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Diagnosing Surgical Emergencies on the Day of Birth

Diagnosing Surgical Emergencies on the Day of Birth Abstract Infant mortality has been considerably reduced by medical progress during the past several decades. Neonatal and especially natal day deaths have been much less significantly diminished over the same period. Reduced mortality due to prematurity and birth injury has resulted from advances in obstetric and pediatric care. As a result, congenital anomalies have assumed a greater relative significance as a cause of neonatal death. Infant operative risks have decreased following refinements in surgical and anesthetic techniques and improved supportive care. Nevertheless, it is clear that neonatal surgical salvage can be further increased by earlier diagnosis and treatment. Only about one-fifth of the survivors of operations for esophageal atresia come from the large group operated on after the first 48 hours of life. Delay or inaccuracy of diagnosis has recently been reported to have been the major contributing factor in two-fifths of the 56 deaths in a consecutive series of 163 References 1. Clatworthy, H. W., Jr., and Lloyd, J. R.: Intestinal Obstruction of Congenital Origin , A.M.A. Arch. Surg. 75:880, 1957.Crossref 2. Richardson, W. R., and Brown, I. H.: Hirschsprung's Disease in Infants and Children, Am. Surg., to be published. 3. Bongiovanni, A. M.; Eberlein, W. R.; Anderson, W. B., and Nagel, W.: Congenital Goiter in the Newborn , A.M.A. Amer. J. Dis. Child. 90:160, 1955. 4. Wilkins, L.; Jones, H. W., Jr.; Holman, G. H., and Stempfel, R. S., Jr.: Nonadrenal Female Pseudohermaphrodism , J. Clin. Endocr. 18:559, 1958.Crossref 5. Lloyd, J. R., and Clatworthy, H. W., Jr.: Hydramnios as an Aid to the Early Diagnosis of Congenital Obstruction of the Alimentary Tract , Pediatrics 21:903, 1958. 6. Moya, F.; Apgar, V.; James, L. S., and Berrien, C.: Hydramnios and Congenital Anomalies , J.A.M.A. 173:1552, 1960.Crossref 7. Gruenwald, P.: Rupture of Liver and Spleen in the Newborn Infant , J. Pediat. 33:195, 1948.Crossref 8. Blanc, W. A.: Amniotic Infection Syndrome: Pathogenesis, Morphology, and Significance in Circumnatal Mortality , Clin. Obstet. Gynec. 2:705, 1959.Crossref 9. Longino, L. A., and Martin, L. W.: Torsion of the Spermatic Cord in the Newborn Infant , New Engl. J. Med. 253:695, 1955.Crossref 10. Sherwood, D. W.; Smith, R. C.; Lemm[ill] R. H., and Vrabel, I.: Abnormalities of [ill] Genitourinary Tract Discovered by Palpation o[ill] the Abdomen of the Newborn , Pediatrics 18:782, 1956. 11. Longino, L. A., and Martin, L. W.: Abdominal Masses in the Newborn Infant , Pediatrics 21:596, 1958. 12. Gross, R. E.: A New Method for Surgical Treatment of Large Omphaloceles , Surgery 24: 277. 1948. 13. Ober, W. B.; Smith, J. A., and Rouillard, F. C.: Congenital Sarcoma Botryoides of the Vagina: Report of 2 Cases , Cancer 11:620, 1958.Crossref 14. Potts, W. J.: Congenital Atresia of the Rectum and Associated Defects , in The Surgeon and the Child , Philadelphia, W. B. Saunders Company, 1959, pp. 203-215. 15. Potts, W. J.: Respiratory Problems of the Newborn, of Infants and of Children , in The Surgeon and the Child , Philadelphia, W. B. Saunders Company, 1959, pp. 61-83. 16. Douglas, B.: The Treatment of Micrognathia Associated with Obstruction by a Plastic Procedure , Plast. Reconstr. Surg. 1:300, 1946.Crossref 17. Taybi, H.: Personal communication to the author. 18. Miller, R. E.: Perforated Viscus in Infants: A New Roentgen Sign , Radiology 74:65, 1960. 19. Hope, J. W., and O'Hara, A. E.: Use of Air as a Contrast Medium in the Diagnosis of Intestinal Obstruction of the Newborn , Radiology 70:349, 1958. 20. Apt, L., and Downey, W. S.: Melena Neonatorum: The Swallowed Blood Syndrome; A Simple Test for Differentiation of Adult and Fetal Hemoglobin in Bloody Stools , J. Pediat. 47:6, 1955.Crossref 21. Trusler, J. A.; Mestel, A. L., and Stephens, C. A.: Colon Malformation with Imperforate Anus , Surgery 45:328, 1959. 22. Richardson, W. R.: Surgical Complications of Staphylococcal Pneumonia in Infants and Children, Amer. Surg., to be published, 1961. 23. Kirkman, H. N., and Riley, H. D., Jr.: Posthemorrhagic Anemia and Shock in the Newborn , Pediatrics 24:97, 1959. 24. Elian, E.; Shwachman, H., and Hendren, W. H.: Intestinal Obstruction of the Newborn Infant: Usefulness of the Sweat Electrolyte Test in Differential Diagnosis , New Engl. J. Med. 264:13-16, 1961.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Diagnosing Surgical Emergencies on the Day of Birth

