Common Paediatric Surgical Problems

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Common Paediatric Surgical Problems

• Philip Morreau
• Starship
• www.kidzhealth.co.nz

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What is Paediatric Surgery?
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Small bowel atresia
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Reality rare common problems
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Condition Condition Type of referral
Abdominal pain-Acute Needing admission and/or urgent assessment. Immediate referral to CED, Starship with phone call if thought appropriate.
Vascular anomalies Diagnostic uncertainty, airway, vision, hearing Area of special concern
Epigastric hernia When noted Fax or letter
Foreskin Asymptomatic non-retractile foreskin does not usually need assessment. Starship does not perform Circumcision for cultural nor religious reasons
Foreskin If prepuce looks scarred Fax or letter
Foreskin Recurrent infection Fax or letter
Fused labia As soon as diagnosed Fax or letter
Hydrocele If persistent after 2 years of age Fax or letter
Hydrocele At any age if diagnostic uncertainty Fax or letter
Hypospadias As soon as diagnosed Fax or letter
Inguinal hernia Reducible - lt 6 months of age Phone /urgent fax
Inguinal hernia Reducible - gt 6 months of age Fax or letter
Inguinal hernia Irreducible or if symptomatic or difficult to reduce (including female) Phone/immediate referral attention
Paraphimosis As soon as diagnosed Phone/immediate referral attention
Testicular torsion Suspected i.e. Acute scrotal pain Immediate phone call
Umbilical hernia After 3 years of age Fax or letter
Umbilical hernia Acutely in rare event of irreducibility Phone/immediate referral attention
Undescended testis If both not fully descended by 3 months post term Fax or letter
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Normal penis
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Phimosis
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Glanular adhesions (and meatal cyst)
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BXO
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Hypospadias
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Smegma
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paraphimosis
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Hernia Vs Hydrocele
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Bilateral hydroceles

• Painless
• Scrotal
• Can not reduce

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Bilateral Inguinoscrotal Hernia
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Inguinal hernia
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N.B.

• IRREDUCIBLE GROIN LUMP
• Inguinal hernia
• Encysted hydrocele of the cord
• undescended testis
• lymphangioma

• HYDOCELE
• Scrotal
• Cant reduce
• Painless
• (trans illumination)

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UDT Vs Retractile?

• testes in the scrotum at birth
• normal size testis
• manipulated to bottom scrotum
• does not retract immediately
• cord not tight, nor painful
• resides in scrotum some of time

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? UDT
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(No Transcript)
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Testicular Torsion
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Testicular Torsion
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Hydatid of Morgagni
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Testicular Torsion
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Neonatal Torsion
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Traps!

• Epididymo-orchitis
• HSP
• ultrasound
• RIF pain
• trauma
• tumour

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Umbilical hernia
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Haemangioma
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Haemangioma- treat with ß blocker ??
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Condition Condition Type of referral
Abdominal pain-Acute Needing admission and/or urgent assessment. Immediate referral to CED, Starship with phone call if thought appropriate.
Vascular anomalies Diagnostic uncertainty, airway, vision, hearing Area of special concern
Epigastric hernia When noted Fax or letter
Foreskin Asymptomatic non-retractile foreskin does not usually need assessment. Starship does not perform Circumcision for cultural nor religious reasons
Foreskin If prepuce looks scarred Fax or letter
Foreskin Recurrent infection Fax or letter
Fused labia As soon as diagnosed Fax or letter
Hydrocele If persistent after 2 years of age Fax or letter
Hydrocele At any age if diagnostic uncertainty Fax or letter
Hypospadias As soon as diagnosed Fax or letter
Inguinal hernia Reducible - lt 6 months of age Phone /urgent fax
Inguinal hernia Reducible - gt 6 months of age Fax or letter
Inguinal hernia Irreducible or if symptomatic or difficult to reduce (including female) Phone/immediate referral attention
Paraphimosis As soon as diagnosed Phone/immediate referral attention
Testicular torsion Suspected i.e. Acute scrotal pain Immediate phone call
Umbilical hernia After 3 years of age Fax or letter
Umbilical hernia Acutely in rare event of irreducibility Phone/immediate referral attention
Undescended testis If both not fully descended by 3 months post term Fax or letter