CHAPTER 1 The Field of Children＇s Surgery 1
CHAPTER 2 Preoperative and Postoperative Care 6
RESPONSIBILITY FOR THE SURGICAL CASE 7
PREOPERATIVE CARE 8
OPERATIVE CARE 11
GENERAL POSTOPERATIVE CARE 13
FLUID THERAPY 19
PROVISION FOR CALORIC NEEDS 30
ELECTROLYTE THERAPY 31
CHAPTER 3 Anesthesia for Pediatric Surgery 38
ANESTHETIC EQUIPMENT 39
PREOPERATIVE PREPARATION 40
CHOICE OF ANESTHETIC AGENTS AND TECHNIQUES 43
INDUCTION 46
MAINTENANCE 48
CHAPTER 4 Disruption of Abdominal Wounds 50
FACTORS CONTRIBUTING TO GOOD WOUND HEALING 50
TREATMENT OF DEHISCENCE OR EVISCERATION 53
STATISTICS 53
REFERENCES 55
CHAPTER 5 Surgery in Premature Infants 56
ALTERED PHYSIOLOGY OF THE PREMATURE BABY 56
PRINCIPLES OF SURGICAL CARE FOR PREMATURE BABIES 58
MATERIAL AND RESULTS OF SURGERY IN PREMATURE BABIES 68
REFERENCES 74
CHAPTER 6 Atresia of the Esophagus 75
TYPES OF ESOPHAGEAL MALFORMATION 75
CLINICAL PICTURE AND ROENTGENOLOGIC FINDINGS 77
PREOPERATIVE CARE 80
SURGICAL PROCEDURES 81
POSTOPERATIVE CARE 93
RESULTS OF THERAPY 95
REFERENCES 101
CHAPTER 7 Esophageal Stenosis or Stricture 103
CONGENITAL ESOPHAGEAL STENOSIS 103
POSTOPERATIVE ESOPHAGEAL STRICTURE 113
ESOPHAGEAL STRICTURE FOLLOWING PEPTIC ESOPHAGITIS 118
ESOPHAGEAL STRICTURE FROM LYE BURNS 119
REFERENCES 124
CHAPTER 8 Cardio-Esophageal Chalasia 126
ETIOLOGY 126
CLINICAL PICTURE 126
DIAGNOSIS 127
TREATMENT 127
RESULTS OF TREATMENT 128
REFERENCES 129
CHAPTER 9 Congenital Hypertrophic Pyloric Stenosis 130
PATHOLOGY 130
ETIOLOGY 131
SYMPTOMS 132
PHYSICAL EXAMINATION 132
DIFFERENTIAL DIAGNOSIS 133
ROENTGENOLOGIC EXAMINATION 135
PREOPERATIVE CARE 135
OPERATIVE PROCEDURES 137
POSTOPERATIVE CARE 139
RESULTS OF THERAPY 142
REFERENCES 143
CHAPTER 10 Peptic Ulcer．Gastrostomy 144
PEPTIC ULCER 144
GASTROSTOMY 146
REFERENCES 149
CHAPTER 11 Congenital Atresia of the Intestine and Colon 150
EMBRYOLOGY 151
PATHOLOGY 151
CLINICAL FINDINGS 153
ROENTGENOLOGIC EXAMINATION 153
TREATMENT 156
RESULTS OF THERAPY 162
END RESULTS IN INTRINSIC CONGENITAL INTESTINAL OBSTRUCTION(ATRESIA AND STENOSIS) 165
REFERENCES 166
CHAPTER 12 Congenital Stenosis of the Intestine and Colon 167
EMBRYOLOGY 167
PATHOLOGY 167
SYMPTOMS AND SIGNS 168
ROENTGENOLOGIC EXAMINATION 170
TREATMENT 170
RESULTS OF TREATMENT 172
REFERENCES 174
CHAPTER 13 Intestinal Obstruction in the Newborn Resulting from Meconium Ileus 175
PATHOLOGIC DATA 175
CLINICAL PICTURE 177
ROENTGENOLOGIC EXAMINATION 178
TREATMENT 178
RESULTS OF THERAPY 187
REFERENCES 191
CHAPTER 14 Malrotation of the Intestines and Colon 192
EMBRYOLOGY 192
PATHOLOGY 193
