'Pediatric General Surgery' posts
About half of all children will develop enlarged lymph nodes (cervical lymphadenitis) in the neck for example, and the vast majority of these are in response to a minor infection in the area (sore throat, sinus infection, ear infection, etc.). Often the infection is quite subtle and might not be identified. These nodes typically go through a pattern of growing and then receding in size once the infection resolves. This process can take several weeks to months. The nodes may become tender, warm, and there may be some redness of the overlying skin. Your child might complain of pain in the area, be fussier, have fever, and/or have decreased appetite. If the node itself becomes infected, it can turn into an abscess and would require antibiotics and a drainage procedure. Any possibly infected lymph node should be evaluated by your doctor.
Some enlarged lymph nodes ...
Here's what you should know about antibiotics in these situations:
- Ear infections ...
Magnets, a common household object with which we are all familiar, can be surprisingly dangerous, especially to children. If this statement is startling to you, here’s what you need to know.
Beginning in the 1970s and 80s, scientists discovered a new type of magnet, the so-called “rare-earth magnet”. Made from some of the “rare earth” metals of the periodic table such as “Neodymium”, these new magnets are not only the strongest, most powerful magnets known to man (magnetic forces up to ten times that of other magnets), they are also permanent and relatively inexpensive to manufacture. These properties revolutionized the production of many household products, even toys. Basically, magnets we find in everyday items today are no longer made using old-fashioned magnets from a generation ago!
As a pediatric gastroenterologist, I am writing this blog to warn you of the dangers, should these powerful magnets be accidentally swallowed. If more than one magnet is swallowed, or if a magnet is ingested along with another metallic object, the formidable strength of these magnets can attract 2 pieces of bowel to stick together with such great strength, it results in serious injury, even death.
This video ...
As the back to school sales begin, we are reminded that soon our kids will be back on the bus and returning to school routines. As adults we may look forward to the return of a consistent routine or dread the increased activity that comes with sports, homework and friends. For our children school can be both exciting and anxiety producing as well.
Stress can be a contributor to many illnesses and is something that we all can use help managing. (Want to find out how much you know about stress and your kids? Take this 5 question quiz here.) The questions bring up some great ways to manage stress daily for our kids; but what about the stresses of chronic illness or hospitalization? What can you do for your child to decrease their anxiety in the hospital?
As a pediatric surgeon, I am often asked when to “worry” about abdominal pain. Children often report aches or pains near the belly button (umbilicus), and the question arises around when this might mean something significant such as appendicitis.
Appendicitis is a common occurrence affecting about 7% of people over their lifetime, and it begins with vague abdominal pain of the central abdomen. Once the appendix becomes obstructed and begins to suffer from lack of circulation (ischemia), the body can detect more accurately the exact source of the pain. After this localization occurs, children older than 6 or so can identify that the pain is most severe in the right lower part of the abdomen. The localization usually occurs within 24 hours of feeling unwell. The pain is typically worse with movement of the appendix during activities such as walking, coughing, and change in position. I often ask children to jump up and down (on their bed is something kids are excited to do!) and watch their face to see if they wince. Typically with appendicitis, a child will either refuse to jump or may try it once but will not continue due to the pain.
Distraction is also frequently used in children that seem to be particularly “focused” on their pain. In gently feeling the abdomen of a child with early appendicitis that is distracted, the abdomen is soft until palpating the area of the appendix. This right lower part of the abdomen is...
There are a wide variety of nodules or lumps of the neck. We often group these growths by their location. While many lumps are simply lymph nodes, which come and go, growths near the “Adam’s apple” merit special attention. Lumps in the front/center of the neck are most likely related to the thyroid gland.
The thyroid gland produces thyroid hormone ,which is a chemical that influences a wide range of the body’s functions such as digestion, heart rate, mood, appetite, temperature, and growth. Younger children tend to have a congenital remnant called a thyroglossal duct cyst. During fetal development, the thyroid gland originates from the base of the tongue and then descends down the front of the neck to its eventual home just below the “Adam’s apple.” These cysts often get infected because they maintain a connection to the throat allowing bacteria to enter. If infected, we treat these initially with antibiotics and then perform a surgery to remove the cyst and its connection. The procedure is typically performed as a day surgery.
Actual thyroid nodules are increasing in number with an estimate around 1% of children developing an abnormal thyroid growth. These can vary from not at all threatening to cancerous (malignant). Firm, solid nodules that grow over time tend to be more concerning; but regardless of how they feel, these lumps should be evaluated by your physician. Sometimes the nodules cause an overactive thyroid gland which can lead to symptoms such as: feeling warmer than others, rapid or irregular pulse, anxiety/nervousness, insomnia, tremor, weight loss. Other times the nodule due to its size may cause symptoms such as pain, hoarse voice, difficulty swallowing.
Evaluation of these nodules includes ...
The most common thing that I see as a pediatric surgeon is a child with a lump that is thought to be a hernia. A hernia is a bulging of tissue through an opening in the muscle layers that isn’t normally present. In children, these openings are usually the result of a developmental process that just didn’t quite reach completion. Some hernias need surgery emergently, while others are observed for years with the expectation that they will close on their own.
Here are some pointers to help understand this wide range of approaches to hernias:
Location is very important in considering how aggressive to be with hernias. Belly button (umbilical) hernias are...