Abdominal Pain and Vomiting

Question 1

What are some surgical causes of vomiting?

Answer 1

Malrotation and volvulus
Pyloric stenosis
Intussusception
Appendicitis

Question 2

What is the major difference between malrotation and volvulus and pyloric stenosis?

Answer 2

M&R is bilious vomit

PS is projectile

Question 3

What is the typical presentation of PS?

Answer 3

Male, 3-6 weeks with projectile vomiting whose hungry

Question 4

What is the metabolic derangement in PS?

Answer 4

Hypochloraemia
Hypokalaemia
Metabolic alkalosis
Paradoxical aciduria

Question 5

Why do you get paradoxical aciduria? What are the implications?

Answer 5

The body is trying to retain Na at the cost of H+ and K

- makes hypokalaemia and alkalosis worse

Question 6

What is the classic examination finding for PS?

Answer 6

Olive mass on abdo exam - represents the thickened pylorus

Question 7

What is the presentation of intussusception?

Answer 7

5-7month old

Vomiting and colicky abdo pain

Question 8

What is the classic Ix finding in intussusception?

Answer 8

Target sign on US