Baby Emesis OME

Question 1

Whats normal baby spit up?

Answer 1

small volume, nonprojectile, formula colored

Question 2

What is billious Emesis in a baby? what does this mean?

Answer 2

green throw up! This means that obstruction is pass the biliary tree/distal to the ligament of trietz

Question 3

causes of bilious vomiting in newborn

Answer 3

Duodenal Atresia, Annular Pancreas, Malrtoation/volvus, Intestinal Atresia

Question 4

What is Malrotation/volvus? Cause?

Answer 4

incorrect alignment of the intestines due ot failure to rotate during development. =kink in gut causes billious vomiting after birth

*seen in mom w/normal prenatal course

Question 5

Dx of Malrotation/volvus?

Answer 5

baby gram –> dbl bubble + normal gas, upper GI series may show abrupt cut off point, contrast enema will show abnormal cecum position

*bilious vomiting

Question 6

Tx of Malrotation/Volvus?

Answer 6

NG tube to decompress and relieve baby of gas then do surgery to correct

Question 7

Which type of bilious vomiting is associated with down syndrome?

Answer 7

duodenal atresia & annular Pancreaus

Question 8

What is Duodenal Atresia? sx?

Answer 8

Duodenum failes ot recanalize in utero. will have polyhydramnios.

• bilious vomiting
• assoc w/down syndrome

Question 9

Dx of Duodenal Atresia? tx?

Answer 9

dbl bubble + no distal air on baby-gram. tx w/surgery to reconnect

Question 10

What is annular pancreas?

Answer 10

failure of apoptosis of panreaus causing it to constrict the duodenum = looks IDENTIAL to duodenal atresia

*bilious vomiting

Question 11

dx + tx of annular pancreas?

Answer 11

dbl bubble + no distal air on baby gram. tx w/surgery to reconnect

*same as duodenal atresia = cant tell them apart untill surgery!

Question 12

Intestinal atresia, rf?

Answer 12

atresia of the intestins at many locations due to VASCULAR ACCIDENT = look for this in a mom who uses vasoconstrictors(cocaine or smoking)

*bilious vomiting

Question 13

Dx of intestinal atresia?

Answer 13

babygram = dbl bubble, air fluid levels throughout bowel == atresia can happen at multiple locations at different points in time due to vascular accident(excessive vasoconstriction)

Question 14

What is a long term consequence of intestinal atresia? why?

Answer 14

Short Gut Syndrome = diarrhea + malnutrition. this is bc in order to repair you have to remove atretic areas and reconnect bowel

Question 15

causes of nonbilious vomting in a newborn

Answer 15

pyloric stenosis, tracheoesophageal fistula

Question 16

how do you dx tracheoesophageal fistula?

Answer 16

coiled NG tube on Xray

Question 17

sx of tracheoesophageal fistula?

Answer 17

nonbilious vomiting, bubbling and gurgling with respirations –> this is bc baby is breathing into stomach as well.

Question 18

Tx of tracheoesophageal fistula?

Answer 18

surgery!

Question 19

Pyloric stenosis sx?

Answer 19

nonbilious vomiting in a 2-8 wk old baby who was previously normal, olive-shaped mass, visable perstaltic waves + abnormal CMP

Question 20

CMP for pyloric stenosis

Answer 20

Hypochloremic, hypokalemic, metabolic alkalosis

Question 21

Dx of pyloric stenosis?

Answer 21

U/S showing Donut Sign

Question 22

Tx of pyloric stenosis?

Answer 22

IVF! correct electrolyte abnormalities(hypochloremic, hypokalemic, metabolic alkalosis) first then do pyloromyotomy