Pediatric Colorectal and Pelvic Surgery

Case Studies

Victoria A. Lane, Richard J. Wood, Carlos Reck, Marc A. Levitt

• Publisher: CRC Press
• Year: 2017
• ISBN:
  9781351800525
• Edition: 1
• Topic: Medicine
• Subtopic: Surgery & Surgical Medicine

This new handbook teaches and explains the key principles in the management of complex pediatric colorectal diagnoses. By using case-based presentations, radiographic images, operative images with Multiple Choice Questions to test knowledge, this book serves as an invaluable educational tool. 'Learning Points' are included and the text includes comprehensive explanatory chapters. The 60 cases includedencompass the full range of pediatric conditions, and theadditional learning materialcompletes this unique handbook.The e-book furtherenhances the learning experience for all clinicians involved in the treatment of children suffering from colorectal disorders.

PART I
	Anorectal Malformations—Primary

1
	Diagnosis of an anorectal malformation

Explanatory chapter—how to make the correct anatomic diagnosis

•Establishing the diagnosis/type of anorectal malformation (ARM) that the infant has is the most important first step when managing a child, after initial resuscitation and basic care.

•Without a clear understanding of the defect, it is impossible to make informed decisions with regards to the ongoing needs of the child.

Male ARM

The male ARM patient can have:

•Perineal fistula

•Rectourethral fistula

•Bulbar, prostatic, bladder neck which correspond to levels of the fistula to the urinary tract

•Recto-bladder fistula (bladder dome)

•No fistula

•Anal or rectal stenosis

•Rectal atresia

•Cloacal exstrophy

The diagnosis can be made on simple clinical examination in the majority of cases. The more complex malformations will require further investigations before one can identify the type of ARM the male infant has.

Perineal fistula

•The rectum is seen to form a fistulous tract to the perineum, anterior to the anal dimple.

•There is no communication with the urinary tract.

•The anterior rectum abuts the posterior urethra.

•Meconium (or mucous beads) will be seen on the perineum.

•Meconium is seen to be running along a fistulous tract along the midline raphe of the scrotum.

•The fistulous tract starts anterior to where the positioned anus should be.

Figure 1.1Perineal fistula.

Figure 1.2Perineal fistula.

Perineal fistula

•There is mucous from the fistula running along the midline raphe of the scrotum.

•The fistulous opening is anterior to the co...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Foreword
• Preface
• Contributors
• Acknowledgements
• Anorectal malformations (ARM) and the ARM continence index
• Part I: Anorectal Malformations—Primary
• Part II: Anorectal Malformations—Reoperations
• Part III: Hirschsprung Disease (HD)—Primary
• Part IV: Hirschsprung disease Post-Operative Assessment Cases
• Part V: Fecal Incontinence and Constipation
• Index