[Initial measures in newborn infants with surgically correctable abnormalities]. / Erstmassnahmen bei Neugeborenen mit operativ zu versorgenden Fehlbildungen.

In newborns with surgically correctable malformations the quality of primary care has considerable influence on the results of the eventual surgical repair. This is particularly true for extensive diaphragmatic and abdominal wall defects as well as for esophageal and intestinal atresia, exstrophy of the bladder and urogenital malformations. The neonatal management comprises measures generally valid for all diseased newborns and measures specific for the particular malformation. The general care concerns heat regulation, fluid balance and other vital functions. Specific regimens are necessary as primary care for diaphragmatic hernia, esophageal atresia, abdominal wall defects and neonatal bowel obstruction. Furthermore this primary management must be extended to include the care of the pregnant mother. Already in utero infants with diaphragmatic and esophageal malformations should be referred to the gynecological-neonatal center.

[Diagnosis and differential diagnosis of congenital fistulas and cysts of the neck]. / Diagnose und Differentialdiagnose der angeborenen Fisteln und Zysten des Halses.

Maldevelopment of the embryonal branchial arches may result in widely different cervical midline and ear anomalies. It should generally not be difficult and clinically feasible to diagnose them and differentiate them against other diseases if one is conversant with the associated special embryological and anatomical features. Nevertheless, false diagnoses are still frequent. The rate of diagnostic errors is almost 20% in our own 318 child patients with swellings in the cervical midline. Hence, it is easy to understand why there is a demand for widening the scope of preoperative diagnosis. Sonography offers a highly effective imaging examination technique. Additional information can also be gained occasionally via CT and angiography. We can, however, usually omit punctures and x-ray imaging of fistulas.

[Disease picture of primary chronic intestinal pseudo-obstruction in childhood]. / Zum Krankheitsbild der primären chronischen intestinalen Pseudoobstruktion (CIPSO) im Kindesalter.

Primary CIPSO involves ileus symptoms without mechanical occlusion; these are caused by absence or ineffectiveness of peristalsis despite normal intestinal wall structure. The neonatal and adult types are differentiated. Ileus is progressive in the neonatal clinical pictures of CIPSO (neonatal CIPSO, MMIHS, congenital short-bowel syndrome) and chronic in the adult type, where it is also ultimately fatal, however. The problems of diagnosis and therapy are discussed and demonstrated in 5 children with primary CIPSO.

[Abnormalities of the stomach]. / Missbildungen des Magens.

Malformations of the stomach are rare, their complications can be very dangerous in infancy. Clinical picture and diagnosis are discussed using 5 own cases (one 2-years-old girl with membraneous atresia, one 3-day-old boy with pylorus atresia, one 2-years-old boy with bleeding diverticulum of the stomach and a newborn with tubular hypoplasia (i.e. microgastria)). The treatment of these malformations is always surgical. Only cases of membraneous stenosis of the stomach may be treated endoscopically.