Isolated abdominal distension in a fullterm normal baby-r/o Hirschsprungs disease Isolated Bilious vomiting in a normal looking newborn- r/o Malrotation Pinkish mass per umbilicus-Umbilical granuloma/Umbilical Polyp Discharging Umbilicus – Urine -Diagnosis is Patent Urachus, Fecal discharge –Patent Vitello-intestinal duct Newborn with Scaphoid Abdomen- Consider Malrotaion of Gut, Pure esophageal atresia (or blocked fistula) Child with recurrent episodes of constipation –r/o Hirschsprung’s disease Recurrent UTI in children- Take Pediatric Surgical Consultation to r/o anatomical causes malformations of GUT Recurrent UTI- R/o VUR-Vesico-ureteric reflux (Risk of Renal scarring and damage) An Infant with acute abdominal symptoms r/o Intussusception Single genital opening in a female baby-is Cloaca Fecal discharge per Vagina- diagnosis is Ano- Vestibular Fistua Newborn with recurrent attacks of tachypnea- R/o Congenital Lobar Emphysema/SOL Lung Chronic discharge from any orifice – R/o occult foreign body Hemolytic Anemia with hypersplenism- Consider splenectomy Urinary incontinence can be surgically treated by Bladder neck repair and Mitrofanoff (continent diversion) Fecal Incontinenece or refractory neurogenic constipation or status permanent colostomy can be surgically treated by Malone Antigrade Enema Technique (MACE)
Management of Empyema depends on Stage of the disease Stage1- Exudative- Tube Thoracostmy+/- Fibrinolytics (doubtful efficacy) Stage 2-Fibrinopurulent –Thoracotomy or Thoracoscopic Pleural Debridement. Stage 3- Organising- Thoracotomy and Pleural Debridement Stage-4- Cicatrising-Encased Lung- Thoracotomy and Pleural Debridement (Decortication-a misnomer).