summary: 9 "things" you need to remember about pediatric surgery

1. Green vomit is a surgical emergency 'till proven otherwise.
2. Midgut volvulus = dead/dying bowel.
3. Polyhydramnios demands exclusion of esophageal atresia (by passage of a radiopaque N.G. tube).
4. Abdominal wall defects: Gastroschisis - "good" / Omphalocoele - "awful"
5. Inguinal herniae are due to congenital processus vaginalis' (i.e. peritoneum), NOT muscular defects of the abdominal wall.
6. Constipation (or failure to pass meconium) may be the only clue to the diagnosis of Hirschsprung's disease.
7. Scaphoid abdomen + respiratory distress (in the newborn) = diaphragmatic hernia.
8. Intussusception - colicky abdominal pain, vomiting ± blood/mucus per rectum
9. Hypertrophic pyloric stenosis is acquired (not congenital) and characterized by projectile, non-bilious vomiting ± the "classic" electrolyte disturbance (hypokalemic, hypochloremic metabolic alkalosis).

G.M. Lees, MD, FRCSC
Department of Surgery
Revised: July 08, 1997