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Schwartz's Principles of Surgery, 9e
Gastrointestinal Tract
Sections: Gastrointestinal
Tract, Approach to
the Vomiting Infant, Hypertrophic
Pyloric Stenosis, Clinical Manifestations, Treatment, Intestinal Obstruction
in the Newborn, Duodenal Obstruction, Treatment, Intestinal Atresia, Malrotation
and Midgut Volvulus, Embryology, Presentation
and Management, Meconium Ileus, Pathogenesis
and Clinical Presentation, Management, Necrotizing
Enterocolitis, Clinical Features, Clinical Manifestations, Pathogenesis
of Necrotizing Enterocolitis, Treatment, Necrotizing
Enterocolitis in Older Infants, Spontaneous
Intestinal Perforation vs. Necrotizing Enterocolitis, Outcome, Short-Bowel
Syndrome, Intussusception, Clinical Manifestations, Treatment, Appendicitis, Presentation, Diagnosis of
Appendicitis in Children, Surgical Treatment
of Appendicitis, Management of
the Child with Perforated Appendicitis, Intestinal Duplications, Meckel's
Diverticulum, Mesenteric Cysts, Hirschsprung's
Disease, Pathogenesis, Clinical Presentation, Diagnosis, Treatment, Anorectal Malformations, Anatomic Description, Associated Malformations, Management of
Patients with Imperforate Anus.
Topics Discussed: anastomosis, surgical; anorectal anomaly; anus, imperforate; appendectomy; appendicitis, acute; correction of midgut volvulus; cystic fibrosis with meconium ileus; duodenal obstruction; duplication of intestine; enterocolitis, necrotizing; gastrointestinal tract; hirschsprung's disease; hypertrophic pyloric stenosis, congenital; intestinal atresia; intestinal obstruction; intussusception; malrotation, congenital; meckel's diverticulum; mesenteric cyst; pediatric surgery; posterior sagittal anorectoplasty; rupture of appendix; short bowel syndrome; vomiting.
Excerpt:
"The majority of infants vomit. Because infant vomiting is so
common, it is important to differentiate between normal vomiting—as occurs
in almost all infants, to some degree—and abnormal vomiting, which
may be indicative of a potentially serious underlying disorder. The
color of the emesis and the child's overall condition must
be assessed. Vomit that looks like feeds and comes up immediately
after a feeding is almost always gastroesophageal reflux. This
may or may not be of concern, as described earlier. Vomiting that
occurs a short while after feeding, or indeed vomiting that projects
out of the baby's mouth, may be indicative of pyloric
stenosis. By contrast, vomit that has any green
color in it is always worrisome. This may be reflective of
intestinal volvulus, an underlying infection, or
some other cause of intestinal obstruction. A more detailed description
of the management of these conditions is provided in the following
sections.The ability to provide timely diagnosis and treatment of infants
with hypertrophic pyloric stenosis (HPS) is another milestone..."
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