Referring Physician E-news

Focus on: Section of Pediatric Surgery

For Your Patients Research Transferring Patients Education

In this e-news edition, we are pleased to bring you news from Rush University Medical Center’s Section of Pediatric Surgery.

We invite you to read on to learn more about how we can help you and your patients.

Appendicitis advances

One of the most common surgical conditions in childhood is appendicitis. But children at Rush with appendicitis are not treated simply as mini adults.

  • Limiting radiation: When diagnosing appendicitis, Rush limits the amount of radiation children receive, often diagnosing appendicitis only with an ultrasound. And when CTs are needed, Rush radiologists routinely dial down radiation to “kid level.”
  • Less antibiotic infusion: Pediatric surgeons have enacted protocols that can lead to less antibiotic administration through the course of the hospital stay. Patients at Rush Children’s Hospital typically receive antibiotics for one hour every 24 hours vs. the current standard of four-hour-long infusions every eight hours, with comparable outcomes.
  • ‘Scarless’ appendectomy: Pediatric surgeons at Rush are among the few surgeons in the Chicago area who offer appendectomies performed through the umbilicus, enabling a “scarless” appendectomy. Children receiving this minimally invasive procedure typically recover more quickly and are often home the following day.

For additional information, or to refer a patient, please call (312) 942-3034.

Gastroschisis complications, managed

Pediatric surgeons at Rush perform an average of 30 surgical corrections of gastroschisis per year. Many are performed immediately for patients who deliver at Rush and are seen through the Rush Fetal and Neonatal Medicine Center for fetal anomalies.

  • In utero: If a baby is diagnosed with gastroschisis in utero, parents can meet with all members of the team that will care for their newborn in one meeting. This multidisciplinary team includes the pediatric surgeons, neonatologists and any other appropriate specialists. 
  • Long-term follow-up: Pediatric surgeons at Rush partner with referring physicians to treat complications related to gastroschisis, such as small bowel obstructions, motility issues and volvulus. This partnership is particularly critical when the abdominal wall defect is only one component of a genetic anomaly.
  • Research: Surgeons at Rush continue to have ongoing research in the field, including ways to decrease time to feeding.

To refer to the Rush Fetal and Neonatal Medicine Center, call (312) 942-9472.

To refer a patient for long-term follow-up, call (312) 942-3034.

GI program for young adults

Rush offers a comprehensive transitional clinic for adolescents with long-term gastrointestinal conditions such as Crohn’s disease, ulcerative colitis, and Hirschsprung’s disease.  This clinic helps children transition from the pediatric team to the adult colorectal surgeon and adult gastrointestinal team.  Adolescents meet with both teams over the course of multiple visits until they transition to adult care.

Colon and rectal surgeons, pediatric surgeons, pediatric gastroenterologists and other specialists see adolescent patients with the following conditions:

  • Inflammatory bowel disease
  • Functional GI conditions, including fecal incontinence and chronic constipation
  • Genetic conditions, including familial adenomatous polyposis and juvenile polyposis
  • Anatomic congenital abnormalities, including imperforate anus and Hirschprung’s disease

“These kids tend to get lost in the system,” says Bruce Orkin, MD, who heads the Section of Colon and Rectal Surgery at Rush. “They might have surgery when they’re young, and do well after that, but in many cases they’ll develop problems later unless they receive regular long-term care. And yet there’s no established pathway for these children to transition to care with adult physicians, particularly adult physicians who are in tune with pediatric problems and know how to manage them.”

For more information or to refer a patient, call (312) 942-3034.

Pediatric bowel management clinic

Constipation is the principal complaint in 3 to 5 percent of all visits to pediatric outpatient clinics and up to 35 percent of all visits to pediatric gastroenterologists, as reported in the literature. It is increasingly common in children with prevalence rates up to 30 percent. 

This problem can be devastating to a child and disruptive to the family. Further, if the appropriate therapy is not instituted, the problem will worsen over the life of the child. 

To offer patients the coordinated care needed for constipation, Rush has introduced a comprehensive bowel management clinic.

  • Multidisciplinary care: Through the clinic, a child can be evaluated by pediatric gastroenterology, pediatric surgery, physical therapy and nutrition support to better delineate the condition’s causes and to evaluate modalities to improve bowel function.   
  • Pediatric physical therapy: As part of their care, children can see physical therapists specially trained in pediatric approaches, including biofeedback.
  • Laparoscopic approaches: Pediatric surgeons can offer laparoscopic placement of a cecostomy or appendicostomy for patients suffering from fecal incontinence.

To refer a patient to the pediatric bowel management clinic, call (312) 942-3034.

Research

Investigating delivery of chemotherapeutic agents

Through a joint appointment with University of Illinois at Chicago, pediatric surgeon Bill Chiu, MD, is conducting translational research to improve the delivery of chemotherapeutic agents to combat neuroblastoma and sarcoma tumors. Chiu is investigating whether controlled release platforms loaded with chemotherapeutic agents applied directly onto the tumor will decrease tumor growth. The goal is to develop targeted drug therapies that can be applied to the tumor and decrease systemic toxicity.

Transferring patients

To facilitate a quick, safe transfer, our transfer team sends out experienced personnel for NICU or critically ill patients to stabilize them at the referring institution before transfer.

Whether your patients need a higher level of care of simply a second opinion, you can rapidly and easily transfer patients to Rush University Medical Center by calling (312) NOW-RUSH or (312) 669-7874.

Education

Lunch and learn for continuing education credits

Earn continuing education credits for physicians and nurses at any of our upcoming lunch and learn symposia. Call (312) 563-3521 for a schedule of upcoming events.

Visiting rotations

Medical students or general surgery residents interested in pediatric surgery can consider a visiting rotation at Rush University Medical Center.

For further information, call (312) 942-6512.

Research electives

Students, residents or fellows interested in participating in surgical research are welcome to collaborate on a project. Our residents have presented at national conferences such as The American College of Surgeons,  The American Pediatric Surgery Association and the American Academy of Pediatrics Surgical Section.   

For further information, call (312) 942-6512.

 

July 2015