Symptoms and Signs in Pediatric Surgery

627 Pages·2012·6.22 MB·English

by  Georges L. Kaiser (auth.)

Symptoms and Signs in Pediatric Surgery

Georges L. Kaiser
Author
Symptoms and Signs
in Pediatric Surgery
Author
Prof. em. Georges L. Kaiser
University of Berne
Department of Pediatric Surgery
Inselspital
Berne
Switzerland
Originally published: Georges Kaiser: Leitsymptome in der Kinderchirurgie.
© Verlag Hans Huber, 2005
ISBN 978-3-642-31160-4 ISBN 978-3-642-31161-1 (eBook)
DOI 10.1007/978-3-642-31161-1
Springer Heidelberg New York Dordrecht London
Library of Congress Control Number: 2012950009
© Springer-Verlag Berlin Heidelberg 2012
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or
part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way,
and transmission or information storage and retrieval, electronic adaptation, computer software,
or by similar or dissimilar methodology now known or hereafter developed. Exempted from this
legal reservation are brief excerpts in connection with reviews or scholarly analysis or material
supplied speci fi cally for the purpose of being entered and executed on a computer system, for
exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is
permitted only under the provisions of the Copyright Law of the Publisher’s location, in its
current version, and permission for use must always be obtained from Springer. Permissions for
use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable
to prosecution under the respective Copyright Law.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a speci fi c statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the date of
publication, neither the authors nor the editors nor the publisher can accept any legal responsibility
for any errors or omissions that may be made. The publisher makes no warranty, express or
implied, with respect to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
Dedicated to my parents Otto and Angela Kaiser and to my
wife Regine Kaiser-Schillig

Foreword
Pediatric surgery as a medical specialty is undeniably living a niche exis-
tence. This is generally re fl ected in university curriculums where the trans-
mission of knowledge and skills in pediatric surgery plays only a minor
role – understandable, given the immense width and depth of today’s medical
knowledge. This marginalization of the young in need of surgery presents a
problem for doctors’ advanced and continuing education and calls for grow-
ing a new generation of specialists in this fi eld in order to secure knowledge,
care, and scienti fi c advancement. Let us not forget the persons directly con-
cerned: newborns, young children, adolescents, and their parents. Even
though pediatric surgery weighs little in medical curriculums, it is crucial for
the patients and their kin. Circumstances necessitating a pediatric surgical
intervention are often far-reaching and tragic for all family members, and the
doctor thus needs to stand by them not only as an expert but as an empathetic
human being.
In 2001, Prof. Georges Louis Kaiser, M.D., submitted a proposal to the
e-learning development team of the Institute of Medical Education (University
of Bern) for the creation of pediatric surgical tutorials over the Internet. His
aim was to make available worldwide the abundant material he had accrued
over the years in pursuit of his vision: preventing any suffering that can be
averted through the dissemination of knowledge. The contents-to-be were
processed over a period of 10 years, in order to meet didactic and professional
requirements. The quintessence of Prof. Kaiser’s work as author of this proj-
ect is the book at hand, and the “book/Internet” duality renders the question
of pluses and cons of one or the other irrelevant because they were made to
complement each other.
That said, we invite the readers to broaden and consolidate their knowl-
edge in pediatric surgery and to contribute to its scienti fi c and clinical
advancement, for there are many who depend on help from professionals in
this medical fi eld.

Bern, Switzerland Stefan Minder
Bern, Switzerland Béatrice Boog
vii

Preface
This book is written for physicians who care for children: pediatricians, gen-
eral practitioners, pediatric surgeons, general surgeons, and specialists whose
activity includes also children. This book has been put together based on
many years of personal experience, serves as source of speci fi c informations
about pediatric surgery for people who need them occasionally or day-to-day,
and represents basic and comprehensive knowledge for pediatric surgeons in
training and afterward.
The central target of this book concerns the clinical signi fi cance and pre-
sentation, differential diagnostic delineation, and indication for speci fi c treat-
ment of most disorders of pediatric surgery and of some in related fi elds. This
book intends to lead the reader and specifi cally the pediatric surgeon of devel-
oped and developing countries to a total care of the con fi ded child even if she/
he or another physician cannot or will not take over surgery in each fi eld.
The reader wonders how this book should or can be used: (1) If the reader
wants a speci fi c information about a known disorder, the index or table of
contents leads her or him to the desired chapter and by stereotypically
arranged headlines “occurrence, clinical signi fi cance or presentation, work-
ups or differential diagnosis, and treatment or prognosis” to the speci fi c infor-
mations of the chosen disorder; (2) If the reader starts from a characteristic
leading symptom or sign without precise knowledge of the most probable
disorder, she or he chooses fi rst the involved body area (they are arranged in
the following order “head, neck, chest, abdomen, urogenital system, and
back”) and fi nds there the most suitable leading symptom or sign of which
totally 35 are available and correspond each to a main chapter. The reader
fi nds at the beginning of each chosen main chapter an introduction to the
assessment of the leading symptom or sign and to correlate it with speci fi c
disorders of the differential diagnosis; (3) Although the diagrams of this book
display essential clinical, radiological, and operative characteristics of some
disorders in an abstracted manner, the reader wants realistic pictures; there-
fore, she or he is referred to the e-learning box at the end of each main chapter
that allows her or him to choose from a relatively large number of clinical,
radiological, and intraoperative fi ndings the wanted disorder by Internet with-
out any additional expenses; (4) Although the often large list of references is
not complete, some case reports enable the reader to participate in the clinical
everyday work, some more detailed papers to complete the knowledge in
some speci fi c fi elds, and other publications to perform her or his own litera-
ture research; (5) Treatment and prognosis in general and those in speci fi c
ix