The Karolinska University Hospital is providing highly specialized medical care according to evidence-based medicine. The foundation for the mission is based on three corner stones: 1. Provision of health care, 2. Education, and 3. Research. The care of patients with Hirschsprung disease, anorectal malformations, esophageal malformations, and congenital diaphragmatic hernia will be centralized to two centers in Sweden, Karolinska University Hospital and Skåne University Hospital, from 1st of July 2018.
1. The Pediatric Colorectal Centre of Expertise at Karolinska University Hospital provides expertise knowledge in Hirschsprung disease, including diagnostics, management and multidisciplinary follow up. Also expertise in total colonic aganglionosis I s provided. The multidisciplinary team comprises pediatric surgeons, specialist nurses, pediatric gastroenterologist, pediatric pathologist, pediatric radiologist, and clinical geneticist. The center is ISO certified colorectal centre since 2010. (certificate no. 89388-2010-AQ-SWE-SWEDAC). Adults are transitioned to the adult care.
2. For congenital diaphragmatic hernia (CDH) we provide, in close collaboration with Pediatric intensive care, ECMO Center, and Fetal Medicine Center, a structured pre- and postnatal management and follow up of patients born with CDH. Karolinska is the only ECMO Center in the Nordic countries, and one of the few in Europe, providing transports on ECMO. We manage CDH patients from within our own region and get referrals from other regions within Sweden and abroad. We provide pre-, peri-, and postnatal management, including stabilization, surgery, and ECMO if required. Furthermore, we provide a structured multidisciplinary prospective follow up program until adulthood. The team is also linked with pediatric pulmonologist, pediatric gastroenterologist, pediatric cardiologist, pediatric neurologist, dieticians, physiotherapists and pediatric radiologists. We collaborate with the CDH Study Group and the CDH Euro-consortium.
3. The Esophageal Atresia Group at Karolinska provides expertise in congenital and acquired esophageal disorders, which includes atresias, stenoses, duplications, and other malformation of the esophagus, as well as strictures and perforations of the esophagus. The team is closely linked with Fetal Medicine Center, pediatric gastroenterologists, pediatric anesthetists, pediatric cardiologists, pediatric pulmonologists, physiotherapists, dieticians, and speech therapists. We provide investigations and management in the neonatal period, reconstructive procedures, multidisciplinary follow up, and interventions for surgical and functional complications up to adulthood. Adults are transitioned in a structured way to adult care.
4. Abdominal wall defects are managed in close collaboration with the Fetal Medicine Center. We provide structured pre- and perinatal management. Furthermore, we provide expert management, including surgery and possible complications during the neonatal period as well as follow up. The team is also linked with pediatric gastroenterologists, pediatric pulmonologists, and dieticians.
5. Intestinal failure is managed by pediatric gastroenterologists in close collaboration with pediatric surgeons. We provide a structured multidisciplinary management also involving nurse specialists and dieticians. The care is focused on enteral and parenteral nutritional support, medical treatment an occasionally surgical reconstructive procedures. We also provide support for home parenteral nutrition.