Immediate surgical care of the baby- Conditions like Gastroschisis, Exstrophy bladder, All intestinal atresias, Anorectal Malformations, Tracheo-osophageal fistula, Posterior urethral valves, severe hydronephrosis, urinary ascites, and meningomyeloceles require immediate surgical attention. Most of the congenital anomalies (60%) can be safely corrected after birth; those cases should be delivered at centre where a pediatric surgeon is available. (FTNVD_Fullterm Normal Vaginal Delivery,IL-Induction of Labour) Fetal Surgery- Only available in limited centers
Some Clinical Tips for Pediatricians and General Practitioners: ‘Children are not just small adults’ –Anatomy, Physiology, Pathology, Nutritional needs, Posology, Growth potential, Child behavior and Surgical principles are different from that of adults. All symptoms or signs in any child require thorough evaluation of the system concerned and the related systems for accurate diagnosis.
All swellings need surgical intervention Almost all Bilious vomitings are surgical but all non bilious vomiting are not medical. Most common causes of bilious vomiting in newborn are gastrointestinal obstruction-Artesia, Malrotation. Most important medical cause of bilious vomiting in newborn is Neonatal sepsis (But only after ruling out surgical causes). Nonbilious vomitings in newborns or children- Preampullary intestinal obstruction. Bilious
vomitings
–always
have
post
ampullary
obstruction
(dynamic/adynamic). Newborn with bilious vomiting- Duodenal atresia,Jejunoilial Atresias, Meconium Ilues Hirschsprungs disease, Meconium Plug syndrome,Enteric Duplication cyst. Nonbilious vomitings in a 2-4 months old - infantile Hypertrophic Pyloric Stenosis (IHPS). Newborn with Bilious aspirates and without abdominal Distension or scaphoid abdomen- S/o Malrotation of Gut.