Common surgical problems in kids

Question 1

vomitting child, stuff not going down, stomach protruding though abdomen (bulging)

Answer 1

obstruction due to pyloric sphincter

Question 2

Surgical repair of obstruction at pyloric sphincter

Answer 2

pyloromyotomy

Question 3

Not stooling, may get blood stained nappy (red-currant jelly), baby may have limpness and paleness.

Answer 3

Intussusception (segment of intestine invaginates into adjoining intestinal lumen) this results in swelling and obstruction.

Question 4

repair of intussusception

Answer 4

AIR ENEMA - blow air into bottom can push intestine back into place.

Question 5

Bumps in the car causing severe abdominal pain suggests…

Answer 5

peritonitis

Question 6

low grade temp, can’t jump, rosvigs sign +ve suggests

Answer 6

appendicitis

Question 7

bile stain vomitting baby colour

Answer 7

green (fairy liquid) - has been digested in stomach (something needs to be done! could be malrotation)
yellow - what it originally looks like

Question 8

malrotation

Answer 8

where the gut does not sit in correct orientation.

Causes twisting of gut and blood supply to cut off.

Question 9

time to save testicle in torsion

Answer 9

4 - 6 hours

Question 10

red rash across testicles and up into groin, also swollen, itchy not sore…

Answer 10

idiopathic scrotal oedema. Does not require operation. May give anti-histamines.

Question 11

closed foreskin at nappy age

Answer 11

is normal (protects glands)

Question 12

urethral stenosis from chronic disease =

Answer 12

balanitis xerotica obliterans (BXO)

Question 13

opening of the urethra is at the underside of the penis instead of at the tip

Answer 13

hypospadias