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.