcomes/State of the Science
Ovarian Tissue and Eggs
Testicular Tissue and Sperm
Dysgenetic Gonads
Ethical Considerations
Conclusion
Editor’s Comments
Further Reading
Index
