The pancreas originates during week 4 of gestation as dual evaginations from the foregut endoderm. The dorsal pancreatic bud gives rise to the body and tail of the pancreas, its minor duct (Santorini) and papilla, and the continuation of the…
A retrospective review of the United Network for Organ Sharing Database (UNOS) from 1987–2012 recently estimated that over 2 million life-years have been saved by solid organ transplant, including both adult and pediatric patients. The ability to successfully perform solid…
Choledochal Cyst A choledochal cyst is a congenital dilatation of the biliary tract. The dilatation can be found along any portion of the biliary tract. However, the most common site is the choledochus. The diameter of the bile duct varies…
Biliary atresia (BA) is a relatively rare obstructive condition of the bile ducts causing neonatal jaundice that first appeared as a distinct entity in the Edinburgh Medical Journal in 1891. The concept of “correctable” and “noncorrectable” forms was introduced in…
Appendicitis is the most common surgical emergency in children. The incidence of appendicitis in the United States is approximately 1 per 1000. Eighty-six cases of appendicitis per 100,000 children are estimated to occur annually, and this number is increasing. The…
Inflammatory bowel disease (IBD) is the broad term that encompasses Crohn disease (CD), chronic ulcerative colitis (UC), and indeterminate colitis. The incidence of IBD continues to rise and is as high as 11.4 new cases per 100,000 children per year.…
Wilhelm Fabricius Hildanus, a German surgeon, first described the presence of a small bowel diverticulum in 1598. However, the diverticulum is named for Johann Meckel, a German anatomist, who further described the anatomy and embryology in 1809. Meckel diverticulum is…
Alimentary tract duplications have been described for hundreds of years, and multiple terms have been used in the literature. The term duplication of the alimentary tract was coined by William Ladd in 1937. He described three common findings: a well-developed…
Intussusception is the most frequent cause of bowel obstruction in infants and toddlers. It is an acquired invagination of the proximal bowel (intussusceptum) into the distal bowel (intussuscipiens). It was first described in 1674 by Paul Barbette of Amsterdam, defined…
Perianal and Perirectal Abscess Perianal or perirectal abscesses are often encountered during infancy. The abscess typically presents as a fluctuant, tender mass in the perianal region ( Fig. 37.1 ). A history of stool abnormalities is typically not elicited. Perianal…