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Publisher
American Medical Association
Copyright
Copyright © 1961 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1961.02080010136021
Publisher site
See Article on Publisher Site

Abstract

Abstract Infant mortality has been considerably reduced by medical progress during the past several decades. Neonatal and especially natal day deaths have been much less significantly diminished over the same period. Reduced mortality due to prematurity and birth injury has resulted from advances in obstetric and pediatric care. As a result, congenital anomalies have assumed a greater relative significance as a cause of neonatal death. Infant operative risks have decreased following refinements in surgical and anesthetic techniques and improved supportive care. Nevertheless, it is clear that neonatal surgical salvage can be further increased by earlier diagnosis and treatment. Only about one-fifth of the survivors of operations for esophageal atresia come from the large group operated on after the first 48 hours of life. Delay or inaccuracy of diagnosis has recently been reported to have been the major contributing factor in two-fifths of the 56 deaths in a consecutive series of 163 References 1. Clatworthy, H. W., Jr., and Lloyd, J. R.: Intestinal Obstruction of Congenital Origin , A.M.A. Arch. Surg. 75:880, 1957.Crossref 2. Richardson, W. R., and Brown, I. H.: Hirschsprung's Disease in Infants and Children, Am. Surg., to be published. 3. Bongiovanni, A. M.; Eberlein, W. R.; Anderson, W. B., and Nagel, W.: Congenital Goiter in the Newborn , A.M.A. Amer. J. Dis. Child. 90:160, 1955. 4. Wilkins, L.; Jones, H. W., Jr.; Holman, G. H., and Stempfel, R. S., Jr.: Nonadrenal Female Pseudohermaphrodism , J. Clin. Endocr. 18:559, 1958.Crossref 5. Lloyd, J. R., and Clatworthy, H. W., Jr.: Hydramnios as an Aid to the Early Diagnosis of Congenital Obstruction of the Alimentary Tract , Pediatrics 21:903, 1958. 6. Moya, F.; Apgar, V.; James, L. S., and Berrien, C.: Hydramnios and Congenital Anomalies , J.A.M.A. 173:1552, 1960.Crossref 7. Gruenwald, P.: Rupture of Liver and Spleen in the Newborn Infant , J. Pediat. 33:195, 1948.Crossref 8. Blanc, W. A.: Amniotic Infection Syndrome: Pathogenesis, Morphology, and Significance in Circumnatal Mortality , Clin. Obstet. Gynec. 2:705, 1959.Crossref 9. Longino, L. A., and Martin, L. W.: Torsion of the Spermatic Cord in the Newborn Infant , New Engl. J. Med. 253:695, 1955.Crossref 10. Sherwood, D. W.; Smith, R. C.; Lemm[ill] R. H., and Vrabel, I.: Abnormalities of [ill] Genitourinary Tract Discovered by Palpation o[ill] the Abdomen of the Newborn , Pediatrics 18:782, 1956. 11. Longino, L. A., and Martin, L. W.: Abdominal Masses in the Newborn Infant , Pediatrics 21:596, 1958. 12. Gross, R. E.: A New Method for Surgical Treatment of Large Omphaloceles , Surgery 24: 277. 1948. 13. Ober, W. B.; Smith, J. A., and Rouillard, F. C.: Congenital Sarcoma Botryoides of the Vagina: Report of 2 Cases , Cancer 11:620, 1958.Crossref 14. Potts, W. J.: Congenital Atresia of the Rectum and Associated Defects , in The Surgeon and the Child , Philadelphia, W. B. Saunders Company, 1959, pp. 203-215. 15. Potts, W. J.: Respiratory Problems of the Newborn, of Infants and of Children , in The Surgeon and the Child , Philadelphia, W. B. Saunders Company, 1959, pp. 61-83. 16. Douglas, B.: The Treatment of Micrognathia Associated with Obstruction by a Plastic Procedure , Plast. Reconstr. Surg. 1:300, 1946.Crossref 17. Taybi, H.: Personal communication to the author. 18. Miller, R. E.: Perforated Viscus in Infants: A New Roentgen Sign , Radiology 74:65, 1960. 19. Hope, J. W., and O'Hara, A. E.: Use of Air as a Contrast Medium in the Diagnosis of Intestinal Obstruction of the Newborn , Radiology 70:349, 1958. 20. Apt, L., and Downey, W. S.: Melena Neonatorum: The Swallowed Blood Syndrome; A Simple Test for Differentiation of Adult and Fetal Hemoglobin in Bloody Stools , J. Pediat. 47:6, 1955.Crossref 21. Trusler, J. A.; Mestel, A. L., and Stephens, C. A.: Colon Malformation with Imperforate Anus , Surgery 45:328, 1959. 22. Richardson, W. R.: Surgical Complications of Staphylococcal Pneumonia in Infants and Children, Amer. Surg., to be published, 1961. 23. Kirkman, H. N., and Riley, H. D., Jr.: Posthemorrhagic Anemia and Shock in the Newborn , Pediatrics 24:97, 1959. 24. Elian, E.; Shwachman, H., and Hendren, W. H.: Intestinal Obstruction of the Newborn Infant: Usefulness of the Sweat Electrolyte Test in Differential Diagnosis , New Engl. J. Med. 264:13-16, 1961.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jul 1, 1961

References