Pediatric Surgery Conditions Treated

Conditions Treated

Urgent Pediatric Abdomen:

• Appendicitis
• Plyoric Stenosis
• Malrotation
• Intussusception
• Cholecystitis and choledocholithiasis

Abdomen (General):

• Necrotizing Enterocolitis
• Meconium disease
• Intestinal duplications
• Mesenteric and omental cysts

Esophagus:

• Gastroesophageal reflux
• Achalasia
• Rupture, perforation, or stricture
• Tracheoesophageal fistula and esophageal atresia

Upper Intestine:

• Surgical disease of the stomach (e.g., pyloric atresia, gastric volvulus, bezoar)
• Duodenal atresia or stenosis
• Jejunoileal atresia or stenosis
• Short-bowel syndrome
• Meckel’s diverticulum
• Annular pancreas
• Pancreatic cysts and pseudocysts
• Hyperinsulinism
• Biliary atresia
• Choledochal cyst

Lower Intestine:

• Hirschsprung’s disease
• Colonic atresia or stenosis
• Medically refractory constipation
• Anorectal malformation (e.g., imperforate anus, cloaca)
• Anorectal disease (e.g., rectal prolapse, anal fissure, perianal abscess, fistula in ano)
• Intestinal polyposis syndromes
• Inflammatory bowel disease (i.e., Crohn’s Disease and Ulcerative Colitis)

Abdominal Wall:

• Gastroschesis
• Omphalocele
• Disorders of the umbilicus (e.g., granuloma, omphalomesenteric duct, urachal remnant)

Hernias:

• Inguinal
• Femoral
• Umbilical
• Epigastric
• Incisional

Male Genitourinary:

• Hydrocele
• Undescended testis
• Circumcision
• Testicular mass
• Testicular torsion

Female Genitourinary:

• Labial adhesion or fusion
• Imperforate hymen
• Perineal cyst or mass
• Ovarian cyst or mass
• Ovarian torsion
• Congenital vaginal or uterine duplication/bifid/septum

Chest:

• Pectus excavatum
• Pectus carinatum
• Cystic lung lesions (e.g., CCAM, pulmonary sequestration)
• Solid lung lesions
• Empyema and lung abscess
• Spontaneous pneumothorax
• Mediastinal cyst or mass
• Diaphragmatic hernia
• Patent ductus arteriosis
• Vascular rings and slings

Head and Neck:

• Thyroglossal duct cyst
• Branchial cleft anomalies
• Thyroid and parathyroid surgical disease
• Persistent lymphadenopathy

Surgical Management of Cutaneous Lesions

Soft Tissue:

• Lumps, bumps, and nodules
• Lymphatic and vascular malformations
• Pilonidal disease
• Hidradenitis suppurativa
• Soft tissue infections
• Polydactyly

Breast:

• Masses
• Gynecomastia

Endocrine Disorders:

• Ambiguous genitalia
• Precocious puberty

Vascular Access

Peritoneal Dialysis Catheter Placement

Surgical Oncology:

• Wilms’ tumor
• Neuroblastoma
• Liver tumors (e.g., hepatoblastoma, hepatocellular carcinoma)
• GI tract tumors (e.g., stromal tumors, carcinoid, adenocarcinoma)
• Rhabdomyosarcoma
• Germ cell tumors (e.g., sacrococcygeal teratomas)
• Testicular and ovarian tumors
• Adrenal tumors

Trauma:

• Straddle injuries
• Burns not meeting criteria for a burn center
• Other trauma not meeting criteria for a trauma center

Prenatal Consultation

Surgical Referrals

As a specialty care clinic, the Pediatric Surgery Division sees patients by referral only. We provide equal availability of services to Tricare Prime and Tricare Standard beneficiaries. When we receive a referral, it is reviewed and dispositioned within one working day.

Referrals from providers at military treatment facilities are placed through our electronic medical record system. You may call the clinic directly or the Hampton Roads Appointment Center within two working days of the referral being placed to schedule an appointment.

Referrals from civilian providers are placed through Health Net Federal Services. You may call 877-TRI-CARE within two to five working days of the referral being placed to check on its status. When the referral has been assigned to our clinic, you may call the clinic directly or the Hampton Roads Appointment Center to schedule an appointment.

How quickly you are seen in our clinic depends on the urgency of the referral, the availability of open appointments, and your schedule. Referrals can be placed with different levels of acuity based on the clinical assessment of the referring provider:

• Urgent (ASAP) and acute referrals must be seen within 24 hours. A call from the referring physician to our urgent/after hours pager is required to facilitate these referrals.
• Seventy-two hour referrals must be seen within three days. A call from the referring physician to our urgent/after hours pager is appreciated with these referrals.
• Routine referrals must be seen within 28 days. The mean wait time for a routine appointment is two weeks.

Surgery is not usually performed on the same day as the initial consultation. If your pediatric surgeon recommends surgery, you will need to pick a date for the procedure and complete the preoperative paperwork and processing. This may be done on the same day as the initial consultation or at a later date, depending on the date of surgery and what is most convenient for you. Our goal is to minimize the number of trips that you have to make to the hospital and the number of school days that your child misses.