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新生兒의 外科的疾患

Emergency Surgery of the Newborn

대한외과학회지 1961년 3권 3호 p.15 ~ 21
李世淳, 金基順,
소속 상세정보
李世淳 (  ) - 延世大學校 醫科大學 外科學敎室
金基順 (  ) - 延世大學校 醫科大學 小兒科學敎室

Abstract


There is no aspect of pediatric surgery more challenging than the management of those congenital anomolies incompatible with life but´ amenable to surgical correction. Imperforated anus, omphalocele, esophageal stresia, diaphragmatic hernia and the several variety of intestinal obstruction are the commonest surgical emergencies in the Newborn. Fundamental to the survival of infants with congenital anomalies incompatible with life are early diagnosis and early treatment, all of these infants have alterations in their physiology demanding that surgery be accompliphed at the earliest passible moment. Under ordinary circumstances a Newborn infant is an excellent operative risk and remains so during the first 48 hours following birth alteration in his physiology, such as normal breakdown of red cells, changed in fluid and electrolyte balance, and gradual diminution of his general reserve, cause the motality rate to rise rapidly after 72 hours and to approach 100 percent toward the end of the first week of life. The Newborn infant has a very limited physiologic reserve, the successful management of fluid loss requires an intimate knowledge of the narrow limits of this reserve.
Evaluation of signs.
Of the lesions under discussion here, the diagnoses in two, namely, imperforated anus and omphalocele, can be made by observation alone. Unfortunately, the presence of the remaining lesion is heralded by signs C) Malrotation of colon with duodenal band and
-which-are. -not pathognomonic. The early diagnosis are vulvulus
cysnosis vomiting, absence of stools and abdominal D) Meconeume ileus
distention. These four signs, if properly interpreted, E) HUrsprungs disease
could lead to an early diagnosis of any of the anoma- 3) Imperforated anus
~´ lies discribed here. 4) Diaphragmatic Hernia
1) Esophageal atresia 5) Omphalocele
2) Intestinal obstruction We described, in brief, regarding some aspect of A) Intestinal stresia embryology, clinical signs, methods of their diagnosis B) Annular pancrease and treatment in those diseases.

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