This book demonstrates clearly how to perform a clinical examination in the infant or child with a surgical condition. While most textbooks of pediatric surgery focus on the pathological classification and overall management of disease, in clinical practice physicians and surgeons usually use a problem-oriented approach to clinical diagnosis. Surprisingly, this is rarely taught to students. The authors attempt to redress this imbalance by providing a clinical approach to the patient which can be learned with a minimum of factual information. The book should therefore remain useful to the practitioner throughout his or her medical career. It includes detailed coverage of the usual presentations of common diseases, but does not attempt to cover all aspects of the presentations of uncommon diseases unless their recognition is important for the well-being or survival of the child. Generously illustrated, this is a book for all who are learning the art of pediatric surgical diagnosis.
This book on oesophageal atresia and tracheo-oesophageal fistula sets out to describe all aspects of a congenital anomaly which has been described as 'the epitome of modern surgery' and 'the raison d' etre of paediatric surgery'. Although the literature contains references to the survival of one baby with oesophageal atresia (without fistula) who was born in 1935, the major component of the oesophageal atresia story concerns the most frequent anomaly, namely oesophageal atresia with a distal tracheo-oesophageal fistula. The first long-term survivals of babies born with this anomaly were in 1939; it is appropriate therefore that this book should be compiled 50 years later. Surgery and neonatal care have made striking advances during this half century, and nowhere is this more obvious than in the field of neonatal surgery. But the care of the baby with oesophageal atresia requires more than a surgeon and a neonatologist, and our experience has shown the need for a multidisci plinary approach involving anaesthetists, intensive care therapists, thor acic physicians, general paediatricians, cardiologists and cardiac surgeons, orthopaedic surgeons, radiologists, nephrologists and geneti cists. The involvement of representatives of all of these disciplines is evident in the pages that follow and in the list of contributors; however, a central theme in the care of patients with oesophageal atresia is that they, and their families, are able to identify with one doctor who has the ultimate responsibility for patient care and the counselling of the family.
This book provides a state of the art overview of all aspects of testicular descent and cryptorchidism, including the mechanisms of descent and the causes, consequences, diagnosis, and treatment of undescended testis. The advances in understanding that have been achieved over the past two decades are clearly explained, covering the latest genetic information on the causes of normal and abnormal testicular descent, the role of INSL3 in transabdominal migration, and the evidence that a neurotransmitter released from the genitofemoral nerve mediates androgenic control of inguinoscrotal descent. Exciting changes in the management of both congenital and acquired cryptorchidism, such as the widespread use of laparoscopy for impalpable testes inside the abdominal cavity, are fully described. Evidence for the benefits of orchidopexy within the first year of life is reviewed, and an individual chapter is also devoted to hormonal treatment. Throughout the book due attention is given to ongoing controversies and divergences of opinion. This new edition of Descent of the Testis will be a timely update and valuable reference for all who are involved in research into testicular descent and management of cryptorchidism.
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