Baby Emesis

Question 1

alarm emesis sx

Answer 1

projectile
not formula colored

• worry: obstruction!

Question 2

projectile Bilious emesis

Answer 2

• obstruction distal biliary tree

distal ligament of treitz

Question 3

projectile Non bilious emesis obstruction

Answer 3

• obstruction above biliary tree (stomach or higher)

Question 4

normal baby emesis

Answer 4

not projectile
after eating
formula colored

Question 5

bilious emesis diagnostics

Answer 5

XRAY

Question 6

xray double bubble sign

Answer 6

malrotation if normal gas pattern after

duodenal atresia with NO gas after obstruction

Question 7

malrotation pathology

Answer 7

failure of gut rotation during embroygenesis

• normal prenatal care
  no issues
• can lead to strangulated bowel

Question 8

malrotation xray

Answer 8

double bubble sign yet normal gas pattern beyond

Question 9

confirm malrotation diagnostics

Answer 9

upper GI series

look for cutoff point

Question 10

malrotation tx

Answer 10

decompress NG tube, probably surgery esp if volvulus involved

Question 11

bilious emesis ddx

Answer 11

1. malrotation
2. duodenal atresia
3. annular pancreas
4. intestinal atresia

Question 12

duodenal atresia path

Answer 12

failure for duodenal to recannulize = obstruction

Question 13

duodenal atresia patho continued after obstruction

Answer 13

• umbilical cord perfuses kidney well so will keep peeing
• baby should be swallowing and absorbing fluid but with obstruction that does not occur
• resutls in polyhydromnios

Question 14

duodenal atresia associated with

Answer 14

down syndrome

polyhydromnios

Question 15

duodenal atresia dx

Answer 15

xray: double bubble plus NO gas beyond

Question 16

duodenal atresia tx

Answer 16

surgery

Question 17

annular pancreas definition patho

Answer 17

pancreas grows on both sides of gut and does not mature and can squeeze down on duodenum

• failure apoptosis of pancrease
• leasd to mechanical obstruction of duodenal atresia
• this form also associated with downs
• tx surgery

Question 18

intestinal atresia patho def

Answer 18

• when vascular accident occurs in utero
• cuts off blood to dev. gut
• mom uses vasoconstrictor (cocaine)

Question 19

intestinal atresia definition downs?

Answer 19

no association

Question 20

intestinal atresia sx

Answer 20

+/- polyhydraminos

Question 21

intestinal atresia xray

Answer 21

double bubble

multiple air fluid levels

Question 22

intestinal atresia tx

Answer 22

surgery

Question 23

intestinal atresia f/u concerns

Answer 23

short gut

Question 24

non bilious emesis ddx

Answer 24

tracheoesophageal fistula

pyloric stenosis

Question 25

tracheoesophageal fistula

Answer 25

5 types can have any combination of atretic areas or fistulas

Question 26

MC tracheoesophageal fistula

Answer 26

type C

• blind pouch esophagus
• fistula goes esophagus to stomach
• stomach connects to trachea
• food gets to lungs / aspiration

Question 27

gurgling baby

nonbilious emesis

Answer 27

tracheoesophageal fistula

bubbles

Question 28

dx tracheoesophageal fistula

Answer 28

NG tube coils up

Question 29

tx tracheoesophageal fistula

Answer 29

parenteral nutrition

surgery

Question 30

pyloric stenosis

Answer 30

hypertrophy of pyloric sphincter

gastric obstruction

Question 31

typical pyloric stenosis pt

Answer 31

male
2-8 weeks
normal feeds to all of a sudden projectile vomit

Question 32

olive shape mass

Answer 32

pyloric stenosis

Question 33

visible peristaltic waves

Answer 33

pyloric stenosis

Question 34

dx pyloric stenosis

Answer 34

u/s doughnut sign

CMP: hypochloremic, hypokalemic, metabolic alkalosis (give IV fluids and correct electrolytes)

Question 35

pyloric stenosis tx

Answer 35

surgery

pyloromyotomy