Paediatric Gastrointestinal Surgery is a subspecialty focused on diagnosing and surgically treating congenital and acquired disorders of the digestive system in infants, children, and adolescents. It involves procedures on the esophagus, stomach, intestines, liver, pancreas, and biliary system.

1. Common Pediatric G.I. Conditions & Their Surgical Treatments

A. Congenital Gastrointestinal Disorders (Birth Defects)

1. Tracheoesophageal Fistula (TEF) & Esophageal Atresia (EA)
   • Problem: Abnormal connection (fistula) between the esophagus and trachea or incomplete esophageal formation.
   • Treatment: Surgery to separate and reconstruct the esophagus.
2. Congenital Diaphragmatic Hernia (CDH)
   • Problem: Abdominal organs move into the chest due to a hole in the diaphragm.
   • Treatment: Surgical repair to reposition organs and close the defect.
3. Duodenal Atresia & Intestinal Atresia
   • Problem: Narrowing/blockage of the small intestine, preventing food passage.
   • Treatment: Surgical resection and anastomosis (joining of intestines).
4. Hirschsprung’s Disease
   • Problem: Lack of nerve cells in the colon, causing severe constipation.
   • Treatment: Pull-through surgery to remove the affected bowel segment.
5. Omphalocele & Gastroschisis
   • Problem: Abdominal wall defects causing intestines/organs to be outside the body.
   • Treatment: Surgery to place organs back and close the abdominal wall.

B. Acquired Gastrointestinal Disorders

1. Hypertrophic Pyloric Stenosis
   • Problem: Thickened pyloric muscle causing severe vomiting.
   • Treatment: Pyloromyotomy (cutting the muscle to allow food passage).
2. Appendicitis
   • Problem: Inflammation of the appendix, leading to infection or rupture.
   • Treatment: Appendectomy (removal of the appendix).
3. Intussusception
   • Problem: Telescoping of one part of the intestine into another, causing blockage.
   • Treatment: Air/contrast enema or surgery if severe.
4. Malrotation & Volvulus
   • Problem: Abnormal intestinal positioning leading to twisting (volvulus).
   • Treatment: Ladd’s procedure to untwist and secure the intestines.
5. Gastroesophageal Reflux Disease (GERD)
   • Problem: Acid reflux causing feeding difficulties and complications.
   • Treatment: Nissen fundoplication (surgical wrapping of the stomach to prevent reflux).
6. Necrotizing Enterocolitis (NEC)
   • Problem: Severe inflammation and death of intestinal tissue in premature babies.
   • Treatment: Surgery to remove dead bowel segments if perforation occurs.

2. Specialized Pediatric G.I. Surgical Techniques

• Minimally Invasive Surgery (MIS): Laparoscopic and robotic-assisted techniques for smaller incisions and quicker recovery.
• Endoscopic Procedures: Used for diagnostic and therapeutic interventions.
• Liver & Intestinal Transplant Surgery: In cases of liver failure or severe bowel disease.

3. Postoperative Care & Long-Term Management

• Nutritional Support: Some children need IV nutrition (TPN) post-surgery.
• Rehabilitation & Follow-up: Regular monitoring for growth and digestive function.