Index Note: Page numbers of article titles are in boldface type. A Abdominal injuries clinical presentation of, 23 24 Abdominal trauma evaluation for pediatric surgeon, 59 74 background of, 60 colon and rectal injuries, 67 controversial topics, 70 72 adult vs. pediatric trauma centers, 71 72 FAST examination, 70 71 negative workup, 71 decision making related to, 68 70 diagnosis of, 60 62 diaphragm injuries, 68 genitourinary injuries, 67 imaging in, 64 66 protocols, 68 initial evaluation and stabilization of, 62 63 introduction, 59 60 laboratory studies in, 64 liver and splenic injuries, 66 modalities in, 63 66 pancreatic injuries, 67 presentation of, 60 62 specific injuries, 66 68 stomach and small bowel injuries, 66 67 treatment in, 68 70 solid organ injuries protocols, 68 70 Activity restriction after blunt solid organ injury during pediatric surgery management, 14 Acute traumatic injury laparoscopy in diagnosis and treatment of, 77 78 Airway(s) pediatric foreign bodies in anesthesia for emergency management of, 225 226 aspiration for, 86 87 clinical outcomes of, 89 clinical presentation of, 86 diagnostic and therapeutic procedures for, 86 87 esophageal, 85 91 (See also Esophageal foreign bodies) Surg Clin N Am 97 (2017) 233 247 http://dx.doi.org/10.1016/s0039-6109(16)52169-0 0039-6109/17 surgical.theclinics.com
234 Index Airway(s) (continued ) introduction, 85 86 Allergic colitis in infants and toddlers, 177 Alvarado score in pediatric appendicitis, 94 95 American Pediatric Surgery Association Trauma Committee, 69 Anal fissures in neonates, 176 Anesthesia/anesthetics for pediatric emergency surgeries, 223 232 airway foreign bodies, 225 226 appendicitis, 227 esophageal foreign bodies, 226 227 facial fractures, 230 231 introduction, 223 224 intussusception, 228 posttonsillectomy bleeding, 228 229 preoperative evaluation, 224 225 ventriculoperitoneal shunt in, 229 230 Angioembolization for liver injury, 10 for renal injury, 10 for splenic injury, 10 Antibiotics in pediatric appendicitis management, 97 Appendectomy incidental in pediatric appendicitis management, 104 Appendicitis acute nonoperative management of, 97 101 surgical options for, 101 102 anesthesia for emergency management of, 227 pediatric, 93 112 antibiotics for, 97 clinical pathways for, 96 diagnosis of, 93 94 differential diagnosis of, 96 imaging of, 96 97 incidence of, 93 incidental appendectomies for, 104 introduction, 93 irrigation for, 103 104 laboratory studies of, 94 nonoperative management of, 97 101 postoperative care in, 104 scoring for, 94 95 surgical options for, 101 104 symptoms and signs of, 94
Index 235 treatment of, 97 104 perforated surgical options for, 102 103 ATOMAC guideline discharge information, 6 8 B Bile duct injury nonoperative management of, 12 Biloma of liver nonoperative management of, 11 12 Bite(s) dog wound management following, 200 Bleeding posttonsillectomy anesthesia for emergency management of, 228 229 Blunt intestinal injury nonoperative management of, 13 Blunt renal trauma nonoperative management of, 9 10 Blunt solid organ injury background of, 1 2 blunt spleen and liver injury, 3 9 (See also Blunt spleen and liver injury, in pediatric surgery) incidence of, 1 nonoperative management of, 1 20 blunt renal trauma, 9 10 concomitant injuries, 13 contrast extravasation and angioembolization in, 10 discharge and follow-up care after, 14 in special situations, 10 13 Blunt spleen and liver injury, 3 9 angioembolization for, 10 nonoperative management of algorithm for, 3 4 ATOMAC guideline discharge information for, 6 8 failure of, 8 9 for patients with recent or ongoing bleeding, 4 6 for stable patients with solid organ injury, 6 8 reimaging after, 14 C Central venous access in preoperative planning in pediatric population, 114 116
