Common surgical problems in neonates Flashcards
what is perforation of the bowels in babies called
necrotising enterocolitis
what does necrotising enterocolitis look like on an X-ray
distended abdomen
gas in the bowels
loops of bowel?
why does necrotising enterocolitis occur and who is more prone to this
premature babies/small babies as the bowels aren’t meant to be used yet so they can’t cope
what kind of problem is necrotising enterocolitis - acquired or genital
acquired
what is a congenital obstruction in the lumen
meconium ileus
what is meconium ileus
meconium gets stuck in the terminal ileum causing obstruction
signs of baby with meconium ileus
not keen to feed, may be vomiting, not emptying bowels, slightly distended abdomen, no meconium or little bits of it for 48 hours
when should meconium be out by
within 48 hours
investigation for meconium ileus and what does it show
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
why is meconium ileus a worrying thing
1/3 of children with CF present with this
treatment of meconium ileus
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
what is atresia
an obstruction in the wall - somewhere in the bowel
when is atresia picked up and what is seen
during pregnancy - seen on scans as a loop of bowel which is getting bigger - loops of bowel are massive
signs of atresia
bowel is distended
baby won’t want to feed and is vomiting
treatment of atresia
surgery
obstruction outside the wall such as a
hernia - congenital in kids
what is the most common congenital hernia in children
an inguinal hernia - loop of bowel has moved into the groin area due to the weakness of the inguinal canal
investigation for hernias
not necessary
how are congenital hernias treated when presented
as emergencies
try and reduce
surgery
colour of the vomit if malrotation
green - like fairy liquid
investigation in malrotation
contrast enema via mouth
wat artery can be pinched in malrotation
superior mesenteric artery
a baby vomiting green is what
malrotation until a enema proves otherwise
why does malrotation occur
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
