Professional Documents
Culture Documents
Standardized Toolbox of
Education for Pediatric Surgery
Intraperitoneal - 20%
• GI Masses - 15%
Flank - 65% • Duplication
• Renal - 55% • Meconium ileus
• Hydronephrosis • Mesenteric-omental cyst
• Polycystic kidney • Hepatobiliary - 5%
• Mesoblastic nephroma • Hemangioendotheloma
• Renal ectopic • Hepatoblastoma
• Renal vein thrombosis • Hepatic cyst
• Nephroblastomatosis • Choledochal cyst
• Wilms tumor • Hydrops of gallbladder
• Nonrenal - 10%
• Adrenal hemorrhage
• Neuroblastoma
• Teratoma
Pelvic - 15%
• Hydrometrocolpos
• Ovarian cyst
• Sacrococcygeal teratoma
CHILDREN AND ADOLESCENTS
Intraperitoneal - 18%
• GI Masses - 12%
• Appendiceal abscess
Flank - 78% • Congenital abnorm.
• Renal - 55% • Other neoplasms
• Wilms tumor • Hepatobiliary - 6%
• Hydronephrosis • Hepatoblastoma
• Cystic disease • Hepatocellular ca
• Nonrenal - 23% • Choledochal cyst
• Neuroblastoma
• Teratoma
• Other neoplasms
Pelvic - 4%
• Ovarian cyst
• Hydrometrocolpos
History Discussion Slide
• What other points of the history do you want to
know?
• Age of child is an important • Medical hx: associated medical
factor that adjust the illnesses
differential diagnosis • Family hx: syndromes (Beckwith-
• Mass: duration, associated Wiedemann, WAGR, Gardner,
pain, changes in eating and MEN2B, Bloom)
elimination patterns, history • ROS: night sweats, malaise,
of trauma bleeding or bruising, skin
• Birth hx: prematurity, difficult changes, sexual history
birth
Differential Diagnosis ??
Physical Exam
• Investigations:
– X-rays – not usually helpful
– US – good first test
– CT Scan – good test to help plan surgery
and for staging
– MRI – limited application
– Nuclear scans – selective use
CT Scans
• Diagnosis
– See flowchart
• Plans
– See flowchart
History, Physical, Lab Tests
Abdominal Radiograph
Abdominal Ultrasound
Confirms
• Peri-operative
– Ileus is common after any abdominal
surgery
– Post-op intussusception is well reported
• Long Term
– Is dependent on the tumor type and
whether rupture has occurred
– Potential for adhesive bowel obstruction
Post-operative Management
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