Pediatric Perioperative Complications and Emergencies

Abstract

Over 15,000 cases of pediatric cancer are diagnosed each year. After trauma, cancer is the second leading cause of death in children aged 5–14 years. The specific cancers encountered in children and their incidences vary widely, and are often very different than those that develop in adult patients. The most common cancers seen in younger children aged 0–14 years are acute lymphocytic leukemia (ALL) (26 %), brain and CNS (21 %), and neuroblastoma (7 %), whereas the most common cancers seen in older children aged 15–19 years are Hodgkin’s lymphoma (15 %), thyroid carcinoma (11 %), brain and CNS (10 %), and testicular germ cell tumors (8 %). Pediatric cancers demonstrate varying levels of invasiveness, rates of metastasis, and sensitivities to chemotherapy and radiation that can make the diagnosis and treatment of subsequent complications very challenging. Although adult complications can be similar in many regards, pediatric oncologic emergencies have many unique characteristics which must be taken into consideration in the care of these often fragile patients. It is imperative that all healthcare providers who encounter children suspected of having or already diagnosed with cancer be familiar with the common emergencies that may arise in order to prevent irreversible sequelae and death.