SYMPTOMS AND SIGNS 195
ROENTGENOLOGIC EXAMINATION 197
TREATMENT 197
RESULTS OF TREATMENT 201
REFERENCES 203
CHAPTER 15 Annular Pancreas Producing Duodenal Obstruction 204
PATHOLOGY 204
EMBRYOLOGY 206
CLINICAL DATA 206
TREATMENT 207
RESULTS OF TREATMENT 210
REFERENCES 210
CHAPTER 16 Meckel＇s Diverticulum 211
EMBRYOLOGY 211
PATHOLOGY 212
CLINICAL FINDINGS 213
ROENTGENOLOGIC EXAMINATION 217
TREATMENT 217
RESULTS OF THERAPY 219
REFERENCES 219
CHAPTER 17 Duplications of the Alimentary Tract 221
PATHOLOGY 221
EMBRYOLOGY 225
CLINICAL SYMPTOMS AND SIGNS 226
ROENTGENOLOGIC DATA 228
TREATMENT 237
RESULTS OF TREATMENT 244
REFERENCES 245
CHAPTER 18 Foreign Bodies in the Alimentary Tract 246
SYMPTOMS 247
ROENTGENOLOGIC STUDY 248
TREATMENT 248
SUMMARY AND CONCLUSIONS 252
REFERENCES 252
CHAPTER 19 Appendicitis 253
PATHOLOGY 253
ETIOLOGY 254
SYMPTOMS AND SIGNS 255
LABORATORY DATA 260
DIFFERENTIAL DIAGNOSIS 260
TREATMENT 262
POSTOPERATIVE CARE FOLLOWING SIMPLE APPENDICITIS 268
POSTOPERATIVE CARE FOLLOWING APPENDICITIS WITH RUPTURE 268
COMPLICATIONS 272
MORTALITY FACTORS 275
PINWORMS AND APPENDICITIS 277
APPENDECTOMY FOR RECURRENT ABDOMINAL PAIN 278
REFERENCES 279
CHAPTER 20 Intussusception 281
ETIOLOGY 281
TYPES OF INTUSSUSCEPTION 282
SYMPTOMS AND SIGNS 282
ROENTGENOLOGIC EXAMINATION 287
TREATMENT 288
FACTORS IN PROGNOSIS 294
CHRONIC INTUSSUSCEPTION 297
RECURRENT INTUSSUSCEPTION 298
REFERENCES 300
CHAPTER 21 Polyps of Intestine and Colon 301
PATHOLOGY 301
CLINICAL FINDINGS 302
ROENTGENOLOGIC EXAMINATION 305
DIFFERENTIAL DIAGNOSIS 306
TREATMENT 308
RESULTS OF THERAPY 313
REFERENCES 314
CHAPTER 22 Chronic Ulcerative Colitis 316
ETIOLOGY 316
PATHOLOGY 317
CLINICAL FINDINGS 318
ROENTGENOLOGIC EXAMINATION 318
DIFFERENTIAL DIAGNOSIS 319
TREATMENT 321
RESULTS OF TREATMENT 326
REFERENCES 329
CHAPTER 23 Congenital Megacolon(Hirschsprung＇s Disease) 330
PATHOLOGY AND ETIOLOGY 330
CLINICAL FINDINGS 333
ROENTGENOLOGIC FINDINGS 335
TREATMENT 336
RESULTS OF TREATMENT 345
REFERENCES 346
CHAPTER 24 Malformations of the Anus and Rectum 348
EMBRYOLOGY AND PATHOGENESIS 348
TYPES OF ANAL AND RECTAL ABNORMALITIES 350
SYMPTOMS 352
PHYSICAL FINDINGS 353
ROENTGENOLOGIC EXAMINATION 354
ASSOCIATED CONGENITAL ANOMALIES 355
TREATMENT OF STENOSIS OR ATRESIA OF ANUS AND RECTUM 355
TREATMENT OF RECTAL FISTULAS 364
RESULTS OF TREATMENT 365
REFERENCES 367
CHAPTER 25 Rectal Bleeding in Infants and Children 369
CLINICAL MATERIAL 370
EVALUATION AND MANAGEMENT OF RECTAL BLEEDING 375
REFERENCES 376
CHAPTER 26 Omental Cysts and Mesenteric Cysts 377
OMENTAL CYSTS 377