236 Index Cervical spine evaluation for pediatric surgeon, 41 53 anatomy related to, 41 clinical examination, 43 clinical outcomes of, 49 52 clinical prediction rules in, 44 46 clinical presentation related, 42 43 CT in, 46 diagnostic-related, 44 48 introduction, 41 management of, 48 mechanism of injury in, 42 43 MRI in, 46 48 pathophysiology-related, 42 plain radiographs in, 46 prehospital management in, 43 Children airway of esophageal foreign bodies and, 85 91 (See also Esophageal foreign bodies) appendicitis in, 93 112 (See also Appendicitis) blunt solid organ injury in surgery for nonoperative management of, 1 20 (See also Blunt solid organ injury, in pediatric surgery) hernias in incarcerated, 129 145 (See also specific types and Incarcerated pediatric hernias) ovarian torsion in, 209 221 (See also Ovarian torsion, pediatric) testicular torsion in, 161 172 (See also Testicular torsion, pediatric) trauma in minimally invasive surgery for, 75 84 (See also Minimally invasive surgery, in pediatric trauma) vascular access in, 113 128 (See also Vascular access, in pediatric population) Colitis allergic in infants and toddlers, 177 Colon injuries for pediatric surgeon, 67 Computed tomography (CT) in cervical spine evaluation for pediatric surgeon, 46 in head evaluation for pediatric surgeon, 37 39 in intussusception evaluation, 182 in pediatric appendicitis evaluation, 97 Contrast enema in intussusception evaluation, 183 Contrast extravasation and angioembolization in blunt solid organ injury management, 10 CT. See Computed tomography (CT) D Diaphragm injuries
Index 237 for pediatric surgeon, 68 Direct inguinal hernias, 138 Doernbecher/Randall children s solid organ injury protocol, 70 Dog bites wound management following, 200 E Emergency surgeries pediatric anesthesia for, 223 232 (See also Anesthesia/anesthetics, for pediatric emergency surgeries) Enterocolitis necrotizing in neonates, 174 Epigastric hernias, 138 Esophageal foreign bodies pediatric, 85 91 anesthesia for emergency management of, 226 227 clinical outcomes of, 89 clinical presentation of, 87 diagnostic and therapeutic procedures for, 87 89 Exposed bone/hardware wound management for, 201 203 F Face fractures of anesthesia for emergency management of, 230 231 soft tissue wounds to management of, 197 200 Fasciitis necrotizing wound management for, 200 201 FAST examination. See Focal assessment with sonography in trauma (FAST) examination Femoral hernias, 137 138 Fissure(s) anal in neonates, 176 Focal assessment with sonography in trauma (FAST) examination in abdominal trauma evaluation for pediatric surgeon, 70 71 Foreign bodies in airway anesthesia for emergency management of, 225 226 esophageal (See Esophageal foreign bodies) Fracture(s) facial anesthesia for emergency management of, 230 231 clinical presentation of, 25 pelvic
238 Index Fracture(s) (continued ) in unstable children during surgery nonoperative management of, 13 G Gastrointestinal bleeding lower, 173 178 (See also Lower gastrointestinal bleeding (LGIB)) Genetic disorders in wound healing, 193 194 Genitourinary injuries for pediatric surgeon, 67 H HD. See Hirschsprung disease (HD) Head evaluation for pediatric surgeon, 35 41 anatomy related to, 36 clinical outcomes of, 40 clinical presentation related, 37 diagnostic-related, 37 39 introduction, 35 36 management of, 39 40 pathophysiology-related, 36 severe TBI related, 39 40 Head trauma clinical presentation of, 22 23 Healing processes, 192 195 Hepatic artery pseudoaneurysm nonoperative management of, 12 Hernia(s). See also specific types, e.g., Indirect inguinal hernias epigastric, 138 femoral, 137 138 incarcerated pediatric, 129 145 (See also specific types and Incarcerated pediatric hernias) indirect inguinal, 129 136 inguinal direct, 138 indirect, 129 136 lumbar, 138 Spigelian, 138 umbilical, 136 137 Heterotaxia syndromes (HS), 156 157 Hirschsprung disease (HD) in neonates, 176 HS. See Heterotaxia syndromes (HS) Hypertrophic scars wound healing and, 194 195
