Common surgical problems in neonates

Question 1

what is perforation of the bowels in babies called

Answer 1

necrotising enterocolitis

Question 2

what does necrotising enterocolitis look like on an X-ray

Answer 2

distended abdomen
gas in the bowels
loops of bowel?

Question 3

why does necrotising enterocolitis occur and who is more prone to this

Answer 3

premature babies/small babies as the bowels aren’t meant to be used yet so they can’t cope

Question 4

what kind of problem is necrotising enterocolitis - acquired or genital

Answer 4

acquired

Question 5

what is a congenital obstruction in the lumen

Answer 5

meconium ileus

Question 6

what is meconium ileus

Answer 6

meconium gets stuck in the terminal ileum causing obstruction

Question 7

signs of baby with meconium ileus

Answer 7

not keen to feed, may be vomiting, not emptying bowels, slightly distended abdomen, no meconium or little bits of it for 48 hours

Question 8

when should meconium be out by

Answer 8

within 48 hours

Question 9

investigation for meconium ileus and what does it show

Answer 9

contrast enema
distended abdomen
loops of bowel that don’t have any contrast in it and are very distended - before the blockage - filled with air
descending colon is narrow and solid

Question 10

why is meconium ileus a worrying thing

Answer 10

1/3 of children with CF present with this

Question 11

treatment of meconium ileus

Answer 11

the contrast itself can cause the meconium to pass
another contrast can be done
if this does not work then laparotomy - bring the bowel out as a temporary stoma

Question 12

what is atresia

Answer 12

an obstruction in the wall - somewhere in the bowel

Question 13

when is atresia picked up and what is seen

Answer 13

during pregnancy - seen on scans as a loop of bowel which is getting bigger - loops of bowel are massive

Question 14

signs of atresia

Answer 14

bowel is distended

baby won’t want to feed and is vomiting

Question 15

treatment of atresia

Answer 15

surgery

Question 16

obstruction outside the wall such as a

Answer 16

hernia - congenital in kids

Question 17

what is the most common congenital hernia in children

Answer 17

an inguinal hernia - loop of bowel has moved into the groin area due to the weakness of the inguinal canal

Question 18

investigation for hernias

Answer 18

not necessary

Question 19

how are congenital hernias treated when presented

Answer 19

as emergencies
try and reduce
surgery

Question 20

colour of the vomit if malrotation

Answer 20

green - like fairy liquid

Question 21

investigation in malrotation

Answer 21

contrast enema via mouth

Question 22

wat artery can be pinched in malrotation

Answer 22

superior mesenteric artery

Question 23

a baby vomiting green is what

Answer 23

malrotation until a enema proves otherwise

Question 24

why does malrotation occur

Answer 24

in utero at one point the gut sits outside the body - physiological hernia and then moves back in
sometimes it doesn’t move in properly leading to malrotation