Common pediatric surgical problems Flashcards
what are the three types of lymphadenopathy? what are the treatments?
infectious - abx
reactive - observation and follow
malignancy - excisional or incisional biopsy
what is the duration of acute lymphadenopathy? aub acute? chronic?
acute - less than 2 wk
subacute - up to 6 wk
chronic - over 6 wk
what are the features of a thyroglossal duct cyst?
midline near hyoid bone
moves with tongue
what are the treatments for congenital toricollis?
PT
surgical division if PT does not work
what is indicative of a “barking cough” of tracheomalacia?
esophageal atresia - TE fistula
what is the VACTERL association? what is it used for?
vertebral anorectal CV tracheal esophageal renal limb
rule-out for TE fistula
where is the majority of diaphragmatic hernias?
left posterior
what anomalies are also associated with omphalocoele?
heart
urinary tract
beckwith-wiedeman
gastroschisis
abdominal wall defect to right of umbilicus
often thickened inflammatory serosal surfaces
may have associated atresias of the gut
what is critical for gastroschisis / omphalocoele?
heat loss
in malrotation / volvulus, what is often found in the vomit?
bile
what must be present for diagnosis of malrotation / volvulus?
upper GI series - duodenum does not cross the midline and rise to level of pylorus
double bubble sign is indicative of what condition?
duodenal atresia
how is duodenal atresia treated?
duodenoduodenostomy
duodenal atresia is associated with what other conditions?
down syndrome
heart defects
midgut atresia is thought to be due to what process?
in utero mesenteric vascular accident
apple peel deformity is indicative of what condition?
midgut atresia
what are the three presentations of meckels diverticulum?
diverticulosis (appendicitis-like)
intussuseception
bleeding
what is the cause of hirschsprung’s disease?
failure of migration of neural crest cells to end of the gut
what is the result of hirschsprung’s disease?
absence of ganglion cells in submucosa - halts peristaltic propagation
an infant with distended abdomen and no bilious vomit suggests what condition?
lower GI obstruction
what type of imperforate anus is more complicated - high or low?
high
what is the characteristic pain associated with intussusception?
paroxysmal - 40m period
crampy
may be normal / subdued between cramps
currant jelly stools are associated with what condition?
intussusception
what are the features of the vomit seen in pyloric stenosis?
projectile
nonbilious
what are the three types of biliary atresia?
A - total fibrosis of ducts
B - fibrosis of proximal ducts only
C - fibrosis of distal ducts only
choledochal cyst is associated with an anomaly of what structure?
common bile duct
are retractile testes normal?
yes
