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Jones’ Clinical Paediatric Surgery
Jones’ Clinical
https://t.me/med1917
Paediatric Surgery
EDITED BY
John M. Hutson
AO, MD, DSc (Melb), MD (Monash), FRACS, FAAP
Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
Chair of Paediatric Surgery, Royal Children’s Hospital, Parkville, Victoria, Australia
Michael O’Brien
PhD, FRCSI (Paed)
Department of Paediatric Urology, Royal Children’s Hospital, Parkville, Victoria, Australia
Division of Surgery, Royal Children’s Hospital, Parkville, Victoria, Australia
Chief of
Spencer W. Beasley
MS, FRACS
Professor of Paediatric Surgery, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand
Director, Department of Paediatric Surgery, Christchurch Hospital, Christchurch, New Zealand
Clinical
Warwick J. Teague
DPhil (Oxon), FRACS
Department of Paediatric and Neonatal Surgery, Royal Children’s Hospital, Parkville, Victoria, Australia
Sebastian K. King
PhD, FRACS (Paed)
Department of Paediatric and Neonatal Surgery, Royal Children’s Hospital, Parkville, Victoria,
Australia
SEVENTH EDITION
This edition first published 2015; © 2008, 2015 by John Wiley & Sons, Ltd.
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Registered Office
John Wiley & Sons, Ltd., The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
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The contents of this work are intended to further general scientific research, understanding, and discussion
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Library of Congress Cataloging-in-Publication Data
Jones’ clinical paediatric surgery / edited by John M. Hutson, Michael O’Brien, Spencer W. Beasley,
Warwick J. Teague, Sebastian K. King. – Seventh edition.
p. ; cm.
Clinical paediatric surgery
Includes bibliographical references and index.
ISBN 978-1-118-77731-2 (cloth)
I. Hutson, John M., editor. II. O’Brien, Michael (Pediatric urologist), editor. III. Beasley,
Spencer W., editor. IV. Teague, Warwick J., editor. V. King, Sebastian K., editor.
VI. Title: Clinical paediatric surgery.
[DNLM: 1. Child. 2. Infant, Newborn. 3. Infant. 4. Surgical Procedures, Operative.
5. Pediatrics–methods. WO 925]
RD137
617.9′8–dc23
A catalogue record for this book is available from the
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not
be available in electronic books.
Cover Image: 06-22-05 © fkienas. Operation. Stock Image:662290
Set in 8.5/12pt Meridien by SPi Publisher Services, Pondicherry, India
Designs and Patents Act 1988.
Designs and Patents Act 1988, without the prior permission of
It is sold on the understanding that the publisher is not engaged in rendering
If professional advice or other expert assistance is required, the services of a
In view of ongoing research, equipment modifications, changes in
The fact that an organization or Website is referred to in this
Internet Websites listed in this work may have changed or
2014028289
British Library.
1 2015
Contents
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Contributors, vii
Foreword to the first edition by
Mark M Ravitch, viii
Tribute to Mr Peter Jones, ix
Preface to the seventh edition, x
Acknowledgements, xi
PART I: Introduction
1 Antenatal Diagnosis: Surgical Aspects, 3
2 The Care and Transport of the Newborn, 7
3 The Child in Hospital, 13
PART II: Neonatal Emergencies
4 Respiratory Distressinthe Newborn, 19
5 Congenital Diaphragmatic Hernia, 26
6 Oesophageal Atresia
and Tracheo-oesophageal Fistula, 30
7 Bowel Obstruction, 35
8 Abdominal Wall Defects, 45
9 Spina Bifida, 50
10 Disordersof Sex Development, 57
11 Anorectal Malformations, 62
PART III: Head and Neck
12 The Scalp, Skull and Brain, 69
13 The Eye, 80
14 The Ear, Nose and Throat, 91
15 Cleft Lip, Palate and Craniofacial Anomalies, 97
16 Abnormalities of the Neck and Face, 106
PART IV: Abdomen
17 The Umbilicus, 117
18 Vomiting in the First Months of Life, 121
19 Intussusception, 126
20 Abdominal Pain: Appendicitis?, 130
21 Recurrent Abdominal Pain, 136
22 Constipation, 139
23 Bleeding from the Alimentary Canal, 142
24 Inflammatory Bowel Disease, 147
25 The Child with an Abdominal Mass, 153
26 Spleen, Pancreas and Biliary Tract, 158
27 Anus, Perineum and Female Genitalia, 164
28 Undescended Testes and Varicocele, 171
29 Inguinal Region and Acute Scrotum, 175
30 The Penis, 183
PART V: Urinary Tract
31 Urinary Tract Infection, 191
32 Vesico-ureteric Reflux (VUR), 197
33 Urinary Tract Dilatation, 202
34 The Child with Wetting, 209
35 The Child with Haematuria, 215
PART VI: Trauma
36 Trauma in Childhood, 221
37 Head Injuries, 228
38 Abdominal and Thoracic Trauma, 235
39 Foreign Bodies, 241
v
vi Contents
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40 The Ingestion of Corrosives, 247
41 Burns, 249
PART VII: Orthopaedics
42 Neonatal Orthopaedics, 257
43 Orthopaedics in the Infant and Toddler, 262
44 Orthopaedics in the Child, 267
45 Orthopaedics in the Teenager, 275
46 The Hand, 280
PART VIII: Chest
47 The Breast, 287
48 Chest Wall Deformities, 290
49 Lungs, Pleura and Mediastinum, 294
