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Ask The Expert Archive

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Pediatric Surgery Archive Questions

Below are Dr. Strauch’s answers to Pediatric Surgery questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Now displaying records 1 to 15 of 40.

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Q : 1

My daughter born with omphalacele intestines on the outside. She gets routine check ups by her doctor. Today she had a visit and they did an ultrasound.They said they saw a little sludge in the gall bladder. Is there anything we can do now to correct this? She is only eight years old.

Sludge in the gallbladder that is asymptomatic is often left alone. Your pediatric surgeon will be able to give more information depending on what else the ultrasound showed and what else is going on with your daughter.

Q : 2

Can an operation for a hernia be performed on a child who is less than 6 months old?

A hernia is a defect in the abdominal wall that allows the intestine or other abdominal content out. The herniated viscera can get blocked or die. Therefore, we'd recommend hernia repair, even for babies.

Q : 3

Where would be a good place to have a surgery to make a bladder exstrophy scar from the belly button to the private areas appear more normal?

The first person to talk to is the surgeon who did the surgery. After, you should consult with a plastic surgeon.

Q : 4

My 18-year-old son had a varicocele repair 4 months ago and now has a hydrocele in the same testicle. Is there a connection?

It is possible the hydrocoele is related to the varicocele repair or it could be from another reason. You should ask your surgeon for more information. Sometimes they will resolve on their own.

Q : 5

Do you have physicians that can diagnose and treat vascular anomalies?

Yes, we do. You can call (410) 328-5730 to make an appointment.

Q : 6

My 4-year-old son has a retractile left testicle. It has always been able to be manipulated down into the scrotum since he was 2, but this year it seems "stuck." I can feel it up high, closer to the base of his penis. What are the chances it will come down without surgery?

If it can't be brought down into the scrotum, then surgery will be needed. Sometimes I can get them down into the scrotum in the office. If surgery is needed, it is a low-risk surgery with few complications and usually a quick recovery.

Q : 7

My four-year-old needs to have surgery to repair a hernia in her stomach. Is it safe to put such a young child under anesthesia?

If your daughter does not have any medical problems, the risk of surgery and anesthesia for an umbilical hernia repair is low.

Q : 8

My 15-month-old has been micro-aspirating for the past year, resulting in numerous health complications (a dozen hospital stays, chronic, unexplained fevers, lung disease, etc). We were told that he was not a candidate for a Nissen fundoplication because he has too many adhesions from previous surgeries (two surgeries to repair CDH). We are wondering if there are any other surgical alternatives to treat reflux-associated aspirations. He is already j-tube fed and has a separate g-tube for venting (which does not prevent the vomiting).

There are many different things that can control micoraspiration. If he is having gastroesophageal reflux leading to aspiration, medical therapy with acid reduction therapy can help such as Prevacid. Motility agents like Reglan can also be used. There are surgeries similar to the Nissen that your baby may be a candidate for. A feeding j-tube can minimize the risk of GERD as the feeds are not in the stomach to reflux. There are more radical ways than a j-tube or an anti-reflux operation to control reflux such as a tracheostomy, an esophageal disconnection, or a glottic closure. The esophageal disconnection would control GERD, but would prevent eating and is a much bigger operation than a Nissen. The glottic closure is a closure of the opening to the trachea with a tracheostomy and would prevent GERD and direct aspiration, but is very radical and is a very large surgery.

Q : 9

My son is 3 years old and his testicles haven't dropped. The doctors are going to do an ultrasound to be sure. Do you think he may need surgery?

Some testicles are retractile and go back and forth. Retractile testicles generally do not need surgery. If they truly have not dropped, then they need surgery to be brought down into the scrotum. If his penis is normal, then he should not show female tendencies.

Q : 10

I have an 11-week-old grandson who had corrective surgery for transposition of the great arteries. His recovery is being hampered by chyle build up. Does this problem take a long time to correct? He is currently giving off 357 mls chyle, but it was thought that it had been arrested after the surgery.

A chyle leak is not uncommon after pediatric cardiac surgery such as transposition of the great vessels. The leak can be treated with time and IV nutrition along with chest tube drainage. The leak can be repaired with surgery, but treatments may be necessary. A leak such as this usually requires patience.

Q : 11

I was told that my baby has cystic hygroma at our 9 week prenatal appointment (via ultrasound). We will be going for another ultrasound next week to see if it is still present. If so, we will be scheduled for a CVS. I have been doing my own research but need help in knowing what to ask the doctor during our appointments. I want to be prepared and aware so I can get the most possible information. What questions should I ask during the appointment?

You need to ask about the size, location, is it singular or are there multiples and does it press on any important structures like the trachea. This is very early in your pregnancy to detect a cystic hygroma or lymphangioma. Is there any hydrops (swelling of the baby), what is the extent of the lesion? This might resolve, get bigger, cause problems, or be asymptomatic.

Q : 12

My son was born with one kidney with junction syndrome. He was successfully operated on, but can he live normally with this kidney?

Yes you can live a normal healthy life with only one healthy kidney.

Q : 13

My son has had a hydrocele for about a year that changes size. He just turned 2 and at his well baby check up, doctor said we'd wait until he was 5 to do anything. Most of what I've read says that if it's not gone by 2 it won't go away on it's own. Should we be waiting around or should he have the surgery sooner to avoid a hernia?

If it is only a hydrocoele most will recommend repair at 2 or older, but there is no rush. If there is a hernia it should be repaired now. If you want a surgical opinion, I recommend you see a surgeon.

Q : 14

I'm a 16-year-old boy and I have just found out that I have a hydrocele in my right testicle. My doctors preformed a light test on my right testicle and it is filled with fluid (it's not a tumor). My physician recommends that I should have surgery, but I would like a second opinion. What are the risks associated with having surgery versus leaving it alone?

The risks of not performing surgery are low as hydroceles are not a serious problem. The need for surgery is based on your comfort and how much the fluid is bothering you physically and cosmetically. The surgery is low risk but not zero risk. Bleeding, infection, recurrence, and injury to the testicle as well as the need for anesthesia are all associated. good luck eric strauch, md

Q : 15

My son has malformation of the tissue (cystic hygroma) in the right side of his neck. What are the possible treatments and side effects?

Cystic hygroma can be removed surgically, sclerosed with injection of sclerosing agents or observed. The cystic hygroma can grow, hemorrhage, get infected, or press on things. The surgery and sclerosing could result in injury to arteries or nerves and recurrence or infection are other possible complications.

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