ENVIRONMENT

ENVIRONMENT

Children, especially infants, should be managed in a warm environment. Compared with adults, children lose more heat and fluid with surface area to weight ratios being higher; - Table

Outline the presentation, resuscitation and operation for • pyloric stenosis Outline causes and management of abdominal pain in • children of different ages Describe two solid abdominal tumours of childhood • TABLE 17.1 Some examples of differences between infants and older children Facts Infants and some young children have a wide abdomen, a broad costal margin and a shallow pelvis The edge of the liver comes below the costal margin, and the bladder is partly intra-abdominal The ribs are more horizontal and are /f_l exible The umbilicus is relatively low lying Implications Transverse supraumbilical incisions can give greater access than vertical midline incisions Abdominal trauma (including surgical incisions) can easily damage the liver or bladder The geometry of the ribs means that ventilation requires more diaphragmatic movement than in adults A stoma in the lower abdomen of an infant must be carefully sited for its bag not to interfere with the umbilicus Costal margin Umbilicus Pubic symphysis Infant Adolescent (width > height) (height > width) Figure 17.1 Topographical differences in the abdomen.

ENVIRONMENT

Children, especially infants, should be managed in a warm environment. Compared with adults, children lose more heat and fluid with surface area to weight ratios being higher; - Table

Outline the presentation, resuscitation and operation for • pyloric stenosis Outline causes and management of abdominal pain in • children of different ages Describe two solid abdominal tumours of childhood • TABLE 17.1 Some examples of differences between infants and older children Facts Infants and some young children have a wide abdomen, a broad costal margin and a shallow pelvis The edge of the liver comes below the costal margin, and the bladder is partly intra-abdominal The ribs are more horizontal and are /f_l exible The umbilicus is relatively low lying Implications Transverse supraumbilical incisions can give greater access than vertical midline incisions Abdominal trauma (including surgical incisions) can easily damage the liver or bladder The geometry of the ribs means that ventilation requires more diaphragmatic movement than in adults A stoma in the lower abdomen of an infant must be carefully sited for its bag not to interfere with the umbilicus Costal margin Umbilicus Pubic symphysis Infant Adolescent (width > height) (height > width) Figure 17.1 Topographical differences in the abdomen.

ENVIRONMENT

Children, especially infants, should be managed in a warm environment. Compared with adults, children lose more heat and fluid with surface area to weight ratios being higher; - Table

Outline the presentation, resuscitation and operation for • pyloric stenosis Outline causes and management of abdominal pain in • children of different ages Describe two solid abdominal tumours of childhood • TABLE 17.1 Some examples of differences between infants and older children Facts Infants and some young children have a wide abdomen, a broad costal margin and a shallow pelvis The edge of the liver comes below the costal margin, and the bladder is partly intra-abdominal The ribs are more horizontal and are /f_l exible The umbilicus is relatively low lying Implications Transverse supraumbilical incisions can give greater access than vertical midline incisions Abdominal trauma (including surgical incisions) can easily damage the liver or bladder The geometry of the ribs means that ventilation requires more diaphragmatic movement than in adults A stoma in the lower abdomen of an infant must be carefully sited for its bag not to interfere with the umbilicus Costal margin Umbilicus Pubic symphysis Infant Adolescent (width > height) (height > width) Figure 17.1 Topographical differences in the abdomen.