PART IX: Skin and Soft Tissues
50 Vascular and Pigmented Naevi, 303
51 Soft Tissue Lumps, 308
52 Answers to Case Questions, 311
Index, 317
Contributors
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Spencer W. Beasley, MS, FRACS
Professor of Paediatric Surgery, Christchurch School
ofMedicine, University of Otago
Clinical Director, Department of Paediatric Surgery,
Christchurch Hospital
Christchurch, New Zealand
Robert Berkowitz, MD, FRACS
Department of Otolaryngology
Royal Children’s Hospital
Parkville, Victoria, Australia
Thomas Clarnette, MD, FRACS
Department of Paediatric and Neonatal Surgery
Royal Children’s Hospital
Parkville, Victoria, Australia
Joe Crameri, FRACS
Department of Paediatric and Neonatal Surgery
Royal Children’s Hospital
Parkville, Victoria, Australia
James E. Elder, FRACO, FRACS
Department of Ophthalmology
Royal Children’s Hospital
Parkville, Victoria, Australia
Kerr Graham, MD, FRCS (Ed)
Professor of Orthopaedics
Royal Children’s Hospital
Parkville, Victoria, Australia
Anthony Holmes, FRACS
Diplomate, American Board of Plastic Surgery;
Plastic and Maxillofacial Surgery Department
Royal Children’s Hospital
Parkville, Victoria, Australia
John M. Hutson, AO, MD, DSc (Melb), MD (Monash),
FRACS, FAAP
Department of Paediatrics
University of Melbourne
Melbourne, Victoria, Australia
and
Chair of Paediatric Surgery
Royal Children’s Hospital
Parkville, Victoria, Australia
Bruce R. Johnstone, FRACS
Department of Plastic and Maxillofacial Surgery
Royal Children’s Hospital
Parkville, Victoria, Australia
Sebastian K. King, PhD, FRACS
Department of Paediatric and Neonatal Surgery
Royal Children’s Hospital,
Parkville, Victoria, Australia
Wirginia J. Maixner, FRACS
Neuroscience Centre
Royal Children’s Hospital
Parkville, Victoria, Australia
Michael O’Brien, PhD, FRCSI (Paed)
Department of Paediatric Urology;
Chief of Division of Surgery
Royal Children’s Hospital
Parkville, Victoria, Australia
Anthony J. Penington, FRACS
Professor of Plastic Surgery
Royal Children’s Hospital
Parkville, Victoria, Australia
Russell G. Taylor, FRACS
Department of Paediatric and Neonatal Surgery
Royal Children’s Hospital
Parkville, Victoria, Australia
Warwick J. Teague, DPhil (Oxon), FRACS
Department of Paediatric and Neonatal Surgery
Royal Children’s Hospital
Parkville, Victoria, Australia
vii
Foreword to the First Edition
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The progressive increase in the body of information
relative to the surgical specialities has come to present a
vexing problem in the instruction of medical students.
There is only enough time in the medical curriculum to
present an overview to them, and in textbook material,
one is reduced either to synoptic sections in textbooks of
surgery or to the speciality too detailed for the student
or the non-specialist in complete and authoritative
textbooks.
There has long been a need for a book of modest size
dealing with paediatric surgery in a way suited to the
requirements of the medical student, general practitioner
and paediatrician. Peter G. Jones and his associates from
the distinguished and productive group at the Royal
Children’s Hospital in Melbourne have succeeded in
meeting this need. The book could have been entitled
Surgical Conditions in Infancy and Childhood, for it deals
with children and their afflictions, their symptoms, diagnosis and treatment rather than surgery as such. The
reader is told when and how urgently an operation is
required, and enough about the nature of the procedure
to understand its risks and appreciate its results. This is
what students need to know and what paediatricians and
general practitioners need to be refreshed on.
Many of the chapters are novel, in that they deal
not with categorical diseases but with the conditions
that give rise to a specific symptom – Vomiting in the
First Month of Life, The Jaundiced Newborn Baby,
Surgical Causes of Failure to Thrive. The chapter on
genetic counselling is a model of information and
good sense.
The book is systematic and thorough. A clean style,
logical sequential discussions and avoidance of esoterica
allow the presentation of substantial information over
the entire field of paediatric surgery in this comfortablesized volume with well-chosen illustrations and carefully
selected bibliography. Many charts and tables, original in
conception, enhance the clear presentation.
No other book so satisfactorily meets the need of the
student for broad and authoritative coverage in a modest compass. The paediatric house officer (in whose
hospital more than 50% of the patients are, after all,
surgical) will be serviced equally well. Paediatric surgeons will find between these covers an account of the
attitudes, practices and results of one of the world’s
greatest paediatric surgical centres. The book comes as a
fitting tribute to the 100th anniversary of the Royal
Children’s Hospital.
Mark M. Ravitch
Professor of Paediatric Surgery
University of Pennsylvania
viii
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