https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/specialist-neonatal-and-paediatric-surgery-snaps-information-parents-and-visitors/refer-patient-specialist-neonatal-and-paediatric-surgery-department-snaps/specialist-neonatal-and-paediatric-surgery-admission-criteria/
Specialist Neonatal and Paediatric Surgery Admission Criteria
This is a list of patient diagnoses and procedures which are admitted to Great Ormond Street Hospital (GOSH) by our Specialist Neonatal and Paediatric Surgery (SNAPS) team, the timeframe in which they should be treated and their estimated length of stay (LoS). Health professionals are reminded that this information is for guidance only.
Emergency admissions
Congenital/neonatal
| Diagnosis/Procedure | Estimated LoS |
|---|---|
| Bowel obstruction | Depends on damage, if any, to the gut |
| Conjoined twins (may also present as urgent or elective depending on anatomy involved) | Depends on anatomy involved |
| Duodenal atresia | 2 weeks |
| Failure to pass meconium | Depends on diagnosis |
| Gastroschisis/exomphalos (may also present as non-emergency) | Up to six months |
| Hirschsprungs | Case dependent |
| Imperforate anus | 2 weeks |
| Malrotation of the gut | 2 weeks |
| Necrotising enterocolitis | 2 weeks if non-surgical treatment is required. May be longer depending on damage to the gut |
| Tracheal oesophageal fistula/oesophageal atresia (if baby not prenatally diagnosed) | Case dependent. 10 days, however babies who have a ‘long gap’ can stay for up to three months. |
Paediatric
| Diagnosis/Procedure | Estimated LoS |
|---|---|
| Abdominal trauma | Case dependent |
| Acute abdomen | Depends on diagnosis |
| Bilious vomiting | Case dependent |
| Bowel obstruction | Depends on damage, if any, to the gut |
| Bowel perforation | Depends on cause |
| Complication of surgery performed at GOSH | Case dependent |
| Gastrointestinal Haemmorhage | Case dependent |
| Hirschsprungs enterocolitis | 1 week |
| Incarcerated hernia | 24 hours |
| Ingested foreign body | 24 hours |
| Intussusception |
2 days for air reduction 5-7 days for operative reduction |
| Mass | Case dependent |
| Oesophageal dilatation (may also present as non-emergency) | Case dependent - some patients require an overnight stay. |
| Oesophageal injury/obstruction | Case dependent |
| Ovarian cyst torsion | 1-2 days |
| Perforated/complex appendicitis | 1-2 weeks |
| Splenic/hepatic injury | 7-10 days |
| Vascular access | 1-2 days |
| Vascular compromise/injury | Case dependent |
Urgent admissions
| Diagnosis/Procedure | Admission timeframe |
|---|---|
| Abscess drainage (in complex child) | 1-3 days |
| Conjoined twins (may also present as an emergency depending on anatomy involved) | Depends on anatomy involved |
| Oesophageal dilatation (may also present as emergency or elective) | Case dependent - some patients require an overnight stay |
| Pyloric stenosis | 1-2 days post-op |
| Tumour | Fits with the patient's oncology treatment plan and response to treatment |
Elective admissions
| Diagnosis/Procedure | Admission timeframe |
|---|---|
| Antegrade Colonic Enema (ACE) | 5 days |
| Biopsies | Day case |
| Circumcision (for medical reasons) | Day case |
| Colostomy closure | 5 days - 2 weeks |
| Conjoined twins (depending on anatomy involved) | Depends on anatomy involved |
| Cyst | Dependent on size and location of the cyst |
| Gallstones (Cholecystectomy) | 3-4 days |
| Gastrostomy insertion | 2-4 days |
| Hiatal hernia | 3-4 days |
| Hickman Line insertion/removal | Overnight stay |
| Hirschsprungs (non-neonatal) | 3-5 days or longer in complex cases |
| Ileostomy closure | 5 days to 2 weeks |
| Inguinal hernia | Day case |
| Jejunostomy | 3-5 days |
| Ladd's procedure | 5 to 10 days |
| Lymph node excision | Day case |
| Mass | Case dependent |
| Nissen fundoplication | 5 days |
| Oesophageal dilatation | Case dependent - some patients require an overnight stay |
| Orchidopexy | Day case |
| Pancreatectomy | 4-10 days |
| Patent Processus Vaginalis (PPV) (Hydrocele) | Day case |
| Pectus excavatum (NUSS bar) | 5-10 days |
| Percutaneous endoscopic gastrostomy (PEG) procedures | 2 days for parental teaching |
| Posterior sagittal anorectoplasty (PSARP) | 7 days |
| Rectal prolapse | Day case |
| Revision of scar | Day case |
| Sclerotherapy (Interventional radiology) | 1-2 days |
| Sigmoidoscopy | Day case |
| Sistrunk procedure | May need to stay overnight |
| Splenectomy | 5 days |
| Thoracic sympathectomy | 3-5 days |
| Thyroidectomy | 2-5 days |
| Tongue tie (under GA) | Day case |
| Umbilical hernia | Day case |
| Undescended testes | Day case |
| Unilateral hernia | Day case |
Reviewed by Mr Joe Curry and Miss Kate Cross, Consultant Surgeons, September 2012