Pediatric Surgery Diagnosis and Treatment Christopher P. Coppola Alfred P. Kennedy Jr Marc S. Lessin Ronald J. Scorpio Editors Second Edition 123 Pediatric Surgery Christopher P. Coppola • Alfred P. Kennedy Jr Marc S. Lessin • Ronald J. Scorpio Editors Pediatric Surgery Diagnosis and Treatment Second Edition Editors Christopher P. Coppola Alfred P. Kennedy Jr Department of Pediatric Surgery Department of Pediatric Surgery Janet Weis Children’s Hospital Janet Weis Children’s Hospital Danville, PA, USA Danville, PA, USA Marc S. Lessin Ronald J. Scorpio Department of Pediatric Surgery Department of Pediatric Surgery The University of Michigan Janet Weis Children’s Hospital Ann Arbor, MI, USA Danville, PA, USA Disclaimer: The authors are not responsible for product liability, negligence, injury, or otherwise for any loss, harm, or injury resulting from any material contained in this work. This work contains information relating to general principles of medical care which should not be construed as specific instructions for individual patients. The responsibility for making treatment decisions lies with the providers caring for specific patients. Pharmaceutical product inserts and manufacturers’ product information should be reviewed for current information, including contraindications, dosages, and precautions. Users of this text accept these conditions. ISBN 978-3-030-96541-9 ISBN 978-3-030-96542-6 (eBook) https://doi.org/10.1007/978-3-030-96542-6 © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2014, 2022 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Foreword It’s 3 AM on a Saturday and, of course, it’s February with ample snow on the ground. The 9-month-old you admitted with dehydration and vomiting is a former 28-week infant who was thriving…until tonight. You examine the abdomen once more, re- look at the X-ray, see the rise in the lactate, and now know you have crossed over the medical chasm—you need a pediatric surgeon. As a pediatric critical care physician, I am fortunate to know unique individuals who have mastered the discipline of pediatric surgery—those physicians who can easily engage and comfort a distressed child (and family) and can adeptly diagnose, repair, and/or remove the source of a child’s distress. The editors are all close friends and colleagues. They are kind, patient-centered, and highly accomplished surgeons with over 75 years of cumulative experience. I have been elbow-to-elbow with each of these surgeons on many a February night. However, I wondered why four of the busiest people I know would take on a textbook. Then I was struck by a line in the preface of the first edition “Every time a pediatrician diagnoses a child with abdominal pain, an emergency medicine phy- sician cleans a child’s wound, or a nurse chooses a location for an intravenous line in an infant, pediatric surgical care is being delivered”. I believe this summarizes the intent of the editors—a desire to educate providers across skill sets so to optimize the care of any infant or child with a potential surgi- cal disorder. This is not surprising and reflects the generosity, lack of hubris and the expertise these thoughtful editors demonstrate day in and day out…nights included. What a blessing to know a good pediatric surgeon. Department of Pediatrics Frank Maffei Janet Weis Children’s Hospital Danville, PA, USA v Preface The surgical care of children is often a source of worry for medical team members due to the high stakes involved. Injury and surgical illness can result in critical con- ditions in children requiring rapid assessment and action to achieve a return to health. It is important to remember when there is a sick child, there is a sick family, and the needs of parents must be addressed. Pediatric surgery as a field is challeng- ing due to its breadth. It remains a generalized discipline in which the conditions treated span literally head to toe. It is oft repeated that children are not small adults. The surgical conditions of children are distinct from adults, and signs and symp- toms in children indicate different etiologies. A relatively small number of pediatric surgeons are concentrated in tertiary treatment centers so children with surgical disease will often present to non-pediatric specific providers. This text is designed to assist those caring for children whether they are on a pediatric surgery team or not. It is organized by specific surgical diseases affecting children at each stage of life, as well as chapters on trauma, neoplasm, and technical procedures. Chapters organize information in outline form to enable rapid diagnosis and treatment. Chapter structure includes key points, a narrative section of addi- tional details, study questions, and further reading. Each topic is written to stand alone for rapid reference, or the text can be used as a whole for study. We editors have devoted our professional lives to improving the lives of children and hope that this work helps others help children in need. Danville, PA Christopher P. Coppola Danville, PA Alfred P. Kennedy Jr Lansing, MI Marc S. Lessin Danville, PA Ronald J. Scorpio vii Contents Part I Introduction The History of Pediatric Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Max D. Hazeltine and Michael P. Hirsh Resources for Pediatric Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Kelly Smith COVID-19 Pandemic and Contamination Response . . . . . . . . . . . . . . . . . 19 Max D. Hazeltine and Michael P. Hirsh Part II P erioperative Issues Fluids and Electrolytes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Ronald J. Scorpio and Alfred P. Kennedy Jr Pediatric Anesthesiology and Opioid Use . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Yohannes B. Getachew Procedural Sedation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Richard L. Lambert Postoperative Neonatal and Pediatric Critical Care . . . . . . . . . . . . . . . . . 