• Abdominal – Hypertrophic Pyloric stenosis, Intussusception, Appendicitis, Intestinal obstruction etc.
• Hepatobiliary – Gallbladder stone, Choledochal cyst, biliary atresia etc.
• Neck lesions – Thyroid lesions, Thyroglossal cyst & fistula, Branchial Sinus, Cystic hygroma, Lymph node biopsy etc.
• Inguino-scrotal swelling - Congenital hernia, Hydrocele, Torsion testes, Epididymorchitis etc.
• Pain abdomen, Constipation, Bleeding per rectum management etc.
• Sebaceous cyst, dermoid cyst, hamartoma excision etc.
Management Of Constipation & Bleeding In Rectum In Children!
Constipation is a symptom, not a disease. Constipation is a digestive disorder system where an individual faces difficulty to expel. An incomplete bowel movement is a sign of constipation. This condition causes the stiffening of stool near the rectum, obstructing the smooth passage of stool. In most of the cases, this occurs because of the improper diet. If one is suffering from constipation the faeces become hard, dry and emptying the bowels become painful. Sometimes it causes bleeding in the rectum. Constipation may also cause the abdominal pain. Constipation is very common in kids. Constipation is a temporary problem, but, chronic constipation may lead to serious problems. The common causes of constipation in kids are improper toilet training and diet less in fibre content. One can avoid this by eating healthy food rich in fibre, drinking more and more fluids.
Symptoms :
Mention below are the symptoms of constipation :
1. Regular stomach ache and less than three bowel movements a week.
2. Bowel moment is slow and hard to pass.
3. Emptying the bowel becomes painful.
4. Blood on surface of hard stool.
5. Abdominal pain
Causes :
1. Toilet training: Improper toilet training is one of the major causes of constipation. One must follow a proper routine for passing out stool.
2. Diet: If you are not providing a child a food rich in fibre than the child may suffer from constipation. Consuming a dairy product also leads to the same problem. Sodas and drinks containing caffeine cause dehydration and worsen constipation.
3. Change in routine: Change in routine such as long travelling, too hot or cold weather and stress can affect bowel functioning.
4. Hirschprungs’ disease: There is absence of ganglion cells in intestine leading to failure of movement of bowel leading to constipation.
5. Rectal polyp, Colonic polyp, Anal fissure: Causes bleeding per rectum. Blood streaks on stool occur in Constipation and Anal fissure. Bleeding in drops after passing stool occurs in Polyps.
Preventions
One can get the better results if an individual combines all the approaches given below:
1. Toilet training: Child should be encouraged to go to toilet at a particular time daily. Provide the child with comfortable footstool so that could comfortably release a stool.
2. Diet: The Proper diet chart should be maintained for children. A balanced diet rich in fibre should be served. Increase the daily water intake of your children. Avoid fast food and dairy product.
3. Medicines: If your child is taking some medicines review it. It may be causing constipation. In case the medicine is causing constipation then go for doctor opinion.
4. Regular exercise: Regular exercise is one of the best ways to avoid constipation. Ask your child to do regular exercise and play outdoor games. Regular exercise increases metabolism and make our immune system strong.
5. Regular check-up: A regular visit to the doctor helps to diagnose the health problem. A Regular check-up is necessary for maintenance of healthy body and it avoids the risk of serious disease caused by constipation.
Surgical Causes Of Vomiting In A Child!
Vomiting in infants and kids are very common. Most of the vomiting cases do not require patients to see a doctor. But there are some conditions that cause forceful vomiting in babies and infants leading to dehydration.
One such condition is called Infantile Hypertrophic Pyloric Stenosis. Infantile Hypertrophic Pyloric Stenosis is a problem that affects infants and requires the immediate attention of a Pediatric Surgeon. In this disease, the lower portion of the stomach known as Pylorus is blocked. Due to the blocked Pylorus, the food in the stomach cannot enter the small intestine. Due to this obstruction, the child experiences vomiting persistently.
Risks Prone to Pyloric Stenosis
• The disease is more common in boys than girls.
• Children from white race are more prone to Pyloric Stenosis.
• There is evidence of genetic predisposition.
Symptoms
The most common symptom of Pyloric Stenosis is frequent and projectile non-bilious vomiting in kids. Whatever feed they take from mothers is vomited after few hours. However, the vomiting is different than that of wet burps which are very common among infants.
• Kids remain hungry after vomiting
• Weight loss
• Ongoing crying
• Lack of energy i.e. lethargic
• Sleeping
• Fewer bowel movements
• Bloating and constipation
Diagnosis
In addition to the physical examination the following investigations are done:
• Blood tests to evaluate dehydration and electrolyte imbalance.
