RT Book, Section
A1 Chaudhuri, Kallol
A2 Ellinas, Herodotos
A2 Matthes, Kai
A2 Alrayashi, Walid
A2 Bilge, Aykut
SR Print(0)
ID 1176458190
T1 Anesthesia for Gastrointestinal Procedures
T2 Clinical Pediatric Anesthesiology
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781259585746
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1176458190
RD 2024/04/19
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.