ABSTRACT
This chapter reviews complications resulting from some of the surgical disorders that are unique to infants and children. Specifically, it focuses upon complications of esophageal atresia, congenital diaphragmatic hernia, Hirschsprung disease, anorectal malformations, and pyloric stenosis. Complications in pediatric surgery generally mirror those encountered in the adult population that are described elsewhere in this text. The diagnosis of esophageal atresia can be suggested in utero with a demonstration of polyhydramnios and/or a small stomach on ultrasound. Neonates usually present with coughing or choking with feedings. Appropriate preoperative management is essential in infants with esophageal atresia in order to prevent respiratory and gastrointestinal complications. It is important to decompress the esophageal pouch with a Replogle tube as soon as the diagnosis is made. The operative management of esophageal atresia with a tracheoesophageal fistula can be open or thoracoscopic. The open approach is through a right posterolateral thoracotomy, unless the patient has a right-sided aortic arch.
