TY - CHAP M1 - Book, Section TI - Anesthesia for Gastrointestinal Procedures A1 - Chaudhuri, Kallol A2 - Ellinas, Herodotos A2 - Matthes, Kai A2 - Alrayashi, Walid A2 - Bilge, Aykut PY - 2021 T2 - Clinical Pediatric Anesthesiology AB - FOCUS POINTSPyloric stenosis is a medical and not a surgical emergency managed first by volume repletion. Hypochloremic, hypokalemic metabolic alkalosis is the classic derangement and once corrected, pyloromyotomy is the surgical intervention of choice.An international randomized multicenter trial did not find any strong evidence that infants exposed to general anesthesia for 1 hour during inguinal herniorrhaphy had any measurable neurocognitive or behavioral deficits at 5 years of age.Insufflation of the peritoneum with CO2 for laparoscopic procedures leads to increased intra-abdominal pressure (IAP) with sometimes clinically significant cardiorespiratory, neuro, and renal physiological changes.Intussusception is the most common abdominal emergency in patients less than 2 years of age with classic presentation of abdominal pain, and bloody (currant jelly) stool.Gastroschisis is usually an isolated abdominal defect, whereas omphaloceles are usually associated with a wide variety of abnormalities (cardiac defects, congenital diaphragmatic hernia, chromosomal anomalies).Congenital diaphragmatic hernia (CDH) presents at birth with respiratory distress-tachypnea, grunting, use of accessory muscles, and cyanosis. Prognostic indicators include the degree of lung hypoplasia and the presence of pulmonary hypertension.The classic presentation of appendicitis includes periumbilical abdominal pain with anorexia, nausea, and vomiting. Leukocytosis and fever may be present. Transabdominal ultrasound (US) is the most common diagnostic modality.Hirschsprung disease or congenital intestinal agangliosis is the most common cause of intestinal obstruction in neonates. Neonates who fail to pass meconium within 48 hours of life should be assessed for this disorder. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/04/16 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1176458190 ER -