Pediatric General Surgery

Aims

1. To become familiar with the recognition, natural history, and general and specific treatment of those pediatric surgical conditions that one would expect to encounter in a general surgery practice in a community lacking the immediate availability of a pediatric surgeon.
2. To familiarize oneself with the pathophysiology of pediatric surgical conditions, and the response of a child to surgery and trauma.

Educational Objectives

Clinical Skills

Given a patient with a pediatric general surgical disease, the clerk will be able to do the following to the satisfaction of his/her supervisor(s):

• Take a relevant history.
• Perform an acceptable physical exam concentrating on the relevant areas.
• Arrive at an appropriate differential diagnosis.

Cognitive Knowledge

The clerk will be expected to demonstrate a fundamental knowledge and understanding of the following general areas and disease processes. The clerk’s knowledge base must be adequate to permit appropriate assessment, investigation, diagnosis, and treatment.

1. Hernias-inguinal, umbilical, epigastric.
2. Common surgical problems in the emergency department-lacerations, burns, skin abscesses
3. The "Acute Abdomen"-acute appendicitis, acute gastroenteritis, bowel obstruction, intussusception, malrotation and volvulus.
4. Rectal bleeding-fissure-in-ano, juvenile polyp, Meckel’s diverticulum, medical conditions that may cause rectal bleeding
5. Common anorectal problems-perianal abscess, fistual-in ano
6. The constipated child.
7. Non-bilious vomiting-pyloric stenosis, gastroesophageal reflux The abdominal mass-Wilms tumor, neuroblastoma, other
8. Common neonatal surgical conditions-neonatal intestinal obstruction, & gastroschisis, necrotizing enterocolitis, imperforate anus, abdominal masses.
9. Trauma-general approach to the multiply injured child.
10. Fluid and dietary management of the pediatric surgical patient Indications for and complications of central venous lines in children.