Pediatrics

TRAUMA

The Pediatric Surgery service is consulted immediately for any pediatric trauma victim with serious and/or multiple injuries. The service will coordinate the trauma work-up, consult the appropriate subspecialty services, perform any necessary general surgical procedures, and coordinate care in the hospital. The service maintains a constant presence and therefore, an easily recognizable source of information for families and caretakers.

TUMORS/ONCOLOGY

The Pediatric Surgery service is intimately involved with the management and performs surgery for surgical childhood malignancies. These include Wilms' tumor, neuroblastoma, hepatoblastoma, hepatocellular carcinoma, rhabdomyosarcoma, teratomas, adrenal tumors, ovarian tumors, and testicular tumors. In addition, the service is involved in performing biopsies for the staging of non-surgical malignancies and performs vascular access procedures for children who will require long-term chemotherapy.

TRANSPLANTATION

The Pediatric Surgery service, in conjunction with Pediatric Urology, performs kidney transplants and participates in the comprehensive care of these pediatric patients. The service provides necessary vascular access for children requiring bone marrow transplantation.

AIRWAY

The Pediatric Surgery service utilizes laryngoscopy, bronchoscopy, and appropriate surgical techniques to evaluate and treat a variety of congenital and acquired airway disorders. These include stridor, laryngomalacia, tracheomalacia, subglottic stenosis, tracheal stenosis, laryngeal or tracheal clefts, and aspirated foreign bodies

HEAD AND NECK

The Pediatric Surgery service addresses a variety of conditions in the head and neck including branchial cleft anomalies and remnants, thyroglossal duct cysts, cystic hygroma/lymphangioma, abnormal/enlarged lymph nodes, neck masses, dermoid and sebaceous cysts, torticollis, disorders of the thyroid and parathyroid glands, and "tongue-tie".

LYMPH NODE

The Pediatric Surgery service evaluates and surgically treats enlarged and infected lymph nodes when appropriate from a variety of conditions which include infections (cat scratch, atypical mycobacteria, tuberculosis, staphylococcus, streptococcus, and a variety of other bacteria) , tumors (Hodgkin and non-Hodgkin lymphoma, metastases from other primary tumors), and idiopathic enlargement.

ENDOCRINE

The Pediatric Surgery service evaluates and treats disorders of the thyroid gland, parathyroid glands, adrenal glands (adrenal tumors, hyperfunctioning and hypofunctioning gland, pheochromacytoma), pancreas (cysts and pseudocysts, hyperinsulinism, islet cell adenoma, tumors).

BREAST

The Pediatric Surgery service evaluates and treats benign lesions of the breast in males (gynecomastia, breast enlargement, infection, congenital anomalies) and females (fibroadenoma, infection, inflammation, cysts, congenital anomalies). Endocrine evaluation is obtained when needed.

CHEST WALL

The Pediatric Surgery service evaluates and treats disorders of the chest wall including pectus excavatum, pectus carinatum, sternal defects, Poland's syndrome, and other congenital and acquired deformities. Cardiac and pulmonary evaluation is obtained when appropriate.

THORACIC

The Pediatric Surgery service evaluates and treats a variety of congenital and acquired thoracic disorders. These include congenital diaphragmatic hernia, diaphragmatic eventration, mediastinal cysts and tumors, bronchogenic cysts, enlarged lymph nodes, pulmonary sequestration, cystic adenomatoid malformation (CAM), lobar emphysema, empyema, tracheal and bronchial malacia, pneumothorax, chylothorax, primary and the metastatic tumors of the lung, aberrant great vessels, vascular rings and slings, esophageal duplication cysts, esophageal atresia and tracheoesophageal fistula (TEF), congenital and acquired strictures of the esophagus, esophageal foreign bodies, esophageal rupture and perforation. Techniques of laryngoscopy, bronchoscopy, esophagoscopy, and thoracoscopy are used when required.

GASTROINTESTINAL

The Pediatric Surgery service evaluates and treats a wide variety of congenital and acquired gastrointestinal disorders. Conditions include pyloric stenosis, esophageal reflux, peptic ulcer, congenital duodenal obstruction (duodenal atresia, stenosis, web, annular pancreas), atresia and stenosis of small and large intestine, meconium ileus, Meckel diverticulum, intussusception, malrotation, intestinal obstruction from tumor or adhesions, short bowel syndrome, intestinal duplication, inflammatory bowel disease (ulcerative colitis, Crohn disease), mesenteric and omental cysts, ascites, polypoid diseases of the intestinal tract, necrotizing enterocolitis (NEC), appendicitis, Hirschsprung's disease, imperforate anus, and tumors of the abdomen and intestine, among others. Laparoscopic techniques are used when appropriate.

LIVER AND BILIARY TRACT

The Pediatric Surgery service evaluates and treats conditions of the biliary tract including jaundice of the newborn, biliary atresia, choledochal cyst, diseases of the gallbladder (gallstones, cholecystitis), common bile duct obstruction, liver cysts and tumors, liver hemangioma, portal hypertension

HERNIAS

The Pediatric Surgery service evaluates and treats a variety of hernias including inguinal, umbilical, epigastric, ventral, and epiploceles

PANCREAS

The Pediatric Surgery service evaluates and treats conditions of the pancreas including cysts, pseudocysts, pancreatitis, neoplasms, hyperinsulinemia, islet cell adenoma

ABDOMINAL WALL

The Pediatric Surgery service evaluates and treats a variety of congenital abdominal wall defects including gastroschisis, omphalocele, and Prune Belly syndrome.

SPLEEN

The Pediatric Surgery service evaluates and treats conditions of the spleen including splenomegaly and hypersplenism from a variety of hematologic disorders (sickle cell anemia, hereditary spherocytosis, Gaucher's disease, idiopathic thrombocytopenic purpura (ITP), thrombotic thrombocytopenic purpura (TTP), thalessemias, autoimmune hemolytic anemias), cysts, tumors, and abscesses.

GENITOURINARY

The Pediatric Surgery service evaluates and treats undescended testicles, testicular torsion, epididymitis, phimosis, cloacal extrophy, cloacal anomalies, labial fusion, clitoral hypertrophy, ambiguous genitalia, Prune Belly syndrome. The service regularly performs circumcision procedures as well.

SOFT TISSUE

The Pediatric Surgery service treats and evaluates congenital and acquired defects of the skin and soft tissue including cysts, nodules, pigmented lesions/nevi, hemangioma, lymphangioma/cystic hygroma.

VASCULAR

The Pediatric Surgery service treats and evaluates congenital and acquired vascular anomalies. These include vascular rings and slings, and vascular injuries. The service also regularly provides vascular access for nutrition, chemotherapy, and dialysis, as well as providing arterial-venous bypass procedures for dialysis

The Pediatric Surgery regularly uses a variety of endoscopic techniques to evaluate and treat conditions of the airway (laryngoscopy, bronchoscopy), the chest (thoracoscopy), abdomen (laparoscopy) and urinary tract (cystoscopy).