Surgical problems in children

Bile-stained vomiting in neonates
Malrotation - emergency referal.
Constipation
Soften with lactulose, stimulate with senna. Hirschprung's disease always has a neonatal history.
Inguinal herniae
Refer immediately for corrective surgery - high incidence of complications.
Hydrocoeles
Congenital hydrocoeles should resolve by age 1-2 years - refer if persistent.
Newly-presenting hydrocoeles should be referred immediately (testicular tumours in older children).
Painful red testis
Torsion until proved otherwise - orchitis is rare in young children.
Umbilical granulation
Silver nitrate cautery weekly until resolved.
Umbilical herniae
No treatment required - resolve spontaneously by age 2. rarely may require surgical correction age 3. Periumbilical hernias do not resolve spontaneously, however.
Undescended testes
Should be discovered at birth or 6-week check. Retractile testes require NO action, so documentation of the presence of testes in the scrotum at birth is important. Refer at age 1 year.