PEDIATRIC SURGICAL

EMERGENCY

dr.Teuku Yusriadi,Sp.BA
 Introduction
• Pediatric surgical emergency diseases:
– Anatomical anomalies
– Physiological changes.
• Children are not little adults and the pediatric
physiology undergoes significant changes
from birth to adulthood.
• Pediatric surgical care requires a unique fund
of knowledge.
Introduction…
• Pediatric surgical emergency diseases
– Congenital
• Intestinal atresia, abdominal wall defect,
Hirschsprung’s disease, etc.
– Acquired
• Infection: NEC, appendicitis, intestinal perforation
• Trauma: Intra abdominal bleeding, peritonitis
• Tumor: Sacrococcygeal teratoma, bladder wall RMS
• Miscellaneous: Gastrointestinal bleeding,
intraperitoneal adhesion
Introduction…
• Pediatric surgical emergency diseases
– Neonatal & Pediatric
1. Neonatal:
• Esophageal atresia
• Congenital diaphagmatic hernia
• Intestinal atresia
• Abdominal wall defect
• Necrotizing enterocolitis
• Anorectal malformation
• Neonatal Hirschsprung’s disease
• Neonatal intestinal perforation
Introduction…

2. Pediatric:
• Hypertrophic Pyloric Stenosis
• Malrotation and midgut volvulus
• Incarcerated inguinal hernia
• Intussusception
• Appendicitis
• Intestinal perforation
• Gastrointestinal bleeding
• Testicular torsion
 Clinical Manifestation
In general, pediatric surgical emergency cases is
manifest as follow :
1. Acute intestinal obstruction
2. Local or diffuse peritonitis
3. Abdominal wall defect
4. Respiratory distress syndrome
5. Gastrointestinal bleeding
6. Abdominal injuries
 Clinical Presentation
Non Bilious Blood mix with
Bilious vomiting
vomiting gastric juice
• Intestinal atresia • HPS • Midgut volvulus
• Anorectal • Duodenal • Gastric volvulus
malformation atresia pars I
• Hirschsprung’s • Gastric outlet
disease obstruction
• Necrotizing
enterocolitis
• Incarcerated
inguinal hernia
Clinical Presentation…

Abdominal Abdominal wall

Abdominal Pain
Distension defect
• Intestinal atresia • Intussusception • Omphalocele
• Necrotizing • Appendicitis • Gastroschisis
enterocolitis • Peritonitis • Incarcerated
• Anorectal • Midgut volvulus umbilical hernia
malformation • Incarcerated
• Neonatal inguinal hernia
Hirschsprung’s
disease
• Intestinal
perforation
Clinical Presentation…

Respiratory
Bloody Stool Acute Local Pain
Distress
• NEC • Incarcerated • Congenital
• Volvulus midgut inguinal hernia diaphagmatic
• Intussuception • Incarcerated hernia
• Gastrointestinal umbilical hernia • Esophageal
bleeding • Testicular atresia
torsion • Diaphagmatic
eventeration
Atresia Esofagus
Hipertrofi Pyloric Stenosis
Atresia Duodenum
Atresia JejunoIleal
Atresia Ani
Hernia Diafragma Kongenital
Gastroskisis
Omfalokel
 Intussuception
Sausage like mass Currant jelly stool Target’s sign

Meniscus sign

Intussusception
Divertikel Meckel
Hirschsprung Disease
Appendisitis
Hernia Inguinal
Intestinal Obstruksi & Perforasi
Asites
Blunt Abdominal Injury
Phymosis
Hypospadia
Epispadia
Ekstrofia Buli
Hygroma Coli
Teratoma Saccrococcygeal
Peritonitis TB
Multipel Vagina