Conditions & Procedures

Preoperative Guidelines

For pre-admission: Report at the hospital reception/ pre-admission office before the planned surgery. Have your ID and medical aid card readily available.

    • Milk and solid food can be allowed until 6 hours before the planned surgery

    • Breast milk is allowed up to 4h before the planned surgery

    • Clear liquids (Water and Apple juice) are allowed up to 2 hours before the planned surgery

    • Your child needs to be in hospital at least an hour and a half before scheduled theatre time: i.e. 7 am for morning theatre cases, 12:30 pm for afternoon theatre cases

    • If your child is on any chronic medication, please call doctor regarding when and how to correctly administer medication before scheduled surgery.

    • If there is any fever, wound infection or other complaint post-surgery, please contact the rooms of Dr. D’hondt immediately.

    • Inform medical staff immediately if starvation guidelines have not been adhered to, as not to put your child at risk

Abdomen

The practice treats a wide range of abdominal conditions in infants and children, including:

  • Disorders of the Umbilicus

  • Congenital Defects of the Abdominal Wall

  • Inguinal Hernias and Hydroceles

  • Undescended Testis, Torsion, Varicocele

  • Hypertrophic Pyloric Stenosis

  • Peptic Ulcer and Other Conditions of the Stomach

  • Duodenal Atresia and Stenosis, Annular Pancreas

  • Jejunal Atresia and Stenosis

  • Meconium Ileus

  • Meckel Diverticulum

  • Intussusception

  • Disorders of Intestinal Rotation and Fixation (Malrotation)

  • Intestinal Obstruction

  • Short Bowel Syndrome

  • Gastrointestinal Bleeding

  • Alimentary Tract Duplications

  • Mesenteric and Omental Cysts

  • Ascites

  • Polypoid Disease of the Gastrointestinal Tract

  • Necrotizing Enterocolitis

  • Crohn’s Disease and Ulcerative Colitis

  • Primary Peritonitis

  • Stoma of the Small and Large Intestine

  • Atresia, Stenosis and Other Obstructions of the Colon

  • Appendicitis

  • Hirschsprung Disease

  • Intestinal Dysganglionosis and other Disorders of Intestinal Motility

  • Anorectal Malformations

  • Other Disorders of the Anus and Rectum

  • The Jaundiced Infant: Biliary Atresis

  • Choledochal Cyst

  • Gallbladder Disease and Hepatic Infections

  • Portal Hypertension

  • Pancreas and Spleen conditions

Appendicitis

2.2. 2. Appendicitis is the painful swelling and infection of the appendix. It is the most common cause of emergency surgery in childhood. If the appendix ruptures, it can be life-threatening.

Symptoms:

  • Sudden pain around the belly button that moves to the lower right abdomen.

  • Pain worsens with movement, deep breaths, coughing, or sneezing.

  • Nausea, vomiting, and loss of appetite.

  • Fever and chills.

Surgical Methods:
1. Open method: An incision is made in the lower right abdomen to find and remove the appendix.

2. Laparoscopic method: Uses several small incisions and a camera (laparoscope). This is the preferred minimally invasive method if the appendix has not ruptured.

Genito-Urinary Disorders

  • Abnormalities of the Female Genital Tract

(Note: For common male genito-urinary conditions like Circumcision and Undescended Testes, please see their specific pages).

Tumors of Childhood

Comprehensive surgical care for pediatric oncological conditions:

  • Wilm’s Tumor

  • Neuroblastoma

  • Teratomas and Other Germ Cell Tumors

  • Liver Tumors

  • Gastrointestinal Tumors

  • Soft Tissue Tumors

  • Rhabdomyosarcoma

  • Hodgkin and Non-Hodgkin Lymphomas

  • Ovarian Tumors

  • Testicular Tumors (Joint Venture with Urologist)

  • Adrenal Tumors

  • Tumors of Lung and Chest Wall (Joint Venture with Cardiothoracic Surgeon)

Head & Neck

  • Salivary Gland Problems

  • Lymph Node Disorders

  • Neck Cysts and Sinuses (Branchial Cleft Anomalies)

  • Pre-auricular Skin Tags

  • Torticollis

Undescended Testes (Cryptorchidism)

This is a condition where one or both testicles have not moved into the scrotum. It affects 1–2% of male infants and is more common in premature babies.

    • Symptoms: One or both testicles appear missing or cannot be felt. The scrotum may look small or lopsided.

    • Treatment: If the testicle does not descend on its own within 6 months, surgery (orchiopexy) is required.

    • Why it matters: Proper placement in the scrotum is necessary for future fertility and early detection of abnormalities later in life. Surgery is often done via laparoscopy.

Hirschsprung's disease

Hirschsprung’s disease (congenital aganglionic megacolon) occurs when intestinal nerve cells (ganglion cells) don’t develop properly, delaying the progression of stool through the intestines. The intestine becomes blocked, leading to constipation. A serious infection called enterocolitis can occur, causing fever, pain, and diarrhea.

Symptoms in Infants:

  • Failure to have a bowel movement in the first 48 hours of life

  • Abdominal distention (bloating)

  • Gradual onset of vomiting

  • Fever and constipation

Symptoms in Older Children:

  • Constipation that worsens over time

  • Loss of appetite and delayed growth

  • Passing small, watery stools

Causes: Genetic factors may be involved. It occurs five times more frequently in boys and is more common in children with Down syndrome.

Thorax

  • Disorders of the Breast

  • Congenital Diaphragmatic Hernia and Eventration

  • Hernia of Morgagni

  • Esophageal Anomalies: Trachea-esophageal Fistula, Rupture, Perforation, Caustic Strictures

  • Esophageal Replacement

  • Gastro-esophageal Reflux Disease (GERD)

Inguinal Hernia

A soft bulge in the groin or scrotum is usually caused by a congenital abnormality. Unlike adults, these are rarely due to muscle weakness in children.

  • Risk: The main risk is “incarceration,” where the intestine becomes stuck. This requires urgent surgery to prevent damage to the bowel.

  • Surgery:A small incision is made, the intestine is placed back, and the opening is stitched closed. Most children go home the same day.

Umbilical Hernia

An umbilical hernia is a bulge at the belly button caused by an opening in the abdominal wall that didn’t close properly before birth.

    • Symptoms: A soft bulge that appears when the child cries or strains.

    • Treatment: Most close on their own by age 5. If it hasn’t closed by then, a simple surgical procedure is used to close the hole with dissolving stitches.

Circumcision

Circumcision is the surgical removal of the foreskin. While often a personal or religious choice, our practice opts to perform circumcisions primarily for medical abnormalities.

    • Benefits: Easier cleaning, reduced risk of UTIs, and elimination of phimosis (inability to retract foreskin).

    • Age: Can be done at any age. In older children, it is performed under general anesthesia to minimize pain and psychological impact.

    • Recovery: Newborns recover within 12–24 hours; older children typically within 3–4 days.

Special Areas

  • Vascular Anomalies
  • Pediatric Peripheral Arterial Disease
  • Burns

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Conditions & Procedures

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reception@atchi.co.za

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