common congenital anomalies in neonate and children

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.