Achalasia
Achalasia is a motor disorder usually affecting the entire length of the esophagus. Although the cause of achalasia is unclear, approximately 10% of cases occur in children. Even though this disease is relatively uncommon in children, it seems to be increasing in frequency.

Ambiguous Genitalia
Ambiguous genitalia refers to a condition of the genitals in which there is a question about whether the sex of the child is male or female. Proper male or female assignment to a newborn with ambiguous genitalia should be expeditious and timely, but it is crucial that it be proper and accurate. Proper gender assignment should entail an approach that includes, but is not limited to, input from pediatric endocrinology, surgery, urology, psychiatry, and radiology consultants and the parents. When an appropriate sex assignment has been made, it is possible to proceed with an operation procedure in a timely fashion, if one is required.

Annular Pancreas
The most frequent abnormality of the pancreas is annular pancreas in which a thin flat band of pancreatic tissue surrounds the first part of the small intestine (duodenum) and continues on either side into the head of the pancreas.

Appendicitus
Acute appendicitis is one of the most common causes of abdominal pain in childhood. This diagnosis must be considered in all age groups but is more common between the ages of 4 and 15 years. The function of the appendix is unknown. However, in rabbits and other animals the cecum is similar in shape to the appendix and plays a role in digestion of food. The middle, inside portion of the appendix may be irregular and somewhat narrow because of the presence of lymph nodes in the wall of the appendix.

Biliary Atresia
In normal infants bile drains from the liver to the duodenum (the first portion of the small intestine) through a series of ducts. Ducts are like pieces of hollow tubing. Thousands of very small ducts in the liver become two large ducts that join to form a single hepatic duct that drains into the intestine. The gallbladder is a reservoir for bile that empties into the hepatic duct halfway between the liver and the duodenum. After the gallbladder joins the main duct draining the liver, the duct is called the common bile duct. Biliary atresia is a disorder occurring in infants in which the bile ducts disappear or scar closed, preventing the passage of bile out of the liver.

Biliary Dyskinesia
A problem that occurs mostly in older children and adults is biliary dyskinesia. This happens when the gallbladder does not squeeze properly and the bile does not drain out of the gallbladder properly.

Branchial Cysts, Sinuses and Remnants
Branchial arches are structures that appear in the fourth week of development on either side of the head and neck. Paired outpouchings from the inner lining of the early part of the mouth and throat along with clefts (inward indentations) appear along with muscular, nervous structures, and connective tissue in the neck area. Continued development in this area, from the outpouchings and from the clefts results in the ear canal, tonsil, throat structures, parathyroid glands and thymus. There are four distinct clefts, each giving rise to abnormalities if incomplete development occurs or there is a failure of these primitive structures to go away.

Breast Problems
Pediatric breast problems can be categorized to those that arise in infancy and those later in childhood. They may manifest as nipple discharge, masses or lumps, with redness or swelling of the breast area. It is not uncommon for some children to have extra breast tissue or extra nipple tissue. This extra tissue rarely causes any physical symptoms but can be removed if it leads to emotional or psychological problems.

BROVIAC Catheters, PICC Lines and Other Catheters

Cervical Cysts, Sinuses, and other Neck Lesions
Cysts (fluid filled lumps), solid lumps, and sinuses (small openings) found about the head and neck are frequently residual structures from embryologic development that have failed to resorb completely or mature. Some lumps may be caused by inflammation, infection or even tumors affecting lymph nodes in the neck area.

Chest (Mediastinal) Cysts
Mediastinal cysts and tumors are relatively common in infants and children. Although cysts of the mediastinum are often asymptomatic, they usually require removal. If cysts are symptomatic, they may present with chest pain, cough, breathing problems, bloody cough or bloody vomiting, and difficulty swallowing. The various cysts encountered include bronchogenic cysts, thymic cysts, enterogenous cysts, neurenteric cysts, dermoid cysts, cystic hygroma, and pericardial cysts.

Cholecystitis Acalculous - (Gallbladder inflammation without gallstones)
Acalculous cholecystitis may occur as a complication during treatment of various diseases. This condition may occur in newborns but is more common in older children. Boys and girls are affected equally. Patients are often severely ill as a result of prior surgery; a severe burn; extensive trauma; massive blood transfusion; and various infections, including pneumonia, a generalized infection (sepsis), typhoid, salmonella, otitis media with meningitis, giardiasis, and Kawasaki disease. The cause is unknown, but may be in part due to dehydration, ileus (a condition where the bowel does not squeeze properly), gallbladder stasis (bile not being squeezed out of the gallbladder), treatment with total parenteral nutrition (TPN), and breakdown of blood from multiple transfusions.

Choledochal Cyst

Cholelithiasis (Gallstones)
allstones are relatively uncommon in blacks (except in sickle cell disease), exceptionally common in groups of Native Americans and Hispanics, and a frequent occurrence in whites. Gallstones currently are being recognized in children with increased frequency. Whether this increase in diagnosis is related to an increase in frequency of the disease or an increase in recognition because of the widespread use of ultrasound for abdominal complaints is unclear. The incidence currently is reported to be 0.15% to 0.22% in children. In comparison, gallstones are found in approximately 10% of adults.

Congenital Diaphragmatic Hernia
Congenital diaphragmatic hernia (CDH) is a condition where there is a hole in the diaphragm and organs from the abdomen go up into the chest cavity. CDH was described in 1848 and the first repair in a baby was by Robert Gross in 1946.

Conjoined Twins
onjoined twinning is a rare and challenging congenital malformation, which has stimulated human interest from early times. For example, conjoined twins have been depicted in sculpture and art dating back from before the time of Christ. Early, though unsuccessful efforts were undertaken to separate the conjoined twins, but occasional successful separation was not reported until the 1960s. More routine success with separation has only occurred over the last 15 to 20 years.

Crohn's Disease
Crohn's disease (CD), also known as regional enteritis, is a type of inflammatory bowel disease (IBD) described by Crohn in 1932. The most common affected site of bowel inflammation is the distal part of the small intestine known as the ileum, although the colon and other segments of the intestinal tract can be involved as well. The other common type of IBD is termed ulcerative colitis, although this disease is limited to the colon (large intestine).

Cystic Hygroma
Cystic hygromas are varying sized cystic abnormalities of the lymphatic system occurring in perhaps 1 in 10,000 births. The word is derived from the Greek meaning moist or watery tumor and can occur equally in boys and girls. Approximately 50 or 60 percent are present at birth and about 80-90 percent appear or are detected before the end of the second year of life.

Empyema
Empyema is a chest infection. Unlike pneumonia, which is an infection in the lung, empyema occurs in the space between the lung and the chest wall known as the pleural space (or pleural cavity). In children, empyema is usually a complication of pneumonia. Inflammatory reaction to the pneumonia produces fluid in the pleural space (“effusion”). If the infection from the pneumonia spreads to this fluid, pus may accumulate, resulting in empyema.

Epididymitis and Orchitis
Epididymitis is a collection of tissue just behind the testicle. Epididymitis may have an infectious or inflammation. Most commonly, epididymitis occurs from the reflux of infected urine or from sexually acquired disease caused by gonococci and Chlamydia . This distinction is important because different antiobiotics are needed for the different causes. Occasionally, epididymitis develops after excessive straining or lifting and the reflux of urine into the vas deferens, which causes a chemical epididymitis; this usually resolves promptly. Any non–sexually active child, especially a prepubertal child who develops epididymitis, should be evaluated for a urinary tract abnormality.