Abdominal pain Flashcards
Framework for abdo pain
Acute vs Chronic
Medical vs Surgical
Adbominal vs Non-abdominal
?Pschological (diagnosis by exclusion)
Intussusception
Most common abdo pain in 3 months - 2 yrs
Telescoping of bowel into more distal bowel
Sx of intussusception
Partially formed stool Red current jelly stool Vomiting (clear then becomes more bilious) Colic abdo pain Mass Infarction Peritonitis
Ix for intussusception
Abdo US
AXR
Abdo US findings for intussusception
Doughnut / target sign
AXR findings for intussusception
Dilated proximal bowel
Multiple fluid levels
Mx of intussusception
Drip and suck resus
Air enema < 120 mmHg
Laparotomy reduction/resection
Extra abdominal causes of abdo pain
Hernia Testes Hip Vertebrae URT LRT
Chronic abdo pain
Less likely to be surgical
Colic pain vs Inflammatory pain
Inflammatory constant - eg. peritonitis
Differentials for RIF pain
Appendicitis
Mesenteric adenitis
Psoas abscess
Apparently pneumonia too but meh
Mesenteric adenitis
Inflammed abdominal lymph node
Abdo pain + tachypnoea
Think respiratory problem
Initial Mx of constipation
Fluid intake
Dietary management
Toileting routine
Laxatives - eg. movicol
Anatomical anomaly which makes testicular torsion more likely
‘Bell and clapper’ anomaly
Differentials for sudden severe testicular pain
Testicular torsion
Hydatid of morgagne
Epididymo-orchitis
Idiopathic scrotal oedema
Mx of testicular torsion
Emergency surgical scrotal exploration
Bilateral orchidopexy
Hydatid of morgagne
Torsion of small outpouching of testes
May see small dark spot
Global developmental delay
2 SD Delay in 2/4 main domains
Only in children <5yo
age of weaning off breast milk
6mo
advice on weaning off early
dont give solid before 4 mo (risk of allergy)
between 4-6 only fruit/veg puree
stages of weaning
smooth texture
mashed food (7-9 mo) + proteins
chopped family food (9-12 mo) + 600 ml/day milk
What type of milk to give when
full fat 1-2 yr
semi-skimmed >2yp
Coeliac o/e
buttock wasting
anaemia
rash
