Journal of the Korean Pediatric Society 1962;5(3):145-152.
Published online July 31, 1962.
Emergency Surgery of the Newborn
Sae Soon Lee
Dept, of Surgery, Yonsei Univ. Medical School
新生兒의 外科的 治療를 要하는 疾患
李 世 淳
延世犬學校 醫科大學 外科學敎室
Abstract
There is no aspect of pediatric surgery more challenging than the management of those congenital anomolies incompatible with life but amenable to surgical correction. Imperforated anus, omphalocele, esophageal atresia, diaphragmatic hernia and the several variety of intestinal obstruction are the commonest surgical emergencies in the Newborn. Fundamental to the survival of infants with congenital anomalies incompatible with life are early diagnosis and early treatment, all of these infants have alterations in their physiology demanding that surgery be accomplished at the earliest passible moment. Under ordinary circumstances a Newborn infant is an excellent operative risk and remains so during the first 48 hours, following birth alteration in his physiology, such as normal breakdown of red cells, changes in fluid and electrolyte balance, and gradual diminution of his general reserve, cause the mortality rate to rise rapidly after 72 hours and to approach 100 percent toward the end of the first week of life. The Newborn infant has a very limited physiologic reserve, the successful management of fluid loss requires an intimate knowledge of the narrow limits of this reserve. Evaluation of signs: Of the lesions under discussion here, the diagnosis in two, namely, imperforted anus and omphalocele, can be made by observation alone. Unfortunately the presence of the remaining lesion is heralded by signs which are not pathognomonic. The early diagnosis are cyanosis, vomiting, absence of stools and abdominal distention. These four signs, if properly interpreted, could lead to an early diagnosis of any of the anomalies discribed here. 1)Esophageal atresia 2)Intestinal obstruction A)Intestinal atresia B)Annular pancreas C)Malrotation of colon with duodenal band and volvulus D)Meconium ileus E)Hirschsprung’s disease 3)Imperforated anus 4) Diaphragmatic Hernia 5)Omphalocele We discribed, in brief, regarding some aspect of embryology, clinical signs, methods of their diagnosis and treatment in these diseases.




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