By William E. Shiels II DO, D. Gregory Bates MD (auth.), Steven Teich MD, Donna A. Caniano MD (eds.)
Reoperative surgical procedure is a winning problem confronted through pediatric surgeons. Reoperative Pediatric surgical procedure constitutes in a single quantity the freshest info and strategies for serious circumstances in the entire pediatric surgical specialties together with oncology, gastroenterology, gynecology, urology, radiology, and cardiology. well-known specialists impart their wisdom of symptoms for reoperative surgical procedures, radiologic overview, surgeries that may require seldom used and very complicated thoughts, and the hazards and results of those really expert ways. those practising surgeons offer perception into elaborate corrective systems related to the location of grafts, stents, and helps with worthwhile forecasting for problems bobbing up from anatomic progress and illness recurrence.
This finished publication is an vital source masking the entire spectrum of pediatric reoperation addressing the problems of universal pediatric surgical procedures together with congenital illness fix, chest wall fix, orchiopexy, hernia fix, fundoplication, and location of vertriculoperitoneal shunts in addition to exact situations of tumor excision and reoperative oncology. With its special masterful process and entire colour pictures, Reoperative Pediatric surgical procedure is the gold-standard for this multi-faceted discipline.
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Additional info for Reoperative Pediatric Surgery
Example text
In addition, the site and cause of the perforation as well as associated complications of phlegmon, abscess, and peritonitis can be assessed (54). Administration of oral contrast is recommended, although extraluminal extravasation is not a frequent CT finding in perforation. Diagnosis of perforation is based on direct findings of extraluminal air or luminal contrast material and direct visualization of a focal ulceration or discontinuity of the stomach wall. An indirect sign of perforation is an inflammatory phlegmon in direct continuity with the wall of the stomach.
A barium esophagram should follow as the initial diagnostic examination of choice. Classic findings identified in achalasia include smooth tapered narrowing of the distal esophagus (“bird’s beak” appearance) associated with atonic dilation of the lower two-thirds of the esophagus and a column of contrast in the esophageal lumen (37) (Fig. 15). CT scans are not generally recommended in the evaluation of achalasia unless there is suspicion of a mass Fig. 15. Achalasia. Lateral view from an esophagram demonstrating a dilated esophagus, air–fluid level (arrowhead) and obstructed distal esophagus (arrow).
With advances in minimally invasive techniques, laparoscopic Nissen fundoplication has become the preferred surgical technique (44). Despite a success rate of more than 90% and low mortality, antireflux surgery is not without complications. The upper gastrointestinal series (UGI), with barium administered orally or through a gastrostomy tube, is the study of choice to evaluate the integrity and the function of the wrap. Loosening or breakdown of the fundoplication is identified by contrast filling the folds of the wrap.