Index 239 I IAI. See Intraabdominal injury (IAI) IBD. See Inflammatory bowel disease (IBD) Incarcerated pediatric hernias, 129 145. See also specific types, e.g., Indirect inguinal hernias direct inguinal hernias, 138 epigastric hernias, 138 femoral hernias, 137 138 indirect inguinal hernias, 129 136 introduction, 129 lumbar hernias, 138 Spigelian hernia, 138 umbilical hernia, 136 137 Incidental appendectomies in pediatric appendicitis management, 104 Indirect inguinal hernias, 129 136 anatomy related to, 130 clinical presentation of, 130 diagnosis of, 130 epidemiology of, 129 130 management of complications related to, 135 nonoperative, 130 outcomes of, 134 135 postoperative care, 136 recurrence following, 134 135 surgical, 131 134 anesthesia in, 131 contralateral groin exploration in, 135 136 laparoscopic repair in, 133 134 open repair in, 131 133 open repair vs. laparoscopic repair, 135 preoperative planning for, 131 Infant(s) LGIB in, 176 177 Infection(s) after vascular access in pediatric population, 126 127 LGIB related in school-age children, 178 Inflammatory bowel disease (IBD) in school-age children, 178 Inflammatory phase in wound healing, 189 190 Inguinal hernias direct, 138 indirect, 129 136 Integumentary injuries clinical presentation of, 25 26 Intermittent testicular pain
240 Index Intermittent (continued ) testicular torsion and, 166 167 Intestinal injury blunt nonoperative management of, 13 Intestinal rotation abnormalities, 147 159 anatomy related to, 147 148 asymptomatic, 156 clinical outcomes, 157 clinical presentation of, 149 150 defined, 148 149 embryology related to, 147 148 HS, 156 157 introduction, 147 management of surgical technique, 153 156 radiologic diagnosis of, 151 153 special considerations, 156 157 Intraabdominal injury (IAI) causes of, 60 Intussusception, 178 186 anesthesia for emergency management of, 228 clinical manifestation of, 180 181 clinical presentation of, 180 described, 178 179 diagnosis of, 181 183 physical examination in, 180 idiopathic, 179 180 in infants and toddlers, 177 pathophysiology of, 179 180 secondary, 180 treatment of, 183 186 nonoperative reduction in, 183 184 recurrence after, 184 surgical, 185 186 laparoscopic reduction in, 186 open reduction in, 185 186 Irrigation in pediatric appendicitis management, 103 104 K Keloid(s) wound healing and, 194 195 L Laparoscopy in indirect inguinal hernia management, 133 134
Index 241 in intussusception management, 186 in pediatric acute traumatic injury diagnosis and management, 77 82 technical considerations, 79 82 LGIB. See Lower gastrointestinal bleeding (LGIB) Line malfunction after vascular access in pediatric population, 125 126 Line thrombosis after vascular access in pediatric population, 126 Liver biloma of nonoperative management of, 11 12 Liver injuries blunt, 3 9 (See also Blunt spleen and liver injury, ) angioembolization for, 10 reimaging after, 14 for pediatric surgeon, 66 Lower gastrointestinal bleeding (LGIB), 173 178 clinical presentation of, 173 174 differential diagnosis of, 174 epidemiology of, 173 in infants and toddlers, 176 177 initial, 173 174 in neonates, 174 in school-age children, 177 178 Lumbar hernias, 138 M Magnetic resonance imaging (MRI) in cervical spine evaluation for pediatric surgeon, 46 48 in head evaluation for pediatric surgeon, 39 in intussusception evaluation, 182 in pediatric appendicitis evaluation, 97 Malignancy(ies) in school-age children, 178 Maternal blood swallowed by neonates, 176 Maturation phase in wound healing, 191 192 Meckel diverticulum in infants and toddlers, 177 Midgut volvulus, 147 159 in neonates, 174 Minimally invasive surgery in pediatric trauma, 75 84 algorithm for, 79 introduction, 75 76