ISOLATED MESENTERIC CYSTS 377
REFERENCES 383
CHAPTER 27 Primary Peritonitis 384
PATHOLOGY AND ETIOLOGY 384
SYMPTOMS AND SIGNS 385
DIFFERENTIAL DIAGNOSIS 387
TREATMENT 387
RESULTS OF TREATMENT 390
REFERENCES 391
CHAPTER 28 Iliac Adenitis 392
CLINICAL FINDINGS 392
TREATMENT 393
REFERENCES 394
CHAPTER 29 Omphalitis 395
ANATOMIC CONSIDERATIONS 395
PATHOLOGY 396
CLINICAL FINDINGS 396
TREATMENT 397
RESULTS OF THERAPY 397
REFERENCES 398
CHAPTER 30 Rare Conditions of the Umbilicus and Abdominal Wall 399
CYST OF THE UMBILICAL CORD 399
CYST OF THE NAVEL 399
WEEPING UMBILICUS 399
PATENT URACHUS AND URACHAL CYST 400
PERSISTENT VITELLINE DUCT 402
NEOPLASMS OF THE ABDOMINAL WALL 402
REFERENCES 405
CHAPTER 31 Omphalocele(Umbilical Eventration) 406
EMBRYOLOGY 406
CLINICAL FINDINGS 406
TREATMENT 410
RESULTS OF TREATMENT 417
REFERENCES 422
CHAPTER 32 Umbilical Hernia 423
PATHOLOGY 423
PHYSICAL FINDINGS 423
SYMPTOMS 423
TREATMENT 423
RESULTS OF TREATMENT 426
REFERENCES 427
CHAPTER 33 Congenital Hernia of the Diaphragm 428
EMBRYOLOGY 428
PATHOLOGIC ANATOMY 429
CLINICAL FINDINGS 430
ROENTGENOLOGIC EXAMINATION 431
TREATMENT 432
RESULTS OF TREATMENT 441
REFERENCES 444
CHAPTER 34 Intra-abdominal Hernia 445
REFERENCES 447
CHAPTER 35 Inguinal Hernia 449
CLINICAL FINDINGS 449
TREATMENT 452
POSTOPERATIVE CARE 460
RESULTS OF TREATMENT 461
REFERENCES 462
CHAPTER 36 Hydrocele 463
SYMPTOMS AND DIAGNOSIS 463
TREATMENT 463
REFERENCES 466
CHAPTER 37 Undescended Testicle(Cryptorchidism) 467
DIFFERENTIAL DIAGNOSIS 467
CLINICAL FINDINGS 468
TREATMENT 469
RESULTS OF TREATMENT 478
REFERENCES 481
CHAPTER 38 Torsion of the Testis and the Appendix Testis 482
TORSION OF THE TESTIS 482
TORSION OF THE APPENDIX TESTIS 483
REFERENCES 484
CHAPTER 39 Tumors of the Testicle 486
PATHOLOGIC TYPES 486
CLINICAL PICTURE 486
TREATMENT 489
RESULTS OF THERAPY 491
REFERENCES 493
CHAPTER 40 Diseases of the Female Genital Tract 494
HYDROMETROCOLPOS 494
HEMATOCOLPOS 495
OVARIAN CYSTS 497
NEOPLASMS OF THE OVARY 499
NEOPLASMS OF THE UTERUS OR VAGINA 503
VAGINITIS 506
REFERENCES 507
CHAPTER 41 Obstructive Jaundice in Infancy 508
DIFFERENTIAL DIAGNOSIS 509
BILIARY OBSTRUCTION FROM ERYTHROBLASTOSIS 510
OBSTRUCTIVE JAUNDICE FROM INSPISSATED BILE OR MUCUS IN THE BILIARY PASSAGES 510
CONGENITAL ATRESIA OF THE BILE DUCTS 511
MEDICAL TREATMENT FOR BILIARY OBSTRUCTION 515
SURGICAL TREATMENT FOR BILIARY OBSTRUCTION 516
RESULTS OF THERAPY 520
REFERENCES 522
CHAPTER 42 Miscellaneous Conditions of the Liver and Biliary Passages 524
IDIOPATHIC DILATATION OF THE COMMON BILE DUCT 524
CHOLECYSTITIS 530
CHOLELITHIASIS 531
HEPATIC TUMORS 532
CONGENITAL ANOMALIES OF THE GALLBLADDER 535
TRAUMA TO THE GALLBLADDER AND BILE DUCTS 538
REFERENCES 540
CHAPTER 43 Diseases of the Spleen 542
CONGENITAL HEMOLYTIC ANEMIA 542
ACQUIRED HEMOLYTIC ANEMIA 547
IDIOPATHIC THROMBOCYTOPENIC PURPURA 548
SECONDARY THROMBOCYTOPENIC PURPURA 551
PORTAL HYPERTENSION 551
HYPERSPLENISM 559
TRAUMATIC RUPTURE OF THE SPLEEN 562
LIPID STORAGE DISEASE 564
CYSTS AND TUMORS OF THE SPLEEN 565
MISCELLANEOUS CONDITIONS 566
TECHNIQUE OF SPLENECTOMY 566
POST-SPLENECTOMY THROMBOSIS 568
REFERENCES 571
CHAPTER 44 Hypoglycemia 574
PATHOLOGY．ETIOLOGIC FACTORS 574
CLINICAL FINDINGS 575
DIFFERENTIAL DIAGNOSIS．ESTABLISHMENT OF THE DIAGNOSIS 576
TREATMENT 580
RESULTS OF THERAPY 584
REFERENCES 586
CHAPTER 45 Embryoma of the Kidney(Wilms＇ Tumor) 588
PATHOLOGY 588
CLINICAL DATA 589
ROENTGENOLOGIC EXAMINATION 591
DIFFERENTIAL DIAGNOSIS 591
TREATMENT 594
REFERENCES 604
CHAPTER 46 Neuroblastoma Sympatheticum 606
PATHOLOGY 607
CLINICAL FINDINGS 611
DIFFERENTIAL DIAGNOSIS 614
TREATMENT 615
RESULTS OF TREATMENT 621
REFERENCES 625
CHAPTER 47 Retroperitoneal Teratoma 626
PATHOLOGIC FEATURES 626
CLINICAL FINDINGS 627
DIFFERENTIAL DIAGNOSIS 628
TREATMENT 629
RESULTS OF THERAPY 632
REFERENCES 634
CHAPTER 48 Uretero-Pelvic Obstruction 635
PATHOLOGY 635
CLINICAL FINDINGS 637
ROENTGENOGRAPHIC FEATURES 638
LABORATORY DATA 642
TREATMENT 642
RESULTS OF THERAPY 656
REFERENCES 657
CHAPTER 49 Double Ureters 659
PATHOLOGIC OBSERVATIONS 659
CLINICAL FINDINGS 661
TREATMENT 664
RESULTS OF THERAPY 669
REFERENCES 670
CHAPTER 50 Ectopic Ureter 672
PATHOLOGIC CONSIDERATIONS 672
CLINICAL FINDINGS 674
TREATMENT 676
RESULTS OF THERAPY 677
REFERENCES 678
CHAPTER 51 Ureterocele 679
PATHOLOGIC FINDINGS 679
CLINICAL PICTURE 680
TREATMENT 683
RESULTS OF TREATMENT 686
REFERENCES 687
CHAPTER 52 Exstrophy of the Bladder 688
CLINICAL FINDINGS 688
TREATMENT 689
RESULTS OF OPERATION 700
REFERENCES 703
CHAPTER 53 Epispadias 705
CLINICAL PICTURE 705
TREATMENT 707
RESULTS OF THERAPY 710
REFERENCES 713
CHAPTER 54 Hypospadias 714
CLINICAL FEATURES 714
TREATMENT 716
RESULTS OF THERAPY 728
REFERENCES 728
CHAPTER 55 Urinary Obstruction from Posterior Urethral Valves 730
PATHOLOGY AND CLINICAL PICTURE 730
ROENTGENOGRAPHIC FINDINGS 731
TREATMENT 733
RESULTS OF THERAPY 738
REFERENCES 739
CHAPTER 56 Urinary and Fecal Incontinence of Neurogenic Origin 740
CLINICAL DATA 740
TREATMENT 741
RECOMMENDATIONS 749
REFERENCES 752
CHAPTER 57 Pectus Excavatum(Funnel Chest) 753
ETIOLOGY 753
CLINICAL FINDINGS 753
INDICATIONS FOR SURGERY 755
SURGICAL TREATMENT 755
RESULTS OF OPERATION 760
REFERENCES 761
CHAPTER 58 Cysts and Primary Tumors of the Thorax 762
GENERAL FINDINGS 762
NEUROGENIC TUMORS 763
NEUROBLASTOMA 763
CYSTIC HYGROMA 770
THYMOMAS 773
TERATOMA 775
OSTEOCHONDROMA 779
HEMANGIOMA 779
BRONCHOGENIC CYST 780
NEURENTERIC CYST 780
DUPLICATIONS OF THE ALIMENTARY TRACT 781
REFERENCES 784
CHAPTER 59 Bronchiectasis 785
PATHOLOGIC AND ETIOLOGIC CONSIDERATIONS 785
CLINICAL PICTURE 789
DIAGNOSTIC STUDIES 792
TREATMENT 792
RESULTS OF THERAPY 801
REFERENCES 804
CHAPTER 60 The Patent Ductus Arteriosus 806
CLINICAL FINDINGS 806
DIAGNOSIS 809
PROGNOSIS IN UNTREATED CASES 813
SELECTION OF PATIENTS FOR OPERATION 814
TREATMENT 817
RESULTS OF SURGICAL TREATMENT 822
REFERENCES 827
CHAPTER 61 Coarctation of the Aorta 828
PROGNOSIS 828
CLINICAL PICTURE 831
DIAGNOSTIC AIDS 833
SELECTION OF CASES FOR SURGERY 837
SURGICAL TREATMENT 838
RESULTS OF THERAPY 854
REFERENCES 862
CHAPTER 62 Interauricular Septal Defect 864
ANATOMIC AND PHYSIOLOGIC DATA 864
CLINICAL FINDINGS 866
SELECTION OF PATIENTS FOR OPERATION 869
METHODS FOR CLOSURE OF INTERAURICULAR SEPTAL DEFECTS 870
RECOMMENDED SURGICAL TREATMENT 872
RESULTS OF OPERATION 882
REFERENCES 884
CHAPTER 63 Tetralogy of Fallot 886
PATHOLOGIC ANATOMY 886
CLINICAL PICTURF 887
ROENTGENOGRAPHIC AND CATHETERIZATION DATA 889
SELECTION OF CASES FOR OPERATION 890
SURGICAL TREATMENT 891
RESULTS OF THERAPY 897
REFERENCES 899
CHAPTER 64 Congenital Pulmonary Stenosis 900
PATHOLOGIC CONSIDERATIONS 900
CLINICAL FINDINGS 902
ROENTGENOGRAPHIC DATA 903
CATHETERIZATION STUDIES 904
INDICATIONS FOR OPERATION 905
SURGICAL TREATMENT 906
RESULTS OF OPERATION 910
REFERENCES 911
CHAPTER 65 Vascular Anomalies in the Thorax Producing Compression of the Trachea or Esophagus 913
DOUBLE AORTIC ARCH 913
RIGHT AORTIC ARCH WITH LEFT LIGAMENTUM ARTERIOSUM 921
ANOMALOUS INNOMINATE ARTERY 926
ANOMALOUS LEFT COMMON CAROTID ARTERY 929
ABERRANT SUBCLAVIAN ARTERY 930
TECHNICAL CONSIDERATIONS OF OPERATION 933
REFERENCES 934
CHAPTER 66 Thyroglossal Cysts and Sinuses 936
EMBRYOLOGY 936
PATHOLOGY 936
CLINICAL FINDINGS 936
DIFFERENTIAL DIAGNOSIS 939
TREATMENT 941
RESULTS OF TREATMENT 945
REFERENCES 946
CHAPTER 67 Cysts，Sinuses，and Other Anomalies of the Branchial Apparatus 947
EMBRYOLOGY 947
CLINICAL DATA 949
TREATMENT 956
REFERENCES 959
CHAPTER 68 Cystic Hygroma 960
PATHOLOGY 960
ETIOLOGY 961
CLINICAL DATA 962
SYMPTOMS AND SIGNS 964
TREATMENT 965
RESULTS OF THERAPY 969
REFERENCES 970
CHAPTER 69 Wringer Injuries of the Arm 971
THE INJURY 971
TREATMENT 973
Index 977