65 Edward A. Everett Jr and Frank A. Maffei Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Alfred P. Kennedy Jr and Bethany J. Beaver Disorders of Clotting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Michal A. Miller Part III Trauma Epidemiology of Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Bryan S. Walters, Emily E. Steinhilber, and Christopher P. Coppola ix x Contents Injury Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Judith Egly Non-accidental Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Carol Hanson Initial Trauma Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Dimitra M. Lotakis and Arthur Cooper Pathophysiology/Pathobiology of Brain Injury . . . . . . . . . . . . . . . . . . . . . 139 Nelson Sofoluke, George Jallo, and Nir Shimony Pediatric Head Trauma and Treatment Algorithm . . . . . . . . . . . . . . . . . . 159 Cameron Brimley, George Jallo, and Nir Shimony Abdominal Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 James DeCou, Sarah Alander, and Christopher P. Coppola Thoracic Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 Aaron Price and Robert Ricca Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 Elizabeth J. Hughes and Sigrid Blome-Eberwein Cervical Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 Joshua Senter and Aileen P. Wertz Traumatic Thoracolumbar Spinal Injuries in Children . . . . . . . . . . . . . . 219 Gretchen Floan and Romeo Ignacio Pelvic Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 Casssandra Ricketts and Meagan Fernandez Common Pediatric Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247 Brian K. Foster, Meagan Fernandez, and Louis C. Grandizio Part IV N eonatal Problems Fetal Surgery and Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263 Abigail J. Engwall-Gill and Erin E. Perrone Necrotizing Enterocolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273 Samir Narula, Pratibha Vemulapalli, and Brian Gilchrist Congenital Diaphragmatic Hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287 Sean C. Skinner Esophageal Atresia and Tracheoesophageal Fistula . . . . . . . . . . . . . . . . . 295 Robert Ricca and Kristine Griffin Extracorporeal Membrane Oxygenation (ECMO) . . . . . . . . . . . . . . . . . . 307 Sean C. Skinner Contents xi Pyloric Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317 Marc S. Lessin Duodenal Atresia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325 Samir Narula, Pratibha Vemulapalli, and Brian Gilchrist Intestinal Atresia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337 Alysia A. Agnoni and Christopher P. Coppola Short Bowel Syndrome and Intestinal Lengthening Procedures . . . . . . . 345 Pooja S. Salvi and Robert A. Cowles Hirschsprung Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357 Michael J. Allshouse and Lindsay H. Devereux Malrotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 Alysia A. Agnoni and Christopher P. Coppola Neonatal Abdominal Wall Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379 Sarah L. Wright and Ryan M. Walk Anorectal Anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399 Laura Tiusaba, Shimon Jacobs, Teresa Russell, and Marc A. Levitt Congenital Lung Malformations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421 Melissa Suh and Shahab Abdessalam Meconium Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433 Niti Shahi and Jeremy T. Aidlen Biliary Atresia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445 Yi-Horng Lee Sacrococcygeal Teratoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 455 Danielle Dougherty and Marc S. Lessin Patent and Persistent Ductus Arteriosus . . . . . . . . . . . . . . . . . . . . . . . . . . 465 Gerhard Ziemer and Cherish Boehm Neonatal Hyperinsulinemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 477 Kody L. Moore and Christopher P. Coppola Part V Common Problems of Infancy and Childhood Inguinal Hernia/Hydrocele . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489 Christie Buonpane and Alfred P. Kennedy Jr Umbilical Hernia and Other Disorders of the Umbilicus . . . . . . . . . . . . . 501 Christie Buonpane and Alfred P. Kennedy Jr Intussusception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 507 Roland J. Scorpio xii Contents Gastrointestinal Foreign Objects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 515 Biren Desai and Brian Maksimak Airway Foreign Objects and Bronchoscopy . . . . . . . . . . . . . . . . . . . . . . . . 525 Jeremy Mock Congenital Cervical Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 537 Randy Lesh, Curtis Gehman, and Aileen P. Wertz Renal Duplication Anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 547 Jasmine I. Kashkoush and Robert Steckler Cryptorchidism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 553 Jasmine I. Kashkoush and Robert Steckler Choledochal Cyst . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 561 Yi-Horng Lee Gastroesophageal Reflux . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 569 Benjamin Kuhn and Kritika Sukumar Benign Disorders of the Anus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 575 Neesha S. Patel, Steven R. Donahue, Katharine A. Armstrong, Kelsey R. Tieken, and Angela M. Hanna Surgical Evaluation of Skin Lesions in Childhood . . . . . . . . . . . . . . . . . . 587 Audrey Dean and Howard Pride Pediatric Gastrointestinal Bleeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 609 Biren Desai and Dean R. Focht Part VI P roblems in School Age Children Lymphadenopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 621 James DeCou Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 629 Tara J. Loux Non-malignant Splenic Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 639 Marc S. Lessin Sickle Cell Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 653 Jeffrey Taylor Empyema and Thoracoscopic Drainage . . . . . . . . . . . . . . . . . . . . . . . . . . . 665 Tiffany Zens, Kara Gill, and Daniel Ostlie Vascular Rings and Aberrant Brachiocephalic Trunk . . . . . . . . . . . . . . . 679 Gerhard Ziemer and Cherish Boehm