242 Index Minimally (continued) laparoscopy in, 77 82 thoracic trauma and, 82 MRI. See Magnetic resonance imaging (MRI) N NEC. See Necrotizing enterocolitis (NEC) Necrotizing enterocolitis (NEC) in neonates, 174 Necrotizing fasciitis wound management for, 200 201 Negative pressure wound therapy (NPWT), 196 197 Neonate(s) anal fissures in, 176 HD in, 176 LGIB in, 174 176 midgut volvulus in, 174 NEC in, 174 swallowed maternal blood among, 176 Nonaccidental trauma, 21 33 clinical presentation of, 22 26 abdominal injuries, 23 24 fractures, 25 head trauma, 22 23 integumentary injuries, 25 26 epidemiology of, 21 22 evaluation/diagnosis of, 26 30 introduction, 21 22 NPWT. See Negative pressure wound therapy (NPWT) O Open reduction in intussusception management, 185 186 Ovarian torsion pediatric, 209 221 anatomy related to, 210 clinical presentation of, 211 212 diagnosis of, 212 214 introduction, 209 pathophysiology of, 210 211 treatment of, 214 217 clinical outcomes after, 217 218 P Pain testicular mimickers of, 167 170
testicular torsion and, 166 167 Pancreatic injury for pediatric surgeon, 67 nonoperative management of, 13 PAS. See Pediatric Appendicitis Score (PAS) Pediatric appendicitis, 93 112. See also Appendicitis Pediatric Appendicitis Score (PAS), 94 95 Pediatric emergency surgeries anesthesia for, 223 232 (See also Anesthesia/anesthetics, for pediatric emergency surgeries) Pediatric ovarian torsion, 209 221. See also Ovarian torsion, pediatric Pediatric surgeon abdominal trauma evaluation for, 59 74 (See also Abdominal trauma evaluation, for pediatric surgeon) cervical spine evaluation for, 41 53 (See also Cervical spine evaluation, for pediatric surgeon) head evaluation for, 35 41 (See also Head evaluation, for pediatric surgeon) Pediatric surgery blunt solid organ injury in nonoperative management of, 1 20 (See also Blunt solid organ injury, in pediatric surgery) nonaccidental trauma in, 21 33 (See also Nonaccidental trauma, ) Pediatric testicular torsion, 161 172. See also Testicular torsion, pediatric Pediatric trauma minimally invasive surgery in, 75 84 (See also Minimally invasive surgery, in pediatric trauma) Pelvic fracture in unstable children during surgery nonoperative management of, 13 Perforation after vascular access in pediatric population, 126 Peripherally inserted central catheter (PICC) in vascular access in pediatric population, 124 Peripheral vascular access in vascular access in pediatric population, 123 124 Peripheral venous access in preoperative planning in pediatric population, 114 PICC. See Peripherally inserted central catheter (PICC) Plain radiographs in cervical spine evaluation for pediatric surgeon, 46 Polyp(s) in school-age children, 178 Posttonsillectomy bleeding anesthesia for emergency management of, 228 229 Proliferative phase in wound healing, 190 191 Pseudoaneurysm(s) nonoperative management of Index 243
