[What must the (abdominal) surgeon know about paediatric surgery - paediatric surgical aspects in general (abdominal) surgery]. / Was muss der (Viszeral-)Chirurg von der Kinderchirurgie wissen - kinderchirurgische Aspekte in der (Viszeral-)Chirurgie.

Due to the advances in neonatal intensive care medicine, prenatal ultrasound-guided diagnostic measures and paediatric surgical options, conditions have been established to achieve long-term survival in newborns with severe diseases. In addition, this means that the "non-paediatric" physician can be increasingly confronted with patients who would not have survived childhood some decades ago. Therefore, the article summarises concisely selected diseases of premature infants and newborns, e. g., congenital abdominal wall defects, and outlines possible long-term consequences based on the surgical interventions and their basic diseases, respectively, which need to be adequately cared for in the case of a surgical disease of the former patient of paediatric surgery. The overview cannot be considered as a complete revision course; however, it might constitute a basic outline for thought-provoking impulses for personal professional skills and expertise in managing such patients in later age from a surgical perspective.

[Incidental finding of an acute appendicitis in a premature newborn with haematochezia]. / Zufallsbefund einer akuten Appendizitis bei einem Frühgeborenen mit Hämatochezie.

In newborns, acute appendicitis is a very rare condition associated with significant lethality. Due to mostly non-specific symptoms, it is difficult to find the correct diagnosis preoperatively. Interestingly, rectal bleeding as a clinical sign in neonatal appendicitis is very uncommon. Here, we report on a 4-day-old premature female newborn with rectal bleeding who, therefore, underwent laparotomy because of a suspected volvulus. Except for an acutely inflamed appendix, no other pathological findings were found intraoperatively, leading to appendectomy. Histological investigation of the specimen confirmed acute ulcero-phlegmonous appendicitis. Thus, the rectal bleeding can be attributed to erosions as part of the inflammatory changes in clinically apparent appendicitis. The postoperative course of the patient was unremarkable, in perticular, no further rectal bleeding episode was observed. In spite of the low incidence of neonatal appendicitis, it has to be included in the spectrum of differential diagnoses if unclear abdominal discomfort occurs and whenever non-specific clinical signs are found in newborns. Early surgical intervention is considered the curative treatment approach of choice and can, thus, contribute to a reduction of the potential complications.

[The acute abdomen in the neonatal period]. / Das akute Abdomen in der Neugeborenenperiode.

Over a period of 22 years 91 cases of perforation or rupture of the intestinal tract were observed. Necrotising enterocolitis was most frequent (45%) followed by ruptures of congenital atresias of the intestinal tract (32%). In the first 11 years the mortality rate was 50%, in the following second period 25%. Infant birth weight registered in the first period was over 3000 g in 26% of the babies, in the second period in 11.5%. Whereas no child weighing less then 1000 g was admitted to hospital in the first period, 14% of those admitted in the second period did.