Members of the Care Team

  • Pediatric Surgeon – A pediatric surgeon is a physician who has earned an undergraduate degree and completed four years of medical school, five years of residency training in general surgery followed by an additional two years of residency specialization in pediatric surgery. Pediatric surgeons are double board certified in surgery and pediatric surgery.
  • Pediatric Anesthesiologist – An anesthesiologist is a physician who has earned an undergraduate degree and completed four years each of medical school and residency training in the medical specialty of anesthesiology. A pediatric anesthesiologist has additional experience or fellowship training in pediatric anesthesiology and may be board certified in both anesthesiology and pediatric anesthesiology. Additionally, many pediatric anesthesiologists also specialize in cardiac anesthesiology, pain medicine, critical care management or neuroanesthesia.

Conditions Treated

  • Omphalocele – Omphalocele is an abdominal wall defect where the muscles of the abdominal wall do not completely develop, forming a hernia. Omphaloceles can be small or very large and usually have a sack that protects the abdominal organs.
  • Gastroschisis – Gastroschisis is a birth defect where a baby is born with his or her intestines outside of his or her abdomen, requiring surgery shortly after birth.
  • Congenital Diaphragmatic Hernia – Congenital diaphragmatic hernia is an opening in the muscle that separates the chest cavity from the abdominal cavity. The hole allows organs from the abdomen to push into the chest and squeeze the heart and lungs, making it difficult for a baby to breathe when born.
  • Congenital Pulmonary Airway Malformation (CPAM) – Congenital pulmonary airway malformations are abnormal growths of lung tissue that can cause recurrent infections or become a tumor. There are many different types of CPAMs, including:
    • Congenital cystic adenomatoid malformation (CCAM)
    • Bronchopulmonary sequestrations (BPS)
    • Bronchial atresia
    • Congenital lobar emphysema
    • Bronchogenic cyst
  • Esophageal Atresia – Esophageal atresia is an abnormality in the development of a baby’s esophagus causing the esophagus to be blocked and the baby being unable to eat. In most cases there is also a connection between a baby’s windpipe and his or her stomach known as a tracheoesophageal fistula or TEF.
  • Duodenal Atresia – Duodenal atresia is an abnormal development of the first part of the small intestine, known as the duodenum, causing a complete blockage of the intestine and the baby being unable to eat.
  • Intestinal Atresia – Intestinal atresia is an abnormal development of part of the small or large intestine, causing a complete blockage of the intestinal tract and the baby being unable to eat.
  • Imperforate anus – Imperforate anus is a birth defect when the anus does not develop and a baby has no place for stool to exit.
  • Hirschsprung’s Disease – Hirschsprung’s disease is a condition where a baby’s intestinal nerves do not fully develop, causing him or her to be unable to stool, and as a result, not tolerate feeding. This condition is most commonly seen in the last part of the gastrointestinal tract, known as the rectum and sigmoid colon.
  • Choledochal Cyst – Choledochal cysts are abnormal development of the biliary system that drains the liver into the small intestine. These cysts can lead to recurrent infections and jaundice (yellowing of the skin and eyes).

Types of Testing

  • Physical examination – A physical examination can help physicians with diagnosing problems or conditions and determine additional testing needs.
  • Ultrasound – Ultrasound imaging, also called sonography, is a method of obtaining diagnostic images from inside the body to help doctors with making diagnoses and treatment recommendations. Ultrasound is painless and does not use radiation, but rather uses sound waves that are reflected from various body tissues.
  • X-ray – X-ray is the oldest and most frequently used form of medical imaging, producing diagnostic images of the body that allow doctors to view and assess broken bones or other injuries.
  • Contrast Study – Contrast study is a diagnostic procedure that uses a contrast solution, either ingested or injected into the body, to create enhanced images of certain organs so they can be seen more clearly with x-ray imaging.
  • Water-Soluble Contrast Enema – Water-soluble contrast enema is a diagnostic procedure that involves putting contrast up a baby’s bottom and using x-rays to produce a picture of the colon and the last part of the small bowel.
  • Computed Tomography (CT) – Computed tomography, also called a CAT scan, uses x-ray and computer equipment to produce cross-sectional images of body tissues and organs. CT imaging is useful because it can show several types of tissue, such as lung, bone, soft tissue and blood vessels. Specialized types of CT are used to obtain high resolution imaging of arteries, called CTA or CT-angiography.
  • Magnetic Resonance Imaging (MRI) – Magnetic resonance imaging, or MRI, uses strong magnet and radio waves to provide clear and detailed diagnostic images of internal body organs and tissues. MRI allows evaluation of many body structures that may not be as visible with other diagnostic imaging methods, including ligaments, cartilage and nervous system tissues.

Treatment Options

  • Primary Closure – Primary closure is a procedure where a surgeon uses stitches to close a hernia or repair gastroschisis or small omphaloceles.
  • Abdominal Silo Placement – Abdominal silo placement is a temporary covering to protect any exposed bowel.
  • Paint and Wait – Paint and wait is a term used to describe the management of large or giant omphaloceles where the abdominal organs are not exposed. Painting the sack with an agent like betadine or silvadene causes a protective scar to form so the baby’s abdomen can be repaired when he or she is bigger and healthier.
  • Congenital Diaphragmatic Hernia Repair – Congenital diaphragmatic hernia repair is a procedure that closes a hole in the diaphragm muscle between the chest and abdominal cavity. A small hole is usually closed with sutures alone, while larger holes may require a patch with mesh or muscle from the abdominal wall.
  • Pulmonary Lung Lobectomy – Pulmonary lung lobectomy is a procedure where a portion of the lung is removed.
  • Bowel resection – Bowel resection is a procedure to remove abnormal intestines. In most cases, the healthy intestines are reconnected. However, if it is not safe to reconnect the intestines, a surgeon may bring the intestine through an opening in the abdomen, called an ostomy. With an ostomy, the baby’s poop will go into a bag until he or she is healthy enough to have the ostomy removed.
  • Esophagoesophagostomy - Esophagoesophagostomy is a procedure that reconnects the esophagus in babies with esophageal atresia, so food can pass from the mouth into the stomach
  • Duodenuduodenostomy – Duodenuduodenostomy is a procedure where the first part of the small intestine, known as the duodenum, is sewn together to bypass a blockage caused by duodenal atresia or annular pancreas.
  • Posterior Sagittal Anorectoplasty – Posterior sagittal anorectoplasty, also known as the Pena procedure, is performed to repair imperforate anus and create an anus for the baby.
  • Rectal Biopsy – Rectal biopsy is a procedure where a biopsy of the rectum is taken, usually to see if nerve cells are present, to diagnose Hirschsprung’s disease.
  • Anorectal Pull-Through – Anorectal pull-through is a procedure where a baby’s abnormal rectum and colon are removed and normal colon is reconnected to the anus, typically for babies with Hirschsprung’s disease.
  • Excision of Choledochal Cyst – Excision of choledochal cyst is a procedure where abnormal bile ducts that drain the liver into the intestine are removed. The liver is then reconnected to the small intestine. 
  • Neonatal Minimally Invasive Surgery – Neonatal minimally invasive surgery is when surgery is performed through small incisions using specialized instruments designed for babies.
  • Rectal Irrigation – Rectal irrigations is a type of enema used to wash the rectum and colon and prevent enterocolitis.

Referral Indications

  • Enterocolitis – Enterocolitis is an inflammation of the intestines, most commonly the colon, which can occur in newborn babies or in children with Hirschsprung’s disease.
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