Pediatric Surgery Course aims to give the student some fundamental knowledge on the most common surgical pathologies affecting the child, in all phases of life from before birth to the adolescence and beyond. About the neonate, the main topic will be the one related to congenital malformations, such as esophageal atresia, congenital diaphragmatic hernia, congenital bowel obstruction, omphalocele and gastroschisis, biliary atresia and hypospadias. About the toddler, the interest will focus on some peculiar acquired pathologies of the first year of life, such as infantile hypertrophic pyloric stenosis and intussusception. About the child the teaching will cover general pediatric surgery (inguinal hernia, hydrocele, gastrointestinal bleeding, acute abdomen; acute appendicitis, etc.), pediatric urology (phimosis, cryptorchidism, varicocele, hydronephrosis, vesicoureteral reflux), pediatric surgical oncology (neuroblastoma, nephroblastoma (Wilms tumor), hepatoblastoma). For all these pathologies emphasis will be given to the diagnostic process, how to suspect and confirm a specific diagnosis, rather than to the surgical technique to adopt in the treatment. Lectures will be therefore structured on symptoms and signs presented by the suffering child, rather than on a classical taxonomic procedure: we’ll discuss about the child presenting with acute abdominal pain, or with a misleading abdominal or inguinal mass, or with gastroenteric bleeding, and so on.
Prerequisiti
Understanding the topics covered in the teaching of Pediatric Surgery requires the student to have basic knowledge of general and surgical pathology, as well as of anatomy and physiology. A basic knowledge of pediatrics is also helpful to focus the attention on children's health requirements
Metodi didattici
In presence teaching, possibly integrated with online platforms. Approach to the “surgical child” will be done also during the traineeship in the Dept. of Pediatric Surgery
Verifica Apprendimento
Oral exam in presence, possibly integrated with MCQ. Being the topic inserted in a multidisciplinary module, the final score (in 30th) will be calculated as the arithmetic average of the scores obtained in the 4 topics. I usually ask questions about these topics, favoring the presentation and the discussion of a clinical case rather than a question on the single pathology. Eg: You are on call and you are requested to visit a child who has blood in the stool. What do you ask to the parents? What do you put in differential diagnosis? What kind of therapy can you set up based on the differential diagnoses? etc.
G.B.Parigi - Chirurgia pediatrica. Approccio e gestione del bambino con problemi chirurgici. Elsevier ed.
Contenuti
1) URGENCES IN PEDIATRIC SURGERY Neonatal intestinal occlusion, intestinal invagination, acute appendicitis, Meckel and complications, Ingestion of foreign bodies, Blood in stools and melena, Acute scrotum 2) ABDOMINAL MASSES Clinical differential diagnosis and imaging of abdominal masses; intra- and retroperitoneal masses; DD between Wilms and neuroblastoma; lymphomas and teratomas; etc. 3) CONGENITAL MALFORMATIONS Congenital airway obstructions; Congenital diaphragmatic hernia; atresias of the digestive tract, from esophagus to rectum; meconium ileus; Hirschsprung; omphalocele and gastroschisis; intestinal malrotation and volvulus 4) ROUTINE IN PEDIATRIC SURGERY Infantile hypertrophic pyloric stenosis, congenital inguinal hernia, hydrocele, cryptorchidism, varicocele, phimosis and paraphimosis