Inguinal hernias have been documented since the dawn of recorded history. The term “hernia” comes from the Greek hernios, meaning offshoot or bud. Because an inguinal hernia is present in many different species of animals, particularly primates, prehistoric humans likely…
Umbilical Hernia Umbilical hernia is a common disorder in children and is frequently evaluated and treated by pediatric and general surgeons. Unlike other hernias of childhood, a fascial defect is present at birth but may resolve without the need for…
The two primary congenital abdominal wall defects are omphalocele and gastroschisis. Although often considered together, they are distinct and separate entities in every way from their etiology to management principles. Differences between gastroschisis and omphalocele are illustrated in Figure 48.1…
The essential role of the spleen in the defense against bacterial organisms is well documented. King and Schumacker first described the susceptibility of splenectomized infants to infection in 1952. The immunologic role of the spleen led pediatric surgeons to initiate…
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.…