common congenital anomalies in neonate and children
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Common Congenital Common Congenital Anomalies in Neonate Anomalies in Neonate
and Childrenand Children
Why do we practice pediatric surgery?Why do we practice pediatric surgery? Is it a branch of general surgery?Is it a branch of general surgery? Is it just the miniaturized surgery of Is it just the miniaturized surgery of
adult?adult?““The whole of surgery applied to a The whole of surgery applied to a
special age group”.special age group”.Require special considerationRequire special considerationPhysical.Physical.Psychological.Psychological.
Physical differences :Physical differences :Cell divisionCell division
Adult:-Repair and reproductiveAdult:-Repair and reproductiveNeonate :Allow for growthNeonate :Allow for growth
Healing PowerHealing PowerTremendous healing powerTremendous healing power
SurgerySurgeryAfter birth is in transitional stateAfter birth is in transitional state
InfectionInfectionDeffence : builds up slowly,little resistance,passive Deffence : builds up slowly,little resistance,passive immunity.immunity.
Conditions necessitating surgery.Conditions necessitating surgery.-congenital malformation-congenital malformation
I.I. INGUINAL HERNIAINGUINAL HERNIA Protrusion abdominal viscusProtrusion abdominal viscus The processus vaginalisThe processus vaginalis The inguinal canalThe inguinal canal Contens:intestine,omentum,ovaryContens:intestine,omentum,ovary Causa: Failure obliteration of the Causa: Failure obliteration of the
pr.vag.pr.vag.
Clinical presentation:Clinical presentation:Bulging in the groinBulging in the groinExtending into the scrotumExtending into the scrotumComes and goesComes and goesDisappear by digital pressureDisappear by digital pressure
Types : a. Lateral inguinal hernia (indirect)Types : a. Lateral inguinal hernia (indirect) b. Medial inguinal hernia (direct)b. Medial inguinal hernia (direct) Diff.Diagnosis:Hydrocele,Undescended Diff.Diagnosis:Hydrocele,Undescended
testis,Abscess,enlarged lymp node.testis,Abscess,enlarged lymp node. Diagnosis: -HystoryDiagnosis: -Hystory
-Physic :reducible bulge in the -Physic :reducible bulge in the groin.groin. -If incarcerated :irreducible -If incarcerated :irreducible bulge,severe pain, bulge,severe pain, symtoms of intestinal symtoms of intestinal - -obstruction:vomiting,distensionobstruction:vomiting,distension and fixed mass in the groin.and fixed mass in the groin.
GRADATION :GRADATION : - - ReducibleReducible - Irreducible- Irreducible - Incarcerated- Incarcerated - Strangulated - Strangulated
Therapy : Shuld be promply Therapy : Shuld be promply repaired.repaired. Ligation of the sac at Ligation of the sac at the the internal ring. internal ring.
Complications: wound Complications: wound infection,bleeding,and acute infection,bleeding,and acute hydrocele.hydrocele.
Prognosis:The risk of recurrence Prognosis:The risk of recurrence 1 in 200.1 in 200.
II. HYDROCELEII. HYDROCELE
Definition :Accumulation of fluid Definition :Accumulation of fluid in the scrotum.in the scrotum.
Fluid accumulation in the Fluid accumulation in the groin:Hydrocele of the cord.groin:Hydrocele of the cord.
Causa: Failure of obliteration of Causa: Failure of obliteration of the processus vaginalis.the processus vaginalis.
Clinical presentation: The Clinical presentation: The sudden appearance of swelling, sudden appearance of swelling, no pain.no pain.
Diagnosis:-Physycal examinationDiagnosis:-Physycal examination -Transillumination-Transillumination
Therapy: High ligation of the Therapy: High ligation of the processus vaginalis if hydrocele processus vaginalis if hydrocele have not disappeared by the age have not disappeared by the age 2.2.
III.CYSTIC HYGROMAIII.CYSTIC HYGROMA.. Is a form of lymphangioma Is a form of lymphangioma
consistingconsisting multilocular cysts.multilocular cysts..isolated lesion.isolated lesion.associated with cavernous .associated with cavernous
lymphangiomalymphangioma.associated with hemangioma..associated with hemangioma..asymtomatic mass,soft,mobile,cystic..asymtomatic mass,soft,mobile,cystic.
Complications:Complications: .Respiratory distress.Respiratory distress .Hemorrage.Hemorrage .Infection.Infection .Displacement of the tongue..Displacement of the tongue.
Diagnosis:Diagnosis:-Physical examination-Physical examination-Chest X- ray-Chest X- ray-USG and CT.-USG and CT.
Therapy : - Excision.Therapy : - Excision.
Prognosis : Excellent.Prognosis : Excellent.
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