A neonate with distended abdomen
In surgery of the neonates and infants, one of the greatest factors in increased morbidity and mortality is hypothermia; especially in an unconscious, paralyzed patient under anesthesia. Appropriate measures must be undertaken to prevent hypothermia. Simple measure like covering the extremities and head, using the electric warming blanket under the patient and/or warm saline bottles on each side of the patient (Fig-A), will prevent this from happening and are important measures to reduce complications.
Gross abdominal distension (Fig-A) in neonates and infants may be due to several causes, such as intestinal obstruction, Hirschsprung’s disease or a very large tumor. Mostly, it is due to intestinal distension, when it can be a cause of hypoventilation, as in this age group the breathing is mainly dependent on diaphragmatic excursion. Even controlled ventilation under general anesthesia might be ineffective. Therefore, an expedient laparotomy will allow the intestine to come out of the abdomen, letting the ventilation become easier (Fig-B).
Prof. Naeem Khan
Professor of Pediatric Surgery