• Abdominal ultrasound is diagnostic to know the presence of pyloric mass and the length of pyloric canal
Treatment
The only practical course for treating Pyloric Stenosis is to operate the infant. However, first doctors administer the infant with the medicines and IV fluid to treat dehydration and electrolyte imbalances. Once the baby is hydrated and ready to get operate, surgery is performed.
TAKE AWAY
Consult a Pediatric Surgeon if your child is vomiting after feeds. He needs evaluation to know the cause of vomiting and treat accordingly.
Gall Bladder stone - How To Manage It In Children?
When gall bladder becomes inflamed, your child may suffer from fever, abdominal pain, and vomiting.
Causes of Gallstones in Kids
Study shows that girls form gallstones more than boys. However, other causes of gallstones in kids are:
• Disease related to red blood cells(Sickle cell disease, Hereditary spherocytosis)
• Fatty diet
• Use of Total Parenteral Nutrition
• Stasis & Sepsis
Symptoms
Generally, gallstones do not create any problems if they are small in size. But when they block the fluid in the gall bladder and make it swell, it is urgent to visit a doctor and go for surgery.
• Pain in the upper part of the abdomen
• Fever
• Nausea & Vomiting
• Jaundice
Diagnosis
If you are experiencing these symptoms, you must immediately consult a Pediatric Surgeon. Ultrasonography of abdomen is done to check the presence of gallstones. If the child has gallstones, the doctor may advise the treatment accordingly.
Treatment
At first, doctors identify the size of gallstones which is apparent from the ultrasound reports. If the gallstones are multiple and not small enough to dissolve by themselves, surgery is necessary for the removal of Gall bladder.
Management of Gall Bladder stone in a child
If the operation is done through laparoscopy, then the child is discharged from the hospital in 2 days. But if the doctors have performed open gall bladder surgery, he might have to remain admitted in the hospital for 4 to 5 days.
Take Away
Consult a Pediatric Surgeon if your child is diagnosed with stone in Gall bladder.
Umbilical Hernia - How To Manage It?
Umbilical Hernia is a common condition in infants in which the intestine protrudes or pokes out through the abdominal muscles in the navel area, where generally the Umbilical cord is located. Umbilical Hernia is generally harmless if not sore and is evident when the bellybutton protrudes. During childhood, Umbilical Hernia closes on its own, but sometimes when it does not, it might require a surgical correction during adulthood. This condition is commonly seen in premature babies and can be diagnosed through physical examination alone.
Symptoms
Umbilical Hernia causes swelling or bulging near the navel and is generally visible under normal circumstances. However, in some cases, the protrusion occurs only when the baby strains, coughs or cries. Though this condition is painless, it can cause discomfort during adulthood. To avoid complications, it is advisable to seek professional help even if the condition initially seems harmless. There might be symptoms of pain, swelling, discoloration, and tenderness in the navel, accompanied by vomiting sometimes.
Causes
When the fetus is still unborn and in womb, the umbilical cord passes abdominal muscles of the baby through a small opening, which generally closes post birth. But in case muscles fail to completely join the midline of abdominal wall, this condition appears post birth, and sometimes later in life.
During adulthood, when there is too much pressure on the abdomen, it leads to this condition. This pressure might build up due to a number of causes like multiple pregnancies, obesity, previous abdominal surgery, ascites (fluid in the abdominal cavity), and long-term dialysis for kidney function.
Complications
Complications might be caused when the protruding part of the intestine gets incarcerated or trapped and fails to push itself back into the abdominal cavity, reducing the blood supply. This leads to tissue damage and umbilical pain. If the blood supply totally fails, tissue death leads to gangrene, causing infection, and posing a life-threatening situation. In such cases, surgery might have to be performed in an emergency.
Treatment
Most of the times, abdominal tissue pushes itself back but sometimes, it has to be done by an experienced medical professional. When this cannot happen, surgery has to be performed to correct the situation. The surgery can be open or laparoscopic.
A small incision is made at the base of the bellybutton during surgery, which is a small and quick procedure. The hernia is corrected and sutures close the incision. For adults, sometimes mesh is used for strengthening the abdomen during open surgery.
Take away
Umbilical Hernia is a condition in which the intestine or abdominal tissue protrudes through the abdominal muscles in the navel area, where generally the Umbilical cord is located. It is a harmless condition but sometimes painful. Generally, it corrects itself but when it fails to do so, corrective surgery is required which can be open or laparoscopic.
