Pediatric surgery during the COVID-19 pandemic

Table 1 Classification of common diagnoses and procedures in pediatric surgery according to their urgency by the American College of Surgeons

Emergency		Urgent	Elective
Ischemia	Testicular/ovarian torsion	Any abscess requiring incision and drainage	Reconstruction	Anorectal anomaly after diversion
	Limb-threatening ischemia	Biliary atresia		Hirschsprung disease after diversion
Trauma	Trauma with uncontrolled bleeding	Symptomatic cholelithiasis		IBD after diversion
	Penetrating trauma	Most oncologic surgeries		Chest wall
Acute intestinal obstruction	Hypertrophic pyloric stenosis	Acute IBD exacerbation requiring resection	Enterostomy closure
	Intussusception non-responsive to radiographic reduction	Any diagnosis requiring gastrostomy for hospital discharge	Removal of an uninfected vascular access device
	Intestinal malrotation	Insertion of a vascular access device	Orchiopexy
	Incarcerated inguinal hernia	Symptomatic inguinal hernia	Asymptomatic inguinal hernia
Congenital malformations	Anorectal anomalies or Hirschsprung disease requiring intestinal diversion		Splenectomy for hematologic disease
	Intestinal atresia		Excision of a breast lesion
	Esophageal atresia with tracheoesophageal fistula		Fundoplication
	Congenital diaphragmatic hernia (symptomatic)		Bariatric surgery
Upper airway/GI foreign body ingestion			Cholecystectomy for biliary colic
Acute appendicitis			Asymptomatic choledochal cyst repair
Intestinal perforation			Branchial cleft cyst/sinus excision
Any diagnosis requiring ECMO			Thyroglossal duct cyst excision

IBD: Inflammatory bowel disease; GI: Gastrointestinal; ECMO: Extracorporeal membrane oxygenation.