Topics Discussed: emergency surgical procedure; gastroenterology and hepatology; pediatric emergency medicine.
Sections: Clinical Presentation and Treatment, Diagnosis, Specific Conditions, Summary, References.
Excerpt:"The term "emergency" is subjective and therefore
can be difficult to define, especially when considering all the
complexities of caring for a sick child with a surgical problem.
To the anxious parent, anything surgical may be an emergency. Healthcare
providers often have differing perspectives on what is or is not
an emergency. The topics in this chapter are all surgical issues that
need intervention, most in a relatively short period of time. But
some might be considered "urgencies" rather than
true surgical emergencies. For example, most surgeons do not consider appendicitis
and pyloric stenosis as true surgical emergencies. The infant with
pyloric stenosis is often delayed hours, possibly even days, while
undergoing the necessary fluid rehydration and resuscitation. Likewise,
appendicitis can be temporized with IV antibiotics overnight and
taken to the operating room the following morning. Conversely, malrotation
with midgut volvulus and other causes of ischemic bowel are always
surgical emergencies due to the impending irreversible effects of
ongoing ischemia. Finally, there are many diagnoses that may fall
over a wide spectrum of severity. Therefore, the clinical picture
will often dictate the presence of an emergency more than the diagnosis.
Many congenital and acquired pediatric surgical issues can progress
to emergencies if the underlying problem has been present long enough.
In a general sense, intervention for surgical emergencies and the
less acute surgical urgencies fall into four categories:..."
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