Published in The Surgical clinics of North America
Wound healing is a highly complex chain of events, and although it may never be possible to eliminate the risk of experiencing a wound, clinicians' armamentarium continues to expand with methods to manage it. The phases of wound healing are the inflammatory phase, the proliferative phase, and the maturation phase. The pathway of healing is determin...
Published in The Surgical clinics of North America
Adnexal torsion is the fifth most common gynecologic emergency. The vague clinical presentation and variable imaging findings make the diagnosis difficult. If suspicion for adnexal torsion is high enough based on clinical symptoms and imaging findings, prompt intervention should include conservative management with laparoscopic adnexal detorsion an...
Published in The Surgical clinics of North America
Anesthesiologist must be prepared on a daily basis to care for children who need emergency surgery. An appropriate perioperative plan must be formulated and executed to ensure successful management of the child. This article outlines how to prepare and effectively manage common pediatric emergency surgeries.
Published in The Surgical clinics of North America
Trauma is the leading cause of pediatric mortality and abdominal injury is a significant contributor to morbidity. The assessment of abdominal trauma in children must be conducted expeditiously and thoroughly. Physical examination, laboratory testing, and imaging are central to trauma evaluation. In children with minor injury, protocols may help to...
Published in The Surgical clinics of North America
Vascular access procedures are an important and frequent component of the day-to-day practice of the pediatric surgeon. Most access procedures can be performed percutaneously via Seldinger or modified Seldinger technique and are aided by technology, such as ultrasound and fluoroscopy. Complications, such as infection, do occur, and the pediatric su...
Published in The Surgical clinics of North America
This article presents an overview of nonaccidental trauma in children, including common clinical presentation, evaluation, and diagnosis.
Published in The Surgical clinics of North America
Indirect inguinal hernias are the most commonly incarcerated hernias in children, with a higher incidence in low birth weight and premature infants. Contralateral groin exploration to evaluate for a patent processus vaginalis or subclinical hernia is controversial, given that most never progress to clinical hernias. Most indirect inguinal hernias c...
Published in The Surgical clinics of North America
Relatively uncommon compared with the adult population, lower gastrointestinal bleeding in children requires expeditious evaluation and management because of the variety of causes ranging from benign to life-threatening conditions. The causes of lower gastrointestinal bleeding (LGIB) vary with patient age. This review focuses on the differential di...
Published in The Surgical clinics of North America
In the last decade, higher rates of nonoperative management of liver, spleen, and kidney injuries have been achieved. An algorithmic approach may improve success on a national level. Factors for success include management strategy based on physiologic status of the child, early attempt at resuscitation using blood products, and appropriate use of a...
Published in The Surgical clinics of North America
Appendicitis is one of the most common surgical pathologies in children. It can present with right lower quadrant pain. Scoring systems in combination with selective imaging and surgical examination will diagnose most children with appendicitis. Clinical pathways should be used. Most surgical interventions for appendicitis are now almost exclusivel...
