Common surgical problems in children Flashcards
what are the first signs of pyloric stenosis
6 week old baby PROJECTILE vomiting milk - no wet nappy for 24 hours- lumps on abdomen
what are the abdominal lumps seen in pyloric stenosis
peristalsis of the bowel pushing against an obstructed pylorus causing lumps in the abdomen
Hoe do you treat pyloric stenosis
pyloromyotomy - surgery to cut the muscle of the pylorus
how does intussesception present
6 month old child, vomiting food - comes in waves- floppy, listless - ‘red current jelly’ faeces
what can you feel in the stomach of a child with intussusception
sausage like mass
what is seen on an ultrasound of a child with intussception
‘target sign’ or a kidney depending on the angle
what causes intussusception
bowel folds in on itself - looks like a telescope
how to treat intusseception
air enema - tube passes through anus and blows air into the bowel - done in radiography
if this doesn’t work surgery can be done
how does peritonitis from appendicitis present
6 year old child with tummy pain - doesn’t like the bumps in the road on the journey to hospital
mild temperature
what does appendicitis look like on US
the tip of the appendix is visible and inflamed (usually hard to see if its not inflamed)
what is a serious diagnostic which must be excluded if a baby is vomiting green
Malrotation with volvulus
why do children with malroation with Volvus vomit green
because the bowel is obstructed where the bile duct and pancreas secretions enter the bowel making the sick green
what investigation is done for malrotation with Volvus
Contrast US - can watch the contrast go down the bowel and see if its in the wrong place
treatment for malrotation with Volvus
urgent surgery to untwist the bowel and put it back in a stable way - if this is not done the bowel will die
what is the most common testicular problem seen in babies
torted hydatid/ appendix of the testes
-embryological remnant of female genitalia becomes necrotic and appears as a black dot on top of testes.