244 Index Pseudoaneurysm(s) (continued) hepatic artery, 12 renal artery, 12 splenic artery, 10 11 R Radiography in cervical spine evaluation for pediatric surgeon, 46 in intussusception evaluation, 181 182 Rectal injuries for pediatric surgeon, 67 Rehabilitation after vascular access in pediatric population, 124 125 Renal artery pseudoaneurym nonoperative management of, 12 Renal artery thrombosis nonoperative management of, 12 13 Renal injuries high-grade nonoperative management of, 10 angioembolization for, 10 reimaging after, 14 Renal trauma blunt nonoperative management of, 9 10 S Scar(s) hypertrophic wound healing and, 194 195 School-age children LGIB in, 177 178 Seldinger technique in vascular access in pediatric population, 118 119 Shunt(s) ventriculoperitoneal anesthesia for emergency management of, 229 230 Small bowel injuries for pediatric surgeon, 66 67 Soft tissue wounds to face management of, 197 200 Solid organ injury blunt
Index 245, 1 20 (See also Blunt solid organ injury, ) Spigelian hernia, 138 Splenic artery pseudoaneurysm nonoperative management of, 10 11 Splenic injuries blunt, 3 9 (See also Blunt spleen and liver injury, ) angioembolization for, 10 reimaging after, 14 for pediatric surgeon, 66 Stomach injuries for pediatric surgeon, 66 67 Swallowed maternal blood by neonates, 176 T TBI. See Traumatic brain injury (TBI) Testicular pain intermittent testicular torsion and, 166 167 mimickers of, 167 170 Testicular torsion pediatric, 161 172 clinical presentation of, 162 163 differential diagnosis of, 162 epidemiology of, 161 imaging and laboratory tests in, 164 165 initial, 163 164 history of, 161 intermittent testicular pain and, 166 167 management of follow-up care, 166 initial, 164 operative, 165 166 overview of, 161 perinatal torsion, 162 Thoracic trauma minimally invasive surgery for, 82 Thrombosis(es) line-related after vascular access in pediatric population, 126 renal artery nonoperative management of, 12 13 vessel after vascular access in pediatric population, 126
246 Index Toddler(s) LGIB in, 176 177 Trauma abdominal for pediatric surgeon, 59 74 (See also Abdominal trauma evaluation, for pediatric surgeon) head clinical presentation of, 22 23 nonaccidental, 21 33 (See also Nonaccidental trauma, ) pediatric minimally invasive surgery in, 75 84 (See also Minimally invasive surgery, in pediatric trauma) renal blunt nonoperative management of, 9 10 Traumatic brain injury (TBI) nonoperative management of, 13 severe in head evaluation for pediatric surgeon, 39 40 Tunneling technique in vascular access in pediatric population, 121 123 U Ultrasound in intussusception evaluation, 181 in pediatric appendicitis evaluation, 96 in vascular access in pediatric population, 120 121 Umbilical hernias, 136 137 Urinoma nonoperative management of, 13 V Vascular access in pediatric population, 113 128 complications following, 125 127 introduction, 113 114 rehabilitation and recovery following, 124 125 surgical technique, 114 124 anatomy related to, 119 cut-down technique, 118 equipment, 117 immediate postoperative care, 124 percutaneous technique, 118 119 peripheral vascular access, 123 124
Index 247 PICCs, 124 preoperative planning, 114 116 preparation and patient positioning, 117 118 procedural approach, 118 124 Seldinger technique, 118 119 tunneling technique, 121 123 ultrasound in, 120 121 Ventriculoperitoneal shunt anesthesia for emergency management of, 229 230 Vessel thrombosis after vascular access in pediatric population, 126 Volvulus midgut, 147 159 in neonates, 174 W Wound(s) soft tissue to face management of, 197 200 Wound healing, 189 207 genetic disorders in, 193 194 molecular requirements for, 192 193 phases of, 189 192 inflammatory phase, 189 190 maturation phase, 191 192 proliferative phase, 190 191 problems associated with, 192 195 hypertrophic scars and keloids, 194 195 Wound management, 195 203 debridement in, 196 for dog bites, 200 for exposed bone/hardware, 201 203 for necrotizing fasciitis, 200 201 NPWT, 196 197 postoperative care, 195 196 soft tissue wounds to face, 197 200 suture types in, 195 196