Pediatric surgery is a surgical subspecialty that focuses on diagnosing and treating childhood surgical diseases. As a child is not a miniature adult, pediatric surgeons must keep in mind that a child’s organism is immature and has certain anatomical and metabolic peculiarities. More specifically, pediatric surgery covers the diagnostics and surgical treatment of congenital malformations and acquired diseases and injuries. The surgical problems related to falls, different traumas and the musculoskeletal system are managed by pediatric surgeons-orthopedists who have received a special training. To give you a better overview of the specialty, we below describe some of the most common conditions that the pediatric surgeons deal with in their everyday work.
Clubfoot is one of the most frequent malformations of feet. The foot points down and inwards and the heel is in a higher position than the toes. Clubfoot usually affects one foot, but sometimes it can affect both feet. Clubfoot surely needs early treatment, because without intervening the condition will get worse, causing additional health problems. In most cases, conservative treatment is applied, which includes bandages, plaster casts and orthoses. If conservative treatment turns out to be insufficient, surgery is performed to lengthen the heel cord. The results of early treatment can be very good, but it must be kept in mind that the treatment must be consistent – only then optimal and permanent results will be achieved.
Pectus excavatum, also called sunken chest, is a chest wall deformity is which the chest wall has a concave or caved-in appearance. This deformity that affects boys more often than girls apparently has a genetic predisposition. In milder cases, the defect is hardly noticable and does not need treatment. In severe cases pectus excavatum may cause problems with heart function and breathing and the patient needs to be operated. The deformity will be corrected by means of a special bar that keeps the bones in right position.
Cryptorchism or undescended testes is the most frequent birth defect in boys. Cryptorchism can be one- or both-sided. Normally the testes descend into the scrotal sac by themselves during the first couple of months after birth. Therefore, watchful waiting is the first tactics, however, if the testes have not descended by the end of the first year of life, operation is performed. Surgical intervention is necessary, because cryptorchism leads to substantial loss of fertility and potential infertility. Also, this condition is an important risk factor for testicular cancer.
Umbilical hernia happens when intestine or fatty tissue pushes through a weak spot in the abdominal wall. The most noticable symptom is a bulge near the navel area. Quite often it is possible to push the hernia back in carefully with fingers, but the bulge tends to reappear. An umbilical hernia becomes especially well visible during strenuous physical activity and when the intraabdominal pressure increases (during blowing nose or coughing). Umbilical hernia may occur in both children and adults. In children, the umbilical hernia usually disappears by 3–5 years of age. Before that age, watchful waiting is the main strategy. When the hernia gate (the opening through which the contents push) is large and does not close by itself, then surgical intervention is contemplated.
Burns are one of the most frequent household traumas in infants and small children. Quite often they even need hospital treatment. Most often, hot liquids (coffee, boiling water etc.) are involved. Children’s skin is much more delicate than in adults and thus a hot liquid that is harmless to an adult may cause deep burns to children. In first aid for burns, quick action and cooling down the burned area are crucial. If the burned area is large and the wounds deep, it is necessary to consult a doctor, because through the damaged area, the organism loses lots of liquid. A pediatric surgeon checks the wounds and prescribes necessary treatment. In less severe cases, special wound care products and regular change of bandages will suffice, however, in more serious cases skin transplantation is necessary.
Pediatric surgeon’s consultation5 clinics
A pediatric surgeon is a surgeon specialized in the surgical treatment of children and newborns. Pediatric surgeons diagnose, treat and monitor the progression of children’s intestinal diseases, hernia, urinary tract pathologies, bone fractures and skin burns. During the first appointment, the pediatric surgeon examines the patient and prescribes necessary tests and analyses.