Surgical Conditions

Abstract

The surgical considerations chapter focuses on conditions that require surgery soon after birth but first require stabilization. Such conditions include anterior abdominal wall defects, neural tube defects, and gastrointestinal obstructions. Gastroschisis and omphalocele are comparatively rare, but protecting such lesions at birth (e.g., by applying a bowel bag) is essential for stabilization. Neural tube defects occur on a spectrum and are more common, but taking immediate steps to prevent injury and infection is necessary. Gastrointestinal obstructions are signalled and/or differentially diagnosed by vomiting, the inability to swallow or handle secretions, delayed meconium, or abdominal distension. Causes of acute abdomen, such as necrotizing enterocolitis, volvulus, or gastrointestinal perforation are considered. Skills such as gastric or Replogle tube insertion, suctioning, and chest and abdominal radiograph interpretation are discussed in detail. Stabilization pathways and protocols are applied in